Question:
Aetna ppo ins with no referral... My doctor...

Well my PCP wont give me a referral... He says that he will not refer any of his patients for this type of surgery because it is too risky. Due to the fact that he would not refer ANY patient I made sure I wrote that on my paperwork at the Bariatric Treatment Center with a big star next to it hoping that my Ins. co. will see that it is not that I am not a good canidate for the ins. its that he wont refer anyone. I am so worried about this, I hope that helps and that they won't deney me because I have no pcp referral. My PCP did tell me that if I go through with the surgery he hopes it works out for me. Anyone else run into this and know if it will really hinder my chances for getting approved? I have to go get my heart checked due to chest pains occasionally, the surgeon sent me home with a pre-op assessment letter to get referred to a cardialogist for that. Please answer or email with any info you may have for me... Very impatiently waiting :) Renee [email protected]    — Renee D. (posted on February 25, 2001)

February 25, 2001
I have Aetna, and they are a GREAT insurance compnay, however, they weigh the opinions and views of the PCP as gold. My suggestion is, change PCP providers it doesn't take long and there is no waiting period. It's unfortunate that your current provider doesn't support you. Aetna would have to determine if you current PCP's reason for not referring you is based on medical reasons and not for his personal disposition to the surgery. Many people have had similar situations as this and have had good outcomes. My advice, change PCP's (only takes a minute) and go forward with your plans for a new, improved, healthy life. Adrienne - 9 days post op RNY/proximal -feeling wonderful!
   — corpdiva2006