Jump to content
×
Are you looking for the BariatricPal Store? Go now!

Recommended Posts

Hey Y'all!

I'm a newbie just starting my 90 day 'hoop jumping' and I have a few questions about Aetna.

My surgery will be covered at 100% after deductible (YAY for great insurance!!) but my surgeon will only be covered at 70% after deductible.

As for the labs, upper GI, phsych eval and physical therapy appointment...will they be covered at 100% b/c the surgery is? Were they covered for you or did you pay out of pocket?

I have everything scheduled (upper GI tomorrow, YIKE!) and I'm wondering if I'm going to have to pay out of pocket. I appreciate any insight!

Thanks for sharing! :D

Share this post


Link to post
Share on other sites

I have Aetna ***. I was in the hospital 3 days. My deductible was $500 per day. That covered surgery, anesthesiology, the room, everything. My total was $1500 for everything. I couldn't believe it was so cheap! I would say call Aetna to find out if that is the case for your insurance. My insurance is getting ready to change. If I had this done later, it would have been $3000.

Share this post


Link to post
Share on other sites

I have Aetna also. I had to pay my portion of each step along the way. My coverage is 85/15 so I had to pay 15% of each step (psych eval, test, etc). Then once I had my surgery in January, I met my out-of-pocket max so I am covered at 100% for the remainder of the year. I am SO thankful for insurance!

Share this post


Link to post
Share on other sites

I also have Aetna PPO. Ur out of pocket will depend on the terms agreeded upon by ur employer. My surgeon & hospital were out of network but he accepted the Aetna payment and did not pass the difference on to me. I pd about $300 for all lab & evaluations after insurance. My first preop visit i pd the $10 copay. Also, look into hospital copays..we do not have one but was billed for one which Aetna worked out for me. Rambling sorry on the bus now...take advantage of the nurse from Aetna they will call to check on u & make sure u understand how to eat, what ur pain level is or your incisions..

Share this post


Link to post
Share on other sites

I have atena and they only paid half it cost me 11000 out of pocket I could have gone to Mexico for half oh well

Sent from my SPH-D700 using VST

Share this post


Link to post
Share on other sites

I have had to fight Atena every step of the way. Remember the people that approve or deny are not doctors but a hourly employee manning the phones. When ever they say no do not believe it just keep on going and fighting up the personnel chain till you get the right person to approve.

Share this post


Link to post
Share on other sites

Create an account or sign in to comment

You need to be a member in order to leave a comment

Create an account

Sign up for a new account in our community. It's easy!

Register a new account

Sign in

Already have an account? Sign in here.

Sign In Now

  • Trending Products

  • Trending Topics

  • Recent Status Updates

    • cryoder22

      Day 1 of pre-op liquid diet (3 weeks) and I'm having a hard time already. I feel hungry and just want to eat. I got the protein and supplements recommend by my program and having a hard time getting 1 down. My doctor / nutritionist has me on the following:
      1 protein shake (bariatric advantage chocolate) with 8 oz of fat free milk 1 snack = 1 unjury protein shake (root beer) 1 protein shake (bariatric advantage orange cream) 1 snack = 1 unjury protein bar 1 protein shake (bariatric advantace orange cream or chocolate) 1 snack = 1 unjury protein soup (chicken) 3 servings of sugar free jello and popsicles throughout the day. 64 oz of water (I have flavor packets). Hot tea and coffee with splenda has been approved as well. Does anyone recommend anything for the next 3 weeks?
      · 1 reply
      1. NickelChip

        All I can tell you is that for me, it got easier after the first week. The hunger pains got less intense and I kind of got used to it and gave up torturing myself by thinking about food. But if you can, get anything tempting out of the house and avoid being around people who are eating. I sent my kids to my parents' house for two weeks so I wouldn't have to prepare meals I couldn't eat. After surgery, the hunger was totally gone.

    • buildabetteranna

      I have my final approval from my insurance, only thing holding up things is one last x-ray needed, which I have scheduled for the fourth of next month, which is my birthday.

      · 0 replies
      1. This update has no replies.
    • BetterLeah

      Woohoo! I have 7 more days till surgery, So far I am already down a total of 20lbs since I started this journey. 
      · 1 reply
      1. NeonRaven8919

        Well done! I'm 9 days away from surgery! Keep us updated!

    • Ladiva04

      Hello,
      I had my surgery on the 25th of June of this year. Starting off at 117 kilos.😒
      · 1 reply
      1. NeonRaven8919

        Congrats on the surgery!

    • Sandra Austin Tx

      I’m 6 days post op as of today. I had the gastric bypass 
      · 0 replies
      1. This update has no replies.
  • Recent Topics

  • Hot Products

  • Sign Up For
    Our Newsletter

    Follow us for the latest news
    and special product offers!
  • Together, we have lost...
      lbs

    PatchAid Vitamin Patches

    ×