Hey Y'all!

I'm a newbie just starting my 90 day 'hoop jumping' and I have a few questions about Aetna.

My surgery will be covered at 100% after deductible (YAY for great insurance!!) but my surgeon will only be covered at 70% after deductible.

As for the labs, upper GI, phsych eval and physical therapy appointment...will they be covered at 100% b/c the surgery is? Were they covered for you or did you pay out of pocket?

I have everything scheduled (upper GI tomorrow, YIKE!) and I'm wondering if I'm going to have to pay out of pocket. I appreciate any insight!

Thanks for sharing!

I have Aetna ***. I was in the hospital 3 days. My deductible was $500 per day. That covered surgery, anesthesiology, the room, everything. My total was $1500 for everything. I couldn't believe it was so cheap! I would say call Aetna to find out if that is the case for your insurance. My insurance is getting ready to change. If I had this done later, it would have been $3000.

I have Aetna also. I had to pay my portion of each step along the way. My coverage is 85/15 so I had to pay 15% of each step (psych eval, test, etc). Then once I had my surgery in January, I met my out-of-pocket max so I am covered at 100% for the remainder of the year. I am SO thankful for insurance!

I also have Aetna PPO. Ur out of pocket will depend on the terms agreeded upon by ur employer. My surgeon & hospital were out of network but he accepted the Aetna payment and did not pass the difference on to me. I pd about $300 for all lab & evaluations after insurance. My first preop visit i pd the $10 copay. Also, look into hospital copays..we do not have one but was billed for one which Aetna worked out for me. Rambling sorry on the bus now...take advantage of the nurse from Aetna they will call to check on u & make sure u understand how to eat, what ur pain level is or your incisions..

I have atena and they only paid half it cost me 11000 out of pocket I could have gone to Mexico for half oh well

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I have had to fight Atena every step of the way. Remember the people that approve or deny are not doctors but a hourly employee manning the phones. When ever they say no do not believe it just keep on going and fighting up the personnel chain till you get the right person to approve.