What should I do before filing a claim with Aetna?

[cmaneice 0]

Hello everyone, any assistance I can get will be greatly appreciated. My doctor (I am overseas) has determined that I am a great candidate for the lapband and they are willing to do the necessary paperwork to try to get me approved through my Aetna insurance. What should I begin to do i.e. I have read some being a 3 or 6 month diet, ask my doctor or diet pills, etc....I am also looking for support as I go through this process hope to get a response soon.

[bkladyp 0]

It would be best to call your Customer Service at Aetna. They will tell you if your surgery is covered and what are the criteria to submit your paperwork. They have a website page that has all the criteria included Obesity Surgery that link should work for you. But again the best thing to do is call to make sure your company doesn't exclude the surgery or say it is medically necessary. I had to do the six month diet. Hope this helps. I have the Aetna POS II NAP.

[cmaneice 0]

thank you for your suggestion, I did call my insurance company and they said it was NOT covered....here's the possible catch....I may be reimburse for the standard tests, x-rays, etc...except the actual surgery and/or antesthia(sp???). I am looking to have the surgery done in July but definetly no later than September....I scrubbed the website like crazy but could not find any information on obesity surgery...another thought is I have accepted a new job and under this company I may be eligible for the surgery working so many things but preparing to pay the cost if necessary