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Tstone83

Pre Op
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  1. Like
    Tstone83 got a reaction from medicpup2 in Waiting patiently for Aetna to approve my surgery   
    I feel like this has been a long hard journey already. I’ve went through 3 different insurance to finally get approved lol. Our work offers two and my husbands work offers 1. I finally got the right one lol!
  2. Congrats!
    Tstone83 got a reaction from Colorado Cowgirl in Waiting patiently for Aetna to approve my surgery   
    I got my approval today 🥳
  3. Like
    Tstone83 reacted to SusieQ2019 in Waiting patiently for Aetna to approve my surgery   
    The process is quite seamless with Aetna. You are on your way to a healthy you.
    Congrats again!!
  4. Congrats!
    Tstone83 got a reaction from Colorado Cowgirl in Waiting patiently for Aetna to approve my surgery   
    I got my approval today 🥳
  5. Like
    Tstone83 reacted to Jdymitc in Waiting patiently for Aetna to approve my surgery   
    Mine took 8 working days with Aetna
  6. Like
    Tstone83 reacted to Sharon B A in Waiting patiently for Aetna to approve my surgery   
    I'm also with Aetna, they took about 8 working days.
    You should hear soon. 🤞🏾🤞🏾
  7. Sad
    Tstone83 reacted to GettingDHealthy in I have Aetna PPO and I was wondering what I’d have to pay out of pocket. We have a 15% coinsurance.   
    I’m on Aetna PPO and got denied this week even though I meet all of the requirements for surgery. They said that bariatric surgery is not covered under this plan 😞
  8. Like
    Tstone83 reacted to SusieQ2019 in I have Aetna PPO and I was wondering what I’d have to pay out of pocket. We have a 15% coinsurance.   
    Take into consideration that there are different types of AETNA insurance plans and what is required. I have Aetna and there are things listed on the above that I did not need to do or was not required to do. It all depends on the plan your company have. For example my deductible is $1000 and and I am responsible for 10% after I've reached my deductible. The surgeon had a specific list of what my plan required.
    One type of Aetna insurance plan do not fit all.
    Wishing you good luck with your surgery.
  9. Like
    Tstone83 reacted to jg7979 in I have Aetna PPO and I was wondering what I’d have to pay out of pocket. We have a 15% coinsurance.   
    If you have access to Aetna's website, you can access the list of providers.
    aetna-ioq-bariatric-guide.pdf
  10. Like
    Tstone83 reacted to jg7979 in I have Aetna PPO and I was wondering what I’d have to pay out of pocket. We have a 15% coinsurance.   
    It was 2-3 weeks after my last nutrition class. I didn't even know it happened.
    When I received the letter, I called the surgeons office to ask if they needed anything, and they said I was all set. Insurance just sends the standard letter, but no news is good news when it comes to approval.
  11. Thanks
    Tstone83 reacted to jg7979 in I have Aetna PPO and I was wondering what I’d have to pay out of pocket. We have a 15% coinsurance.   
    The best estimate is your out-of-pocket maximum. Between the scopes, scans, and pokes to get cleared for surgery and the actual surgical costs, you are going to reach the max. My advice is to start the process soon to keep all of the costs in the same year, or wait until next year and max out your HSA/FSA contributions to pay for it.
    Before I signed up, I did not realize all of the pretesting that was needed--ultrasounds, x-rays, lab tests, ekg/cardiac, stress test, endoscopy, sleep study, psych clearance, nutrition classes. There were several thousand dollars in bills before I was ever approved for surgery. I have Aetna PPO and they require you to use a facility they designate as a center for excellence, so the requirements may be higher than the non-insurance/cash programs.
    I have been billed about $20k for the actual surgery (hospital, surgeon, anesthesia), but insurance has reduced contracted rates. I will likely receive a couple more bills, but my out of pocket for surgery is about $2500 because I already spent $2000 on the other expenses (not including nutrition classes).
    The hidden costs: All of these appointments and tests require substantial time away from work. Lean Protein and fresh vegetables cost more. Protein Shakes, protein powders, supplements, etc. add up quickly (and you will want variety). I will save on prescription costs though since I will not need several medications anymore.
  12. Like
    Tstone83 reacted to Panda333 in I have Aetna PPO and I was wondering what I’d have to pay out of pocket. We have a 15% coinsurance.   
    Hello, I have Aetna POS II. I'm still in pre-surgery and have been reseraching this. My deductible is $2200 but out of pocket max for in network is $6,000.00. mayo clinic is in network for aetna so my cosgt will be $6000.00 That's why I'm considering Mexico it's $4200.
  13. Like
    Tstone83 reacted to SusieQ2019 in I have Aetna PPO and I was wondering what I’d have to pay out of pocket. We have a 15% coinsurance.   
    I have Aetna EPO plan and my deductible is $1,000.00 plus $50.00-$60.00 for some doctors visits.
  14. Congrats!
    Tstone83 reacted to Panda333 in Aetna is covering my procedure!   
    Hi Everyone, I'm really, really early in my weight loss journey. This board has been invaluable. Still in the insurance phase. I was initially all for going to Mexico because a friend went and had great results as well as the attractive cost and basically not having to wait and deal with red tape. I also feel the drs. in mexico are just as good. I did find out my Aetna PPO will cover in the USA - Hurray. I have a choice of 6 month nutritional counseling or 3 month nutritional and primary dr. visits. I'm opting for the 3 month obviously because I'm an impatient person. I really wanted to go to Jacksonville Florida to the mayo Clinic. But the Mayo clinic bariatric said I wasn't covered. I showed them the info that I was covered and we went back and forth and I finally gave up. I felt sad too because I know Mayo Clinic is top notch and I've had other surgeries there. So after leaving messages at several bariatric providers in Florida, Florida Hospital actually now Advent Heath in Celebration called me back and assigned me an advocate. I know it's not the mayo clinic but its still a good hospital. I gave them my insurance info and what do you know, I'm covered! (Just like I thought) So...just starting my 3 month journey but this post is to let people know to not give up. I have a full time job and it felt like just scheduling and doing this research has been a 2nd full time job. I was willing to spend out of pocket $20k for this surgery in US. Then happy to find it was $4200 for mexico surgery. Now Advent Heath told me my co-pay will be $476.00 I'm elated and plan to use any extra money towards any skin removal surgery, even though everyone says why bother you are in your 40s. I don't care, lol!

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