Insurance Issues! Aetna...ugh!

kaitmike
on 12/2/11 8:17 am - Sussex, NJ
RNY on 09/23/15
 Hi all,  My step-dtr lost 230 lbs.  She is now ready for plastic surgery.  She found a surgeon who will do a full body lift i.e. arms, belly, butt, back and breast implants.  Of course, surgeon alone is $14k and in total will be $20k.  We were told that insurance would cover 50% of going price.  Now we have been told that even with the skin irritations, that insurance will not cover since her skin does not hang down 6 inches or more past pubic area.  It is 3-4 inches hanging.   Does anyone have any ideas on how to get the Aetna to pay?  Would emotional issues/seeing a therapist due to depression from excess skin, etc possibly help?  Appreciate your help!!  
leeleeo
on 12/4/11 5:59 am - Culpeper, VA
 if you do a google search, Aetna very clearly has listed the requirements for coverage.  If you she meets the requirements, they will pay.  I was approved the for on my first go for a panniculectomy and just had my surgery on Wednesday.  Good luck!  I
-=lee=-

At goal!
lost 155 lbs, go me!
kaitmike
on 12/4/11 9:47 am - Sussex, NJ
RNY on 09/23/15
 WOW!  SO happy for you!  Hope you are feeling well!   I will def check out their requirements.  Her mom was told by them that they wouldn't authorize but I will check it out for myself...  Thanks so much!  

Kristie S.
on 12/5/11 12:50 am
They may cover SOME things on that list -  but liekly not all.  For example, implants will likely not be covered.  They may cover a breast lift if she can prove the medical necessity -  but implants are usually only approved for breast cancer patients. 
Kristie
  
Most Active
×