Aetna Managed Choice Open Access

[GettingSleeved 1]

Hello,

I recently got a job with Aetna insurance, I didn't have insurance before but was bummed when I found out there is no bariatric coverage. I have a BMI of 39 and really want to get the surgery soon. Is there any way to get insurance to partially cover the surgery? And does anyone know a really helpful surgeon in either NYC or Long Island that will work with me? Thank you in advance!

[SunflowerGal 30]

I have great insurance through work, yet my WLS is not covered by my plan; I am a cash-pay patient. My insurance is covering a lot of the pre-op tests but will not cover the surgery itself.

There are many financing programs available through doctor's offices; if you choose a surgeon, you may want to ask him/her about financing options. Another potential consideration is a low-interest credit card. And, you may want to look into surgery in Mexico, it may also be an option for you.

Good luck!

[twittymilk 51]

Obamacare allows states to choose medical procedures that are considered Essential Health benefits. This specifically applies to private insurance. So I'm from NY and my state says if you offer insurance in this state bariatric surgery must be covered and my insurance does (Aetna). Aetna does not have the bariatric surgery information on my insurance documents it's in fine print. The states that require insurance companies to cover bariatric surgery, I think it's about 23 states now that force insurance companies to pay for it. So if you live and work in NY, it most definitely should be covered.

I'm adding the link but the state you work in matters for whether the insurance company covers it or not:

http://www.bariatric-surgery-source.com/lap-band-insurance.html#plan

Weight Loss Surgery States (for Individual, Family & Small Group Plans)

• Arizona
• California
• Delaware
• Hawaii
• Illinois
• Iowa
• Maine
• Maryland
• Massachusetts
• Michigan
• Nevada
• New Hampshire
• New Jersey
• New Mexico
• New York
• North Carolina
• North Dakota
• Oklahoma
• Rhode Island
• South Dakota
• Vermont
• West Virginia
• Wyoming

- See more at: http://www.bariatric-surgery-source.com/lap-band-insurance.html#plan

[GettingSleeved 1]

Thank you for two great answers, I think self pay is going to be the best option and getting my insurance to pay for all of the testing. Did you find you can get the surgery much easier through self pay? I'm in New York and I've been having trouble finding a doctor that is reasonable.