Aetna Insurance Question ~ Revision Medically Necessary

Jamelle S.
on 6/12/09 6:45 am - West Orange, NJ
My Surgeon is in network, and aetna covers barriatric surgery.  However my individual policy does not. 

Here is my question has anyone ever been able to prove that the revision of the original surgery is a medically necessary repair? 
Renfairewench
on 6/20/09 1:05 pm

You should contact Aetna and speak to one of their representitives. I'm sure that they would be able to give you an answer.

What type of revision surgery are you looking for? I am just making an educated guess, but I would think that only a fistula would be a medically necessary repair, assuming you had an RNY.

I have Aetna also, however I do not have a WLS exclusion in our policy. I am going to have an RNY to DS revision and was approved in just a couple of days.

 

                   HW (pre RNY) 430 HW (pre DS) 302 / SW 288 /
                          Lowest weight 157 / CW 161
GW 150
                "I'm just one stomach flu away from my goal weight"
                                       
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