Question:
Has anyone had luck with Aetna covering Gastric bypass?

Has anyone had luck getting approved for RNY, through Aetna? I have a close friend who has been denied after taking all the necessary steps. Any Suggestions on what to do next? We live in Ohio.    — regina6913 (posted on June 25, 2010)

June 25, 2010
I live in Atlanta and I have Aetna HMO and it was no problem getting approved. It helps that the surgeons who did my surgery know how to gain approvals, so early on you receive a packet with the guidelines for Aetna and if you follow it, the approval is a cinch!!! I will say this, they only approve Centers of Excellence.
   — Vikki12

June 25, 2010
Like any insurance coverer Aetna has a lot of plans. So it will depend on your plan and your employer (some employers exclude surgery for obesity). It also depends on if your surgeon is in their network and most importantly if you qualify. I'm not sure if you're asking the question to help your friend or because you also have Aetna and want surgery. Do you know why your friend was denied surgery? More details are needed for me to help her decide what to do next.
   — Caribou ME

June 26, 2010
I called Aetna and spoke to them about plan and made sure there were no exclusions and found out what the requirements were at the beginning of the process. My plan required a 6 month supervised diet prior to surgery but I was approved with no issues. Make sure you are using a surgeon who has a staff experienced with getting bariatric approval and stay informed. Even if there are exclusions I have read that people were able to get approved with appeals proving medical necessicity. Good luck!
   — Diane324