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Is there anyway you could send me a copy of the paperwork for the 6 month diet that you have. My insurance needs me to do the diet too.
My email is: [email protected]
Thank you!!
I have UHC POS and there is a written exclusion. Has anyone been able to get bariatric surgery covered under this plan? I'm desperate and cannot afford the cost of the surgery. I've already asked my employer to add the benefit to the plan. NO response of course. PLEASE ADVISE. Thank you!
I have Aetna. I called member services and asked if it was covered. They got my member number etc. Told me it was covered and then emailed me a detailed document that basically tells what you need to do to qualify. The member services rep was very helpful, but I do know that you have to tell them your member ID number and they will tell you whether or not your company has purchased the obesity rider.
Hollykim,
Thanks for the suggestion. I am hoping to push them into changing the policy due to numerous severe comorbidities. My husband's company is Self Insured, and I plan to throw a lot of stats at them that it would save them money in the long run to allow it for me at least...I've already had 2 spinal surgeries, and need a 3rd, as well as a knee replacement which may possibly be put off IF I were to lose the 200 pounds I am over my ideal.
Cheers,
RhainyC
If you have been approved, what is the name of your insurance company and what type of policy/name of policy did you have?
Which insurance companies are the easiest and worst to deal with?
I really can't get into the politics of it but suffice to say that I know for a fact others with the same policy and exact same insurance had the surgery paid for. No, they did not have their spouses pay for it. I have the most expensive, highest end policy our company offers so that cant be it. HOWEVER, if they did go out and buy their own, I'd be interested in knowing how that works. Mostly, how do you navigate Aetna POS? Anyone have any luck?
I am trying to work through the Aetna system and so far, have been met with a lot of frustration. I was told to check on my approval by my bariatric provider. So, I called Aetna and was told that my policy did not cover bariatric surgery. HOWEVER, I know several people who have my exact same policy in my company who have had the surgery. No, they did not self-pay or go to Mexico. There has to be something that I am not doing correctly. I am appealing to you--what do I need to do? How do you get approved? Aetna is sort of vague on their website. On one hand, they say that tell you the exact steps that you need to take in order to do the surgery. I'm on board with that. Trying to get all of my stuff together. NO PROBLEM. My bariatric provider (on my first visit) went on and on about what I need to do (mirrored exactly what Aetna said on their website). BUT... also on their website it says that they don't cover bariatric surgery. Am I using the wrong words? I told the Aetna rep, when I called, do you cover bariatric surgery? She said, "No, we don't." I asked about riders or buying coverage.
How did you navigate the Aetna maze? What do I have to do to get covered? I have an appointment in 3 weeks with my surgeon. Do I let the provider submit it and then be rejected? What are the steps that I need to take. And, no I can't discuss the surgery with those that had it. They are in another state and I would not feel comfortable in broaching that subject.
THANK YOU!
I am trying to work through the Aetna system and so far, have been met with a lot of frustration. I was told to check on my approval by my bariatric provider. So, I called Aetna and was told that my policy did not cover bariatric surgery. HOWEVER, I know several people who have my exact same policy in my company who have had the surgery. No, they did not self-pay or go to Mexico. There has to be something that I am not doing correctly. I am appealing to you--what do I need to do? How do you get approved? Aetna is sort of vague on their website. On one hand, they say that tell you the exact steps that you need to take in order to do the surgery. I'm on board with that. Trying to get all of my stuff together. NO PROBLEM. My bariatric provider (on my first visit) went on and on about what I need to do (mirrored exactly what Aetna said on their website). BUT... also on their website it says that they don't cover bariatric surgery. Am I using the wrong words? I told the Aetna rep, when I called, do you cover bariatric surgery? She said, "No, we don't." I asked about riders or buying coverage.
How did you navigate the Aetna maze? What do I have to do to get covered? I have an appointment in 3 weeks with my surgeon. Do I let the provider submit it and then be rejected? What are the steps that I need to take. And, no I can't discuss the surgery with those that had it. They are in another state and I would not feel comfortable in broaching that subject.
THANK YOU!
Aetna covers WLS,IF,your employer bought the coverage for their employees. Maybe your co workers bought a different,more expensive plan that includes it? Or maybe they had secondary policies from their spouses? How do you KNOW they have the exact same policy that you have if you are not comfortable talking about it with. Them?
aetna will tell the ppl whose policy does include the coverage what to do. They won't discuss. It with ppl whose policy excludes it.
Youneed to request a a copy of YOUR plan from them as that will tell you if it does or does not cover.
The plan information on line is pretty generic. It intended for general information then you have to look at your particular policy to see if it. I included or excluded.
I have bcnm retired, moved to Florida to care for parents, have been going to my Nutrition classes.
now I find out they want me to go back to Michigan to have it.
any chance of an Appeal?
Kermit
Hockeymom87 · 0 replies · 611 views
