Question:
Ha s anyone been approved this year thru Aetna Hmo?

Has anyone been approved thru Aetna Us health care Hmo this year 2005. All I have found has been from 1999-2004. I understand that they have a exclusion now against wls.I am wondering if you have several co-morbities if you could appeal and win. Thanks to anyone that could be of help.    — Patricia Stephenson (posted on May 14, 2005)

May 14, 2005
Hi! I have Aetna HMO (I'm not sure if that's the same as Aetna Us healthcare HMO) and I was able to get very specific information about their requirements for WLS. I went on to Aetna.com and logged in. Then in the 'contact us' section, I sent them an email. I told them in the email that I wanted to know about their specific requirements for WLS and that I was not able to get the answers I needed when I called. They sent me back a link that allowed me to read all of their requirements ie; must be overweight for 5 yrs, have a BMI of 40 or more, or 35-39 with co-morbids, etc, it was like 5 pages long... I think some policies are different, depending on what our employer chooses to provide under the plan. But from my experience, doing it via email and having it all in writing was very helpful. Good luck to you!
   — Andrea Q.

May 16, 2005
I had my done Dec 27, 2004 I was with the EPO at the time. There were some people in the office talking about how they rec a letter from Aetna saying that as of Jan 5,2005 they would no longer cover it. I switched to HMO and the DR office told me to call cause they may not cover the follow up for 2 years. Good luck I hope it works for you. Just appeal if they denie you.
   — jaime