KDC213 1 Posted March 24, 2016 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. Sent from my SM-G920T using the BariatricPal App Share this post Link to post Share on other sites
WL WARRIOR 692 Posted March 24, 2016 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. Share this post Link to post Share on other sites
KDC213 1 Posted March 24, 2016 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. Sent from my SM-G920T using the BariatricPal App Share this post Link to post Share on other sites
rking 484 Posted March 24, 2016 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. Share this post Link to post Share on other sites
Falecha 50 Posted March 28, 2016 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. Sent from my SM-G920T using the BariatricPal App It doesn't make sense to me. You need to get a second opinion. Hey by the way I live in Springfield , Mo Falecha Share this post Link to post Share on other sites
Angie74 170 Posted March 28, 2016 it doesn't make sense I would have the Dr's office check into it Sent from my SAMSUNG-SM-N900A using the BariatricPal App Share this post Link to post Share on other sites
J.lynn 50 Posted March 29, 2016 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 Share this post Link to post Share on other sites
KDC213 1 Posted April 2, 2016 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. Sent from my SM-G920T using the BariatricPal App Share this post Link to post Share on other sites