Aetna EPO
Shellie,
We have Aetna PPO, and I went to Dr. Curry in Cincinnatti. I did the 3 month surgery prep regimen. At the end of the 3 months everything was submitted to insurance, and 14 days later I got the call that I had been approved...and just a little over 2 weeks later I was in surgery. From what I learned, you do what Aetna wants before you submit. It worked for me, I had no problems at all. Tracy with Dr. Curry's office took care of everything....she is Awesome! My only out of pocket so far has been my Co-pays. Thanks again to Dr. Curry and Staff! I hope this helps you...good luck and best wishes!
Mary
Shellie...if you havent already call Aetna and ask them is WLs is covered under your employers plan. I know that at the end of 2004, Aetna wasnt covering too much, that the employer needed to buy into a special program so that it would cover WLS. But I am no expert and this is all hear say. I was denied due to no weight history being that I was 416..I could never weigh on my PCP scale. I went to my PCP and we formulated a plan to go to a diabetic counselor who is also a dietician and I went once a month there and got weighed each time. I also visited the doctor every 6 weeks for 6 months. I was meticulous in making sure the doc and dietician noted everything. You are paying for them to do it so make them do it. After the 6 months Aetna did approve me within days. I have paid no out of pocket for one single thing. Aetna wants what they want and if you dont meet it then forget it. I also submitted a 4 page letter to them outlining my quality of life which I hope someone read. I wish you the best of luck.....I truly do!!
Lisa Durbin
416/346/?
12-15-04
Dr. Selwyn / UC Physcians West Chester Ohio
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