Have Aetna Healthcare??

Hi names John and very new to the board, like tonight well anyway I'm thinking very seriously about the lapband, i'm 6'6 1/2 335 lbs, and a type 2 diabetic (main reason for the lapband) friend of a friend had it and they were on insulin and after 6 mths there off of it, but anyway, I work for the State of NJ and have Aetna US Healthcare, anyone have any luck with them, maybe a number where to call to see if I can get the surgery, and most of all a good dr in the area, i'm in Howell (Monmouth Cty) near Jersey Shore, Centra State Medical Center (Freehold) sorry for all the questions but I have alot to ask thanks in advance for any and all answers John

Hi John This may be of some help..best of luck to you. http://www.aetna.com/cpb/data/CPBA0157.html Susan

Hey John I also have Aetna USHC. As of January 1st they will not cover WLS for any reason. But, some employers have taken riders out to cover it. Best bet is to check with your employer! Best of luck to you! love, linda

Hey Linda how are ya, thanks for getting back to me, I just got off the phone with Aetna and they assured me that thru 2005 the lap band procedure will be covered, now I just have to find a dr that handles Aetna

Hi John,.. I have Aetna EPO, and I'm 11 days RNY post op. all i've heard on these boards, and from my docotors office is how lucky I was to be approved because Aetna is so difficult. When I spoke to my insurance company, they also told me that they would not be covering *any* WLS of any kind starting January 1, but employers could purchase a separate rider to cover it. Maybe that's the case with you,.. or maybe it's just a different plan entirely. I wasted 3 months time with a doctor I really was happy with, to only find out he wasn't "In-Network". So i'd strongly suggest you find out if the surgeon you look for needs to be in network, or if it can be out of network. If it has to be in-network, as mine,.. GOOD LUCK! There aren't many... but I lucked out. I ended up in Paterson at Barnert hospital with Dr. Vazquez. The hospital was far from my first choice,.. it was a long drive and kinda ghetto, but Dr. Vazquez was great,.. and I'm very thankful to have been able to have the surgery and be doing as well as I am. I wish you the same success. Happy New Year, Laura C.

Hi John, I am surprised aetna USHC is covering lapband. A rep sent me their guidelines for 2004 and it said they do not cover lapband. also, in 2005 they would not cover any WLS. You have clearly got my interest up! I haven't even bothered to investigate any further! Could it be your employer has a rider for it? Please let me know how you get along. There is a doctor in freehold who performs WLS, another really nice group out of Staten Island. love, linda

Linda if you can email me I will fill ya in what I have so far, hope to hear back from you John

Hey John, My email addy is [email protected]... Feel free to email me anytime! love, linda

Hi John, I have Aetna HMO and I had my surgery in March with Dr. Bertha, his office is in Florham Park, and he does his surgery in Morristown...I HIGHLY recommend him and his office staff are great, especially the girls who deal with the insurance, they know everything as soon as the criteria changed last year, they knew it. Hope this helps! Sue

Hi John, I have Aetna HMO and I had my surgery in March with Dr. Bertha, his office is in Florham Park, and he does his surgery in Morristown...I HIGHLY recommend him and his office staff are great, especially the girls who deal with the insurance, they know everything as soon as the criteria changed last year, they knew it. Hope this helps! Sue