Need Atena Info

[mwest1 4]

i have atena insurance they approved me and i think i have to pay half, i dont know how much half is but hopefully not that exspensive. does any one know how much aetna will pay. or how much does the band cost???

[Dawn200321 146]

It all depends on your insurance plan. I have Aetna and they paid 85 percent. It also makes a difference if your deductable is paid at the time of surgery or not. The best way to know for sure is to contact Aetna directly and ask the customer service rep. They are usually pretty good at finding out what you will need to know

[Sojourner 2,446]

I also have insurance through Aetna. I had my surgery last Friday, and they paid 85% of the hospital only (which is a lot, considering that we were told by the finance people at the hospital that the surgery total cost would be about $40 grand). The program fee through the doctor's office was $1200. Of that, I was required to pay about $900.

It does matter what type of plan you have, and you should also research if your doctor and intended hospital for surgery is considered "in network" for Aetna. I chose a doctor/hospital because of their rating as a "Center of Excellence", and was not in network for my insurance.

If I had chosen an in network doctor/hospital Aetna would have covered 90% of the cost. Dawn is correct, it makes a major difference if you have met your annual "out of pocket" expense or not.

Hope that the information helps...best wishes and good luck!!

[bluetigereyes 95]

Your insurance has different levels of payment based on what your employer chose and if you use an in-network doctor/hospital. Typically Aetna will get a "Contract adjustment" of a certain percentage, then they will pay at your policy level. For example, if the hospital has a contract to accept 90% of billed charges, then that 10% will be written off up front. Then your insurance will pay at 80% of the remaining amount, leaving you with a 20% co pay.

Here is an example

Cost: 10,000

Discount 1,000

Balance 9,000

80%=7,200

your 20% = 1,800

Hope that makes sense

[mwest1 4]

Does Aetna pay for fills. If any one can answer tjat I would b grateful. Hopefully I get banded on March 29

[angbutler0712 30]

I have Aetna and they paid all but $40 of my surgery. Luckily I had hit my deductable when I had the surgery on 11/23/11. So far I have had two fills and have yet to receive a bill for them. So either Aetna is paying for them, or the hospital is behind on their billing. Good Luck!

[Ajai 0]

Usually when you're approved for a procedure or surgery, the insurance company covers follow up visits for 3 months. If you don't have a copy of your approval, contact your insurance company and request a duplicate copy. Also check bc usually your co-pay is waived for that period too.

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