Question:
Did you have Aetna and get approved for Hernia repair/abdominoplasty?

I am in the process of trying to gat approved for a hernia repair/abdominoplasty with Aetna. It clearly states in the policy that the only 2 ways to get approved for abdominoplasty (tummy tuck) is 1. panni hangs to or lower than pubis with 3 months documented rash history or 2. True incisional hernia repair. My surgeon has diagnosed me with a hernia and has submitted for approval for a hernia repair/abdominoplasty. They required photos of my abdomen to see the pannis and rash. It has now gone to the review board, and the nurse at Aetna assigned to my case said it will most likely be denied due to lack of documented rash history. My question is.......I clearly have a hernia and the policy clearly states that abdominoplasty is covered with hernia repair. How then can they deny me?? I clearly meet criteria with the hernia, why is the rash even an issue?? I'm not trying to get approved due to rashes.....only the hernia. Anyone else have experience with Aetna and tummy tuck approval?? Please help!! Thanks!!    — skymaxjr (posted on September 12, 2002)

June 28, 2003
I'm not sure what the answer is on this, but I have an almost identical situation. I am only now starting the process of getting in to see a plastic surgeon, so please email me and let me know how this came out for you, or post here. Thanks, Greg
   — Greg P.