Garth Davis...

txaberry · April 1, 2008

I have Aetna POS with a $2000.00 out of pocket Max. Be aware that Dr. Davis is not an aexcel specialist. I was grandfathered in because I was a patient before he dropped aexcel. Make sure you don't need an aexcel specialist. good luck.

bethanyjoy2824 · April 7, 2008

When you talked with them what are your expected out of pocket costs after the 2k maximum is met with Aetna? I'm trying to figure that out and no one can give me an estimate.

txaberry · April 7, 2008

If you meet the 2k out of pocket maximum, they pay 100%. If you are approved for that benefit, you won't pay more than $2000.00 - I paid the Dr. $325 for my surgery - now the bills from the hospital are coming in so I don't know the totals yet.

bethanyjoy2824 · April 7, 2008

I just talked with Aetna and they said if I have a 10k maximum Aetna will pay towards bariatric, if the surgery is 17k total i will pay the difference of 7k. They told me the 2k out of pocket max only applies to the percentage i pay of the approved amount (10% of the 10k). Paying 7k sounds like a lot...any ideas?

txaberry · April 7, 2008

You may have a different version of Aetna than I do. That sounds kinda confusing. My out of pocket maximum is 2K - since my surgery was pre-certified, its my understanding that that is the max I'll pay. I may be wrong, but I hope not. I think yours is different. Do you have your benefits information where it is all laid out? I called them with that in hand and asked. Also, call and ask to speak with a supervisor - once I got 2 differnt information.