Question:
Any info on this company?

I live and work in Maine, but my employer is housed in Maryland therefore my insurance comes out of Maryland also. Has anyone else had any experience with Aetna U. S. Healthcare? I have the core plan as they do not have the HMO type plan in this state. This company has host sites all over the US, so I am sure others in my position for RNY have had to deal with them. Any information anyone has as to how to deal with them or if they don't have any problems approving this surgery would be appreciated. Thanks, Janice P.S. I have found this site to be very encouraging and supporting in my quest to have this surgery. Many of my doubts have been alleviated by everyones comments. Again Thanks.    — Janice M. (posted on August 7, 1999)

August 7, 1999
Yes. I have Aetna US Healthcare QPOS/HMO insurance in Florida. This is both indemnity and HMO. They have an exclusion that reads "unless approved by Medical Director". Do not despair they will approve. Expect a first denial. This is their internal policy to deny this surgery the first time for anyone. Then you will file an appeal and be prepared to prove you have had a medically supervised diet program. that is the key here. They will appove. Approved me in first appeal process 60 days into the new policy and my wife during second appeal . they are SLOW and will take approx. 10 weeks start to finish but it will get done. Feel free to contact me.
   — Samuel D.

August 7, 1999
Janice, I don't know if this will help...I am in PA and have Aenta UShealcare as my insurance provider,I had a VBGon 7/14/99 and was approved within 2 weeks back in June...everything was covered in full with no problems...Even after I had to go back in with complications...an infection (due to me being diabetic) they even approved 28 home nurse visits to help me and also sent me a box of supplies (gauze and tape etc.) so far so good...I hope you have the same response I have ...I am really pleased with my insurance...take care and good luck...Mona
   — Mona S.