Question:
Has anyone dealt with obtaining Aetna's approval for BPD/DS type WLS

I just had my first one-on-one appointment with WLS surgeon. He informed me that my insurance Aetna HMO will NOT approve BPD/DS or any other type of Duodenal Switch. Has anyone been able to get Aetna's approval for this type of WLS? If so please let me know. I plan to contact the Obesity Law & Advocacy Center, but I would like to try other obtions.    — Penny B. (posted on May 21, 2002)

May 21, 2002
My Dr. also told me that I was going to need the DS due to polyps in my stomach. Aetna refused to cover it under any circumstances. I had the open RNY on Jan. 3, 2002 down 77 pds.
   — roshelle P.

May 21, 2002
I don't know about Aetna HMO, but I do know that several people have been approved with Dr Keshishian that have Aetna Open Choice and others have been approved with other doctors. I suggest joining the duodenalswitch e-group and asking there or contacting the doctors listed on www.duodenalswitch.com The e-group is groups.yahoo.com and the main list is just called 'duodenalswitch' Anita in Denver Open DS - 11/08/01 Dr Keshishian
   — Anita N.

May 21, 2002
I have Aetna MCN and I was approved for the BPD/DS but after my surgeon spoke with the Dr. in the medical review board. FOR ME the RNY was potentially life threatening due to prior surgery for Acid Reflux(Nisson Fundlopication)and my surgeon felt that it was too risky for the RNY and the Review Bd. Dr. agreed. I was originally denied for the DS and approved for the RNY but my surgeon refused to do that surgery on me. So, on 4-11-01 I had an open BPD/DS and Aetna approved and paid for the whole thing. Best wishes on this wonderful journey!
   — Linda M.

September 18, 2002
I have Aetna HMO also, go to www.aetna.com/cpb/data/CPBA0157.html This will tell you..... Aetna covers the following sugical treatment of obesity when patient criteria are met. Who is your surgeon? Any other questions, just email me at [email protected]
   — Trisha W.