Insurance questions (Aetna) for newbie to the room

Hi Everyone my name is Loretta and I use to visit the site and got lots of info. After I was denied the first time with GH, I wanted to switch insurance and got denied again. That was about 1 1/2 yrs ago. Now I have decided to pursue and fight this time. I am insured thru Aetna. Does anyone have any advise for me on what to expect or do, etc. I am thinking positive but I am sure they are going to deny me again. Any suggestions on what to do so I can be prepared to fight back right away and appeal! I have no known co-morbidities, yet. So that I can't use all to much with them. I have three drs. and two different surgeons that have stated to them I am an ideal candidate and would highly benefit from this surgery. I have not seen a psychiatrist nor wrote a personal letter to them yet explaining how this has affected my life. I was told Aetna cares nothing about any of that. All they care about is there 6 mos weight supervised diet. Anyhow, appreciate any support and help/information. Hope everyone is doing well and take care!

I have Aetna KingCare (King County insurance administered through Aetna). I'm still waiting for the Dr's office to submit the letter and documentation; and then I'll probably be denied, which I will appeal. I searched the insurance board and found only 5 people with Aetna KingCare, and most of them had been denied; but I'm not sure why. So, the first thing is whether it is true Aetna, or does Aetna just administer it for a major employer. Then, go to Aetna's website, and read through their requirements, and meet them! Especially look at their coverage policy bulletins for code 0157 (obesity surgery). It's all spelled out there: http://www.aetna.com/cpb/data/CPBA0157.html Good luck, I'll keep you in my prayers, Susan

Well I have the same insurance, Aetna thru KC. I am sure it will be denied, it was in the past. However, at that time I did not provide them what they wanted, requirement wise. Just not sure what else I can do when it gets denied. They like to deny. They basically want you to fight your butt off to get approved. However, they won't even consider it if every piece of information they require isn't there. Nice to know there is someone else with same insurance out there looking to do the same thing. I will be praying we all get it!!! Thanks for the information though. Loretta