Question:
Has anyone heard of Aetna paying for the D/S instead of RNY?

My husband is interested in having the D/S procedure but he heard that Aetna pays only for the RNY, anybody have any different info? Thanks so much! Donna    — donnalawbabe (posted on August 9, 2004)

August 9, 2004
I dont know; you could check their policy it is online at aetna.com .. BUT even if its not covered you can certainly appeal.. there was a few ladies in our support group that had BCBS when they weren't paying for the DS and got it 'approved' on appeal. And I dont know what 'type' of Aetna you have; but we have Aetna but our company has the 'last say' on appeals and CAN over ride Aetna check your policy on appeals to see if its an outside review or your company on the final appeals process.
   — star .

August 9, 2004
Absolutely! I had to fight their STUPID RIDICULOUS UNINFORMED policies all the way up to external review and then negotiated directly with their in-house attorney, but THEY PAID! And I know several other people with Aetna who got them to pay for the DS as well. Each time, Aetna gets told OVER AND OVER that their reasons for denying the DS procedure ARE WRONG, but they steadfastly refuse to change their policy. They are EVIL, but they can be beaten. FIGHT THEM ALL THE WAY!
   — [Deactivated Member]

August 9, 2004
Donna, Have you been over to the DS Forum here on AMOS? Diana Cox is over there, and she's amazing and wonderful - and incredibly knowledgeable about the whole insurance end of things. (And she's an attorney to boot!) I'd recommend you get over there and see if she can offer any advice. She's very sweet. Blessing, dina Open BPD/DS July 2, 2002 - 210 pounds ago
   — Dina McBride