Aetna

Who has Aetna?  What were/are your dealings with Aetna like? I just would like some info.  Thanks. Sonny

I have Aetna HMO, and my plan does not cover any sort of weight loss surgery, so I had to do self-pay. Each company(employer) makes their own specific agreement with Aetna, and so your plan may be different.  You will need to contact your Aetna customer service & they should be able to provide you with the necessary information. Good luck!

I have Aetna PPO and our insurance has Bariatric coverage.  It also allow you to do 3months of Doctor supervised WL program to qualify for WLS. Here is a copy of WLS criteria for Aetna. Hope  this was helpful.     http://www.aetna.com/cpb/medical/data/100_199/0157.html

Great link, thanks!  We are going to be switching to Aetna.  Any idea how they handle the whole "pre-existing condition" thing?  I didn't find in on that page.  It's silly because WLS is a last ditch effort, so  wouldn't it be pre-existing, for most?

I have Aetna and i was just apoved today.been doing all the thing thay ask me too started in dec hope surg date will be in 2 weeks

i have aetna's point of service plan, which is a PPO.  i switched from an hmo to  aetna's ppo two years ago in anticipation of possibly having this surgery.  even though i knew they covered the surgery, i wasn't entirely sure what their approval criteria were.  i was very worried because my bmi is over 40, but i don't truly have any other comorbidity factors, such as high blood pressure, diabetes, apnea, etc.  after my first visit with my surgeon, they informed me that aetna would likely approve me based on my bmi and proven history of trying to lose weight and failing (i had to provide this history to my doctor).  before submitting to aetna, they had to show that they had been on a medical weighloss plan for three months and they wanted to see a psych eval.  So, in short, i was approved based on:  current BMI, history of obesity, three months of medical weighloss and testing, psych eval.  i was approved three days after my paperwork was submitted!  my surgery is on july 16, 2008.  hope this helps.

I have Aetna insurance, well we just got it, and I am interested in the weight loss surgery. I was wondering how long it took you to get approved after speaking to your doctor and do you know how much Aetna will cover?

My story is a little like yours, my bmi is over 40 but don't have any other comorbidity factors, atleast none that I'm aware of. I plan to start gathering all my doctors records because I have fought weight loss for a very long time. I can remember when I was in middle school my mom getting me tested for thyroid problems because I had such a hard time losing weight. I see that your surgery is a week away, how exciting!

I appreciate any and all information that can be passed to me, like what I can expect and so forth.

Was Aenta really strict on the 3 month supervised weight loss plan?  I have been on wirght loss plans for 20 years, none fully supervised by a physician.

wow.. i just realized that question was asked a year ago!  i guess this forum is not used often!  LOL

Pamela, Eventhough the question was old, you helped me!! I have the same insurance, and my papers were submitted 7-1. I called 7-3 to check on them, but no luck. I guess I will call again on Monday. I just wanted to know how soon a decision might be made. Thanks!!!