Just got hit with an unexpected today - found out that on my company Aetna plan where it says they will cover 100% of WLS if you use one of thier Centers of Excellence, is not really 100%. Apparently (and I called Aetna to verify - the lady I got had to go ask someone else cause she did not know) the Surgeon and the Anesthesiologist are not covered at 100% - they are 80% covered. The Surgeons office called me up and said I will need to pay $523.36 (my 20%) but I have no idea what the Anesthesiologist is and what I need to pull from savings.

Does anyone who has had thier sleeve done know what the Anesthesiologist "agreed" rate is with Aetna?

Thanks!

That is so weird. Why are the surgeon and anesthesiologist only covered at 80%?

Yes it is weird, and painfull. It would have been nice knowing it more than the day before I have to write the checks!

Don't get me wrong, I am big time gratefull that it is covered at all. So many people on this forum have to pay 100% and then have to fly across or out of the country alone for thier surgery.

I wouldn't mind paying $500 for the anesthesiologist rate, I got hit with a bill for $4,100 from the anesthesiologist.

on the bill it says that the insurance company did not respond, whatever that means. I'm calling them up and asking them to resubmit.

i find it absurd that the surgeons office nor the insurance company wouldn't follow up with this prior to surgery. I got hit with 2 bills grand totaling $10,000. If I wanted to pay $10,000, I would have paid out of pocket

fight it if you can, have them resubmit it. do whatever you can.