Aetna of Missouri

[KDC213 1]

I called Aetna and was told the gastric sleeve was approved 100% with a 6 month diet before. I just attended a seminar with the surgeon I am interested in and turned in some paperwork that the insurance verifier for the company to verify that it was covered before we proceed.

She called me today and said that Aetna only covers it if they are my secondary insurance. Does this sound right? Aetna is my only insurance right now.

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[WL WARRIOR 692]

I used a different plan through Missouri Health net that covered everything and didn't require any dieting or meetings before surgery. I think the open enrollment period is coming up, so you may want to consider switching.

[KDC213 1]

I used a different plan through Missouri Health net that covered everything and didn't require any dieting or meetings before surgery. I think the open enrollment period is coming up, so you may want to consider switching.

What insurance do you have?

I used a different plan through Missouri Health net that covered everything and didn't require any dieting or meetings before surgery. I think the open enrollment period is coming up, so you may want to consider switching.

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[rking 484]

I have Aetna TRS in Texas. Aetna covered, but has a $5000 co pay. I had the choice of a 6 month diet, etc., or a 90 pre surgery regimen, which basically is the same, but add exercise program supervised by your dietician, basically. You needf to call them and ask where to find the policy specifics about bariatric surgery. I can help you get through the policy as I spent lots of time figuring it out. We can compare it to my Aetna.

and btw, my doctor only made me pay $2000 of the $5000 co pay.

[Falecha 50]

I called Aetna and was told the gastric sleeve was approved 100% with a 6 month diet before. I just attended a seminar with the surgeon I am interested in and turned in some paperwork that the insurance verifier for the company to verify that it was covered before we proceed.

She called me today and said that Aetna only covers it if they are my secondary insurance. Does this sound right? Aetna is my only insurance right now.

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It doesn't make sense to me. You need to get a second opinion. Hey by the way I live in Springfield , Mo

Falecha

[Angie74 170]

it doesn't make sense I would have the Dr's office check into it

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[J.lynn 50]

Hi there!

I had some issues with communication between my surgeons office and my insurance company as well. The best advice I can give you is to call your insurance yourself and get all of the requirements from them in writing. My surgeons office told me that sometimes the insurance companies are hesitant to talk to them or are not as thorough - or maybe they aren't asking the right questions. Who knows

I have personally never heard of an insurance company denying coverage for a covered procedure because you don't have another primary insurance.

Good luck

[KDC213 1]

Thank you for the replies. I called both my insurance and doctors office back. I must have misunderstood. The doctors office I was wanting to go through is the one that only accepts Aetna as a 2nd form or insurance. They will not accept Aetna alone. And she informed me that the closest place to me that accepts Aetna as the only form of insurance is about 2 hours away.

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