Question:
i have aetna hmo--the only exclusion in the plan reads

"weight reduction programs or dietary supplements--does this exclude revision..i am trying to have one done..I am told that I will need 3 months of doctor visits--which i have have..but I cannot afford to go to a nutrtionists too..anyone with aetna hmo..Is there a way to get around the nutrionists--also will they approve the surgery?? thanks    — tylerswife (posted on July 24, 2006)

July 24, 2006
Congrats on trying to begin your journey. Now for the bad new. Insurance companies in general are making it very difficult for people to have WLS. In most states you have to be on a 6 month diet from a doctor. Then most quality surgerons make sure that you see a dietican and a shrink. This is very important for success and for your health. A lot of insurance companies require a lot from patients, so I would enlist your PCP, Surgeon, Dietican, shrink, and anyone else who can help you. I would also begin asap going to your local support group. In these groups someone had gone through what you are or have been. Let them help you. Good Luck
   — Steve Cohen

July 24, 2006
Hi , I have Aetna HMO and I am 4 months post op. They first denied the request but they made an error and it was reverdsed. The nutritionist was with the surgeons office so I did not have to pay for it. I had to go through a 6 month weight management/WLS info class prior to meeting with the surgeon. Each state may be different, Im in Calif. Good Luck, it is worth ALL the heartache you have to go through, I PROMISE
   — jomamma

July 24, 2006
have you had a visit with the surgeon? usually the surgeon has a nutricionist in the wls program and a spycologist. these may be included with the surgeons fees. Also Aetna does cover nutricionist, all you have to pay is your co-pay. Trust me you will have to see severl specialist before you have the surgery. consult with your surgeon's office, they will give you a list of specialists you must see and go to the aetna website and use docfind to locate dr.'s in the network.
   — Ulises Robles

July 24, 2006
I think it depends on the Dr. you have as to whether you have to pay for a nutritionist out of pocket. The Doctors in the town closest to me require a $700 out of pocket expense for the nutritionist and psychological work-ups because they had their own group. My Dr. lets you go to ones of your choice with a referral so that the insurance pays for it, no out of pocket expense. You may want to check to see if this is possable. Good luck.
   — rose2rose

July 24, 2006
I have Aetna HMO. I was approved within a week for the lapband after my surgeon's office presented all the paperwork. I went with my surgeon's nutrionist and physc. but if you have diabetes I know Aetna will pay for a nutrionist. You just have to check for a participating one and one that is knowledgeable about weightloss surgery and get a referal from your PCP. Donna C.
   — Grandma Blue Eyes

July 25, 2006
I have Aetna POS II, Nd I find that the best thing to do is to follow their guidelines exactly. If they say you must see a nutritionist, then you must. I had to go through all that, too. did you say you are getting a revision or the initial surgery/?
   — Novashannon