Question:
I have Aetna HMO, do I need a referral from my PCP?

I have been going to my PCP for 3 months for weight ins but haven't told him why, do I need his referral before seeing the surgeon?    — neicey (posted on April 19, 2004)

April 19, 2004
Yes, if it is HMO, you need referral from your PCP. I also have Aetna HMO. Good luck!
   — jenn a

April 19, 2004
Yes. I also had Aetna HMO and they also wanted 5 years of weight history and they mean 5 years! Good luck!
   — Marie F.

April 20, 2004
I have Aetna HMO as well and I fought them tooth and nail over this. You will need a referral from your PCP, but also one of their new requirements is that you see a nutritionist in conjunction. Also you will need proof that the doctor is treating you for this, that you are on some type of diet and that it is recorded in the doctor's notes. Just going and getting weighed won't cover it, I know, because I tried that and even had a letter from my PCP and they denied because there wasn't any documentation about a "diet." Also, the nutritionist thing is a must. Go to the aetna web site and look up the requirements for this surgery. Good Luck!! Julie Lap RNY 2-13-04 -42 lbs.
   — Julie S.