Aetna and Conversion

[ireallywannabthin 286]

Hi everyone. I was banded on 2/6/13 and am in the beginning phases of converting to the sleeve. I have Aetna and would like to find out if anyone has done this through Aetna and how the process went... Were there any requirements?

Thanks!

Jennifer

[Elode 8,093]

I have no clue but you should call the customer service and ask them.

[emsgirl114 88]

I have bcbs. They denied a first but then surgeon called and explained the issues I was having and what the future held and then they approved.

[nurseforlapband 11]

Hello, I was banded back in 2008 and now considering doing revision to gastric sleeve as well and I have Aetna. The requirements should be the same if you had Aetna for the lap band. I just finished doing my 3 month physician supervised diet, psych eval and nutrition eval. You can always go to Aetna.com to view the Clinical policy bulletin on obesity surgery(http://www.aetna.com/cpb/medical/data/100_199/0157.html) and it will give you all the requirements in detail. I would also contact Aetna customer service just to make sure that your plan does not require you to have this surgery done at an Institute of Quality for Bariatric. That is the problem I am currently running into. The facility I chose is not an IOQ and they denied me for that reason. So, I'm appealing to try to get approved. Hope that helps! Please keep me updated.

[Babydolls 0]

I was banded Aug 2007 and revised on September 2014. I have Aetna and no issues at all. My doctor told Aetna that the band did not work, and that I gained all my weight back from the lap band. All I had to do was blood work, EKG, chest xray and to get clearance from my family doctor. The whole process took about a month. Aetna paid everything except for 300.00 for the nutrionist. (42,000 total)

[Hulahan 1]

I had my gastric band removed 1 year ago due to erosion under a different insurance plann(Cigna). I now have Aetna and they required me to do a 4 month nutrition and medical monthly visit. The only requirement was that I maintain my current weight or lose and provide documentation that I lost weight and maintained it during my time with the gastric band. I chose a hospital within the network and I ended out paying only my yearly deductible

Good- luck.