The hell I like to call Aetna

I have now been fighting with Aetna for almost a year next month to have WLS paid by them. In March of 2004 they gave me a doctor's name that was supposed to be in network and perform gb. It took me over a month to get an appointment with him and when I finally got to see him, he stated he was no longer doing WLS and how did I get his name. So, I started the process all over again only to find out there were no doctor's in the Baton Rouge area in network performing WLS. It then took me two months to get Aetna to agree out of network. After the package was sent to insurance company to approve, they denied in October 2004 stating I must do a 3 month prep program. NeWeigh already knew they were going to do this, so we had already started in August the prep program according to THEIR requirements. We sent the appeal in in January 2005 and they have now denied the appeal because I didn't do a prep program. I am so frustrated by this entire deal. (To top it off, this is only the last year, it does NOT include the two years previously when my employers had a weight loss exclusion on their previous insurance policies.) So, once again, we are appealing the appeal. I guess I am wondering, do I have a chance, or should I just give up. BTW, I have now quit working with the company where I received the Aetna insurance and paying cobra payments. Four times what I was paying while employed with them. My insurance with cobra runs out of December of 2005. I don't know if anyone can help me, but it feels good to be able to rant and rave here. Any suggestions, you can email me at [email protected]. Thanks in advance.

Lori, I too am getting the shaft from Aetna. I am going to the Ohio Insurance Commission because my WLS is medically needed due to the many meds I'm on and the poor quality of life I have with slleep apnea, diabetes, thyroid disease, HBP, high cholesteral, asthma, joint pain etc. Each state has an insurance commision to advocate for peple like you and me who are getting the shaft. Good Luck and don't give up. On a previous complain I had results in 60 days. Luann

Thanks Luann for the advice. I have gone to the Louisiana Insurance Commission's website and already downloaded the complaint form and am in the process of filling it out.