Aetna pos

[beedo 0]

I have Aetna POS and I initally went in for Lap Band as I had never heard of the sleeve, but in the middle of my nutritionalist visits I was told about it from a friend. But anyway, my question is I had the Dr. office call and I am covered 100% for lap band and the sleeve no copays or deductables. I have my last nutritional visit the 4th of Dec, do you think I will get rejected and have to go through the appeal process? I have done all of my PSYC, Phyysical, and even had a stress test done and I didnt know if anyone has had any problems if they are covered 100% or not. I was also wondering what the average time from approval to the point where you can set a date is, and this is my first post. I have never heard of this site before but I was on lap band talk and was reffered here, looks like I can get a lot of my general questions answered here with a little reading, but hello all and thanks for reading!

[Norma 10]

Welcome! I can't answer your insurance questions as my insurance covered nothing related to weightloss. I am sure that you can get a date fairly quickly once you are approved. Definitely go for the sleeve over the band--no maintaineance vs very time consuming followup--IMO the band should be outlawed. I have lost over 40lbs and haven't even been sleeved for a month yet.

[beedo 0]

LOL at the band should be outlawed!!! I have a friend thagt has it and it is sad to watch him eat, he looks completely miserable. But wow 40 lbs in a month! How long were you in the hospital and how long were you out of work?? I really dont t to be out of work for more than a few days if at all possible but I am still looking at the down time.

[Norma 10]

I had the sleeve on Oct 30 was released from hospital in 3 days and could have worked 2 days later. I took 2 weeks off because I needed the mental health break from work.

[beedo 0]

That sounds really good, I am hoping not to have to take more than about 5 days off work. Thinking if I can have it done on a Monday I can return the next Monday, hoping! How are you liking it so far? Anything that you wish you knew before you had it done, how uis the pain. Thanks for the insight, good luck on making it to your goals

[Norma 10]

I picked the best doctor and hospital so have had no pain, no nausea, no problems. I did a low fat, low carb, high Protein diet for 2 weeks prior to surgery--drank a Protein Shake for Breakfast and had lean meat and salad for lunch and dinner. It would be worth it to see if your insurance would pay if you went to Dr Aceves in Mexico. I chose him because he does 3 leak tests and doesn't use barium which could cause complications if it leaked into abodmen. He has done 700+ sleeves without a single leak. He uses a full hospital and watches you for 3 days after surgery. He comes to see you 3 or 4 times a day himself in the hospital--you don't get that kind of attention in the US.

Important things for the hospital is to take GAS X strips and a heating pad for use to dissapate the gas they use to inflate the stomach. I did not wear my own clothes in the hospital as I had an IV and a drain. The hospital gown was fine with me. I loved taking a shower each day. Be sure that you know how the anesthiaologist is going to put you under--I liked having the epidural and the general and that in Mexico they deliver your anti nausea meds by IV. In my previous surgeries in the US, that has always been done by gas and I have extreme nausea and cold rigor chills which did not happen at all this time.

[beedo 0]

I really don't know if my insurance will cover the dr in mexico and honestly I don't think I can get a passport and all that bs done right now. I am somewhat concerned about my dr, I initially went to him for lap band and he is one of the best in dfw area but I have no idea about the skleeve, b ut I do know that he is a bariatric surgeon for a long time. Ij spoke with him and he was really pushing me towards the band and giving me all of the side effects and what not on the sleeve. I am thinking of calling around but since I have done all of my nutritionalist and all of the other required tests in his office I don't know if I will be able to switch. I still have time, but I still have to make sure I am not the first few sleeves that he has done.

[Norma 10]

I don't even know your doctor's name but if he is pushing you to a band, find another doctor. Find someone who does sleeves and has done at least 500 of them and find out his or her complication rate. Lap band doctors are not pleased with the competition and have quite a racket set up with charging $150 + for fills and all the followup care required by the band. If people learn that the sleeve is a better surgery and start going for it, lap band doctors will have to learn a new surgery and will need better skills. Don't let your insurance company push you around. You have to decide what you want for your body. I turned down gastric bypass on 3 different occasions with 3 different insurance companies in the last 12 years. I finally went to Mexico for the sleeve as a self pay and am estactic that I did.

[beedo 0]

It is not the insurance that is pushing me, they will cover either one that I decide. My main concern is the dr and how many he has done but I guess he just just stating that lap band is a great surgery and that the sleeve there is not really enough information on the long term results. He did say that we can sit down and discuss both options and I can choose which ever one that I want but what if I go through all of this for the last couple months and the dr does not have enough experience with the sleeve, wonder if I will have to start all over again with another doctor

[WingRider 1]

I have Aetna POS in Texas as well. They will cover my band but will not cover the sleeve as my first WLS only as a revision. They tell me they consider the sleeve experimental. Who did you contact at Aetna? I am scheduled for Mexico on 12/29 and will lose my deposit and 1000.00 worth of plane tickets if I don't go there.

I know that as soon as I get it done, Aetna will cover it. That is just going to be my luck.

Bill

[beedo 0]

Bill, I don't know where you are located but I am in dfw. I had my dr.'s office call for me, a few days later she said all is covered! I have aetna pos and it is based out of El Paso, but I also work at Lockheed Martin and we have damn good insurance. The last company I worked for had bcbs and they covered it but my company did not "add" that to the cxoverage so that may be your case, but I have not contacted aetna personally, I have let ther nurse do it all for me. How long has it been since you contacted them? I am going through dr richard carter in arlington. I can get his number and the girls will call your insurance and verify it for you.

[WingRider 1]

Hey beedo

If you don't mind can you post or pm me your Dr's contact info? I have bariatric surgery coverage on my policy. I have been going through TruResults for lap band as my contingency plan. I just got approved for the band from Aetna two weeks ago. I had to do the 6 months of psych, nutrition, and exercise stuff to get it approved. I have called Aetna personally and they have told me that their stance on VSG is that it is experimental. Even on their member's portal that I have you can find that verbiage in their benefits policy. I want to completely exhaust all avenues of getting my insurance to cover it so I can have the surgery here before the end of December.

bill

[beedo 0]

Well you have me worried now about my coverage, I do know that I had choice between aetna pos,hmo, or ppo and the only one of them that covered lap band was pos. I an hoping that she didn't enter the wrong code or something when she called but she did tell me that most insurance do not cover it when I asked about it the first time. But look up carterlapband.com and I have been talking to Mia here and she has been very nice ( nice looking too)! He does the sleeve And the band and after reading up he is an excellent dr

[beedo 0]

I will get you the phone number tomorrow if you need it, I am in San Antonio visiting the wifes family right now. Thank god for cell phones! No internet here just my phone

[beedo 0]

They turned all of my info in on Friday and said it takes 7-10 days for a responce. Kinda nervous but ready for an answer!