aetna insurance

teresaNnyc
on 6/17/10 2:42 am - new york, NY
i'm starting a new job and insurance will be with aetna and it's also a union job.

i'm curious to know if anyone has had PS with aetna and what was the process for approval like?
i am fortunate that the union will back me in getting PS as it's reconstructive but would like any feedback from OH'ers.


201 pounds lost since surgery!! And I'm 2 1/2 inches taller too!!

And YES I still eat Carbs and Fats but I know what portion control is!!


Surgery Date: 6/5/07
jenjengrins
on 6/17/10 3:40 am - Olathe, KS
They only cover the panniculectomy if it hangs a certain size and you have documented visits for rashes.  Nothing more.  I was just approved but I am having a tummy tuck.  

It just depends on what they consider restructive because the panni removal isn't considered that its medically necessary due to rashes.

7.8 cc in a 10 cc band, Started at 378 lbs
Goodbye 300 forever and ever! 07/18/2009
 
Tummy Tuck August 13, 2010


Cicerogirl, The PhD
Version

on 6/17/10 5:17 am - OH
Yep, the only thing Aetna will cover is panni removal IF it hangs below the pubic bone and you have documentation of rashes that have not responded to other treatment.  (You need documentation of the treatments tried.)  I had no trouble getting the panniculectomy approved with photos, records from my PCP and letters form both the PCP and the PS.

My batwings were pretty big and I was getting rashes in my armpits (that even the nystatin powder was only helping a little bit) and would get small infected nicks in the skin from trying to shave with all the droopy, wrinkly skin. Despite letters of necessity from 3 docs, photos of the rashes and one of the infections, they refused to cover any part of an arm lift.

Lora

14 years out; 190 pounds lost, 165 pound loss maintained

You don't drown by falling in the water. You drown by staying there.

Alli14ppfk
on 6/17/10 5:22 am - Buffalo, NY
I also have Aetna. Same thing. Covers just the skin removal if it hangs below the pubic bone and you have three months of treatment for rashes
Open RNY Gastric Bypass February 16, 2009
Fleur di lis abdominoplasty June 5, 2010
Mastoplexy Scheduled for February 28, 2011

SW 296/Surgeon's Goal 196/My Goal 175    

  
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