Question:
MY employer has health insurance through Aetna, which policy should I

pick out..which one will pay the quickest without much hassle. I live in Texas!    — [Anonymous] (posted on June 4, 2001)

June 4, 2001
Consider yourself lucky that your employer offers Aetna! I hear that they are one of the best in approvals! That being said, I have an HMO plan. I paid $15 for my initial consultation with the surgeon and not a dime in the hospital. I was approved in less than 24 hours. I know that a lot of people are turned off by HMOs but I lucked out. My mother had to go in the hospital for a heart catherization under the PPO plan, and had to pay about $900. Boy, was I happy with my HMO. And I had a top notch doctor.
   — Jeannet

June 4, 2001
You need to know the policy the employer has first. Just because they have Aetna dsn't mean contractually they have approval for WLS surgery. There are many Aetna policies that have WLS exclusions. Mine was one of them until a strike contract radified the contract and now my husbands policy offers WLS as of 1/1/01. When Aetna pays most policies cover the RNY but not necessarily the BPD/DS and others. So, contact the human resources person or Benefits Coordinator and find out exactly what is covered under this policy before you make a choice. Could be a big difference. Best wishes
   — Linda M.

June 4, 2001
I also have Aetna US Healthcare HMO. I was approved in 4 weeks. They also paid 100%. I live in TX.
   — jmasks

June 5, 2001
AETNA IS THE BEST. I WAS APPROVED IN TWO HOURS. AETNA HMO IN OHIO WAS THE INSURER. GOOD LUCK.
   — MICHAEL Z.

June 5, 2001
I have Aetna US Healthcare, they approved me in 2 hours over the phone....If you go into there web-site, and search Morbid Obesity, It will come up, that they cover the surgery. Good Luck
   — Marie B.

June 5, 2001
I just switched to aetna hmo myself. your employer may have a clause that excluses WLS surgery. they do that to save money. The best way to fond out is to ask your human resources department for the "group number" that your job is identified by with aetna. My job acted like they didn't know it, so i got resourcesful. I asked a friend who had aetna what her group # was. I assured her that i wanted to check on the coverage they offered, but did not tell her specifically what i was looking for. Then, I called aetna at 1-800-323-9930 and told them it was open enrollemnt at my job and that their web site and my employer did not provide me with enough info. I specifically told them that i wanted to find out what exclusions were in our contract. They searched and then i got more specific and asked was there a clause or exception against "surgical treatment of obesity" they told me no. I am really paranoid so i called back 4 more times throughout the day and spoke to a new person and asked all over again, just to be sure. Also, this is the page from aetna's web site that shows how they handle approval for surgery. As long as there are no exceptions in your contract they will follow this: www.aetnaushc.com/cpb/data/CPBA0157.html All policys under Aetna follow this regardless of whether they are HMO, PPP or QPOS. The only reason to not pick the HMO is if you have a doctor you plan to go to that is not a netwrok provider. If you have a few docs that you are thinking about, use Aetnas web site again and go to "choose a provider", put in your location and try different surgeons names. If they don't come up, they are out of network and an HMO may be a poor choice. I found that all but one of the doctors I was considering was in network, so I picked the HMO. Good luck!
   — Courtney W.