Aetna covers Lapband?

[mamiofjna 0]

Has anyone had Aetna cover the lapabnd recently? I have Aetna and was just wondering what the requirements are

[kll724 3,055]

I have Aetna, 2 years ago they required me to have a 6 month diet, and a nutritionist. My son, also, has Aetna, he just finished his 6 month diet, and is waiting for approval, now. So, from what I can tell, they require a 6 month diet, and 40 BMI and then will determine from there. Good luck, Karen

[mamiofjna 0]

Thanks karen, I have my appt with the nutitionist on monday. I was kinda hoping to get it donebefore the end of the year. I saw some posts that they require a 3 month diet.

I have Aetna, 2 years ago they required me to have a 6 month diet, and a nutritionist. My son, also, has Aetna, he just finished his 6 month diet, and is waiting for approval, now. So, from what I can tell, they require a 6 month diet, and 40 BMI and then will determine from there. Good luck, Karen

[sweetpea61956 6]

I have Aetna too and was banded on 5-26-11 and I only had to have 4 dr visits. Each plan is a little different. I would call and talk to them yourself.

[darknlovely 2]

I have Aetna as well and i did a 3month diet,sleep study,see a psychiatrist, see a nutritionist and show proof of my weight history for the Past two years.then i was approved.

[MOMW 71]

I have Aetna also. I too would suggest that you find out the specifics of your plan. Go on their website, I was able to find the information there. I was banded Jan 28. I had to do the 3 superivosed program which included the psychologist, 3 preop classes and weigh in at those classes. I also was assigned an Aetna case manager that calls periodically to check on my results and answer questions also. I was pleased that Aetna had a very fast turn around in their approval. My first visit was in August and I could have got my band in December. The staff at my Bariatric clinic were/are excellant and knew how to get this all done. I did nothing but show up and fill out what they asked.

Besides the 3 month requirement, they used a bmi of 40 or 35 if you have 2 or more comodalities (blood pressue, diabeties, cholesterol, sleep apenea, etc).

[papoose 48]

I have Aetna had to see the surgeon for 6 months before surgery. I then followed all of the dr's requests, nutritionist, psychologist, endoscopy, get a letter from my primary dr. supporting the surgery. At the end of the 6 month period the Dr's office submitted the paperwork to Aetna in 24 hours I got a call that I was approved. They scheduled my surgery for about a month later.

[mamiofjna 0]

Do you all think that I should start with my pcp or should I got straight to a bariatric surgeon?

[papoose 48]

I went Aetna's online to look for a bariatric surgeon, so this way I would know what Dr. is in my network. When I found one, I went to his seminar and then made an appointment. My first consultation with him, he talked to me more about the surgery and told me I would qualify. They gave me a packet of what his requirements were. I called Aetna to find out what there requirements were. I went to his office once a month for 6 months and took all the tests and requirements that they wanted. Lucky for me Dr. Gritsus and his staff were very professional and nice. I spoke to my primary during that time and told him what I wanted to do and he said he thought it was a good idea. He wrote me a medical letter of necessity for Aetna. So maybe you should start with Aetna and then look for a good bariatric surgeon in your area or ask your primary dr. for a suggestion. Whenever I go to a Dr. I always check online or call Aetna to make sure they are in my network, so I won't get billed. I just had to pay my co-pay everytime I seen him. Good luck in your journey.

Do you all think that I should start with my pcp or should I got straight to a bariatric surgeon?

[CheckYes 46]

Has anyone had Aetna cover the lapabnd recently? I have Aetna and was just wondering what the requirements are

My Aetna policy did not cover Lapband surgery.

[mamiofjna 0]

Thanks everyone for the great info. Does anyone regret having the lapband? What are the biggest obstacles to overcome once you have it.

[sweetpea61956 6]

My plan didn't cover it in Dec 2010, but with the new plan year on Jan 1, 2011 it did!

My Aetna policy did not cover Lapband surgery.

[Alli789 0]

I have aetna ***- so everything had to go through my pcp. I think they required everything you could imagine for me- 6 month diet with pcp, seeing a pulmonoligst, cardiologist, gastro, nutritionist, psychiatrist, lots of tests and a sleep study. I did it all and got approved with a relatively low bmi (like 36-37). They did deny me at first but the surgeon called to fight for me and got it approved

[mamiofjna 0]

wow thats great for you and encouraging for me!!!! I hope that i can get mine covered as well.

My plan didn't cover it in Dec 2010, but with the new plan year on Jan 1, 2011 it did!

[MaggieB 6]

Do you all think that I should start with my pcp or should I got straight to a bariatric surgeon?

I would go straight to the surgeon. The surgeons office will know exactly what to submit to the insurance since they deal with it everyday. I have Aetna & had surgery done june 2010, my husband will have his done in August. We went straight thru the surgeons office for all the required appointments - the only info he needed from the PCP was a 2 year weight history. They weight history did not even need to be an official letter either - the PCP made copies of his exam sheet for us.