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I have Aetna and they reqiure three months of PCP monitored diet, psych eval, etc. Well, on Sat during my first visit to my PCP, she looked at me like I had two heads and told me that she doesn't get reimbursed for "weight loss visits". Then she said that she can't get reimbursed for the EKG they did because there was no reason to have one done (Pre-op is not a reason). After a lot of explaining, I convinced her to see me 2 more times (self pay) and she said that she would see me just to agree with whatever the nutritionist is saying.

So for my other visits (abdominal ultrasound, bloodwork, chest x-ray, etc.) do I have to "fake symptoms" so they will cover it? I have an open access plan, so getting the PCP to make a referral isn't an obsticle (thank goodness because she's doing minimal work on this). I need to know if Aetna will pay for my other visits to specialists.

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I have Aetna and they reqiure three months of PCP monitored diet, psych eval, etc. Well, on Sat during my first visit to my PCP, she looked at me like I had two heads and told me that she doesn't get reimbursed for "weight loss visits". Then she said that she can't get reimbursed for the EKG they did because there was no reason to have one done (Pre-op is not a reason). After a lot of explaining, I convinced her to see me 2 more times (self pay) and she said that she would see me just to agree with whatever the nutritionist is saying.

So for my other visits (abdominal ultrasound, bloodwork, chest x-ray, etc.) do I have to "fake symptoms" so they will cover it? I have an open access plan, so getting the PCP to make a referral isn't an obsticle (thank goodness because she's doing minimal work on this). I need to know if Aetna will pay for my other visits to specialists.

In my experience with Aetna, my suggestion is to call them because Aetna tends to make their own rules. Make sure you argue with them if they require you to get these tests inorder to approve your surgery then there is no reason for you to have to pay for them out of your own pocket. That's crazy.

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