Aetna???

itsadoozy · June 29, 2005

Anyone with Aetna HMO that have been approved?

Alexandra · June 29, 2005

Aetna is a bear. There are way too many issues to generalize about any insurer, but I can tell you I was approved by Aetna after a long fight and third-party review. Since that time (2002-3) they have changed their policies and it's now marginally easier to get approved than when I did it. ON THE OTHER HAND, I've just heard that Aetna is excluding bariatric surgery from their standard large-group plans, so check your policy for an exclusion before you do anything else.

Are you medically qualified, as far as you know, for bariatric surgery? That's the first and biggest question. What's your BMI?

itsadoozy · June 29, 2005

Hi Alex,

I actually checked my policy last night, and it was amended to include weight loss surgeries as of 1/2005. That's about all I understood whith all the goobledy-gook insurance talk! And I work for Allstate! haha!! My BMI was 39.43

keri · June 29, 2005

i have Aetna- but a PPO and was orignally denied but I appealed and was approved for coverage- I was banded on 6/15.

Alexandra · June 29, 2005

Hi Alex,
I actually checked my policy last night, and it was amended to include weight loss surgeries as of 1/2005. That's about all I understood whith all the goobledy-gook insurance talk! And I work for Allstate! haha!! My BMI was 39.43

Well then! If your policy absolutely includes bariatric surgery, the next step is to see if you and your doctors can make a case for you medically. Your BMI is just below 40 so you'll need to list co-morbidities. Do you have a surgeon yet?