Hi my name is Kim I now have beech street insurance my insurance is changing Aetna ... My insurance before covered wls I want to kno is there anyone with this insurance and what was the process like I'm in the middle of my process with just sleep study , phys eval and six month diet .. The enrollment for this new insurance is in June and it will take effect in August .... So I just want alittle in site on it I kno insurance varies depending what your employers pick ...

My insurance before covered wls I want to kno is there anyone with this insurance and what was the process like ...

Ebonieskin

hi there,

I would definitely call Aetna. You must go right to the hores mouth.

We could tell you probably and maybe this or that - but you need to know officially if Aetna accept WLS and any other questions. IMO. Good luck.

See you at the finish line as you start on your lifelong journey. good luck

kathy

I'm not a member yet so Do u think calling will help usually when call a insurance company they ask for your member ID but maybe I should call to find out in general .. Thank you Kathy imma do that appreciate you

You can get a summary sheet from your company's benefit administrator.

You then have several options.....

1. Your company has chosen an option that includes WLS. Call the Aetna administrator to let them know that you have been pre-approved for the surgery and inquire what documentation Aetna will require to uphold your previous insurer's decision.

2. Your company has chosen an option that does NOT include WLS. You can opt out of enrolling in the new insurance and choose to go on COBRA with the old insurer. There are challenges with this option. You must pay the entire premium out of pocket. It cannot come from your paycheck (otherwise you may be transferred to Aetna's COBRA who would of course deny your request).

3. Do nothing/Pay out of pocket.

You can get a summary sheet from your company's benefit administrator.

You then have several options.....

1. Your company has chosen an option that includes WLS. Call the Aetna administrator to let them know that you have been pre-approved for the surgery and inquire what documentation Aetna will require to uphold your previous insurer's decision.

2. Your company has chosen an option that does NOT include WLS. You can opt out of enrolling in the new insurance and choose to go on COBRA with the old insurer. There are challenges with this option. You must pay the entire premium out of pocket. It cannot come from your paycheck (otherwise you may be transferred to Aetna's COBRA who would of course deny your request).

3. Do nothing/Pay out of pocket.

I would add another option. If its not covered talk to your employer and explain where you are in the process and see if it's covered. Depending on if your company is fully insured, self-insured or fully funded, your employer may be able to override any exclusion. Plus, if Aetna generally covers it, your employer may not opt for the coverage.

Thanks ladies very helpful .. I haven't been pre approved yet I'm still in process