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Aetna Copay?

Hey all, I just submitted my paper work in to my new doctor, and we are waiting to hear what other pre op tests I need to do. Back in July I had Cobra insurance, and after going through all the pre op tests with a doctor in my town, I was denied. I have Aetna now, and am going to an in network hospital and doctor about an hour away. Did anyone else with Aetna have to pay a copay? My insurance is called Aetna open choice ppo if that helps at all. Either way, I can't wait to get sleeved!

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Hey all, I just submitted my paper work in to my new doctor, and we are waiting to hear what other pre op tests I need to do. Back in July I had Cobra insurance, and after going through all the pre op tests with a doctor in my town, I was denied. I have Aetna now, and am going to an in network hospital and doctor about an hour away. Did anyone else with Aetna have to pay a copay? My insurance is called Aetna open choice ppo if that helps at all. Either way, I can't wait to get sleeved!

I have Aetna ***, I think PPO is better. Anyway,the only copays I had were for the actual visits prior to being sleeved and labs and diagnostic stuff. Aetna is also an insurance that doesn't always require you to wait six months. I only had to wait 3 months but it took me almost 3 months to get all the required stuff done. Post op the surgeon should see you for 90 days with no copays. after that im not sure . good luck.

thats weird it blocked out the H M O

  • Author

I saw that in the email I got, i wondered if you were swearing! Would I still have to wait 3 months if I already did a 6 month supervised diet with my other insurance? (one more question!) did you pay anything out of pocket for the surgery?

I don't think you have wait as long as its with in 2yrs u should be good I also have Aetna ppo .. I have three more diet visit and eval then off to submit papers

Nothing out of pocket for the surgery and I am not sure if you will have to re do the waiting. If you are using the same surgeon but just have the different insurance, I would guess that you wouldn't have to wait. Your surgeon already has all the info and just needs to submit it.

  • Author

I had to get a new surgeon too, he's not in network with Aetna and they are training to be a center of excellence so they don't take self pay patients. With Aetna, out of network they would only cover half so I'd have to pay that 15k before surgery. Plus, they are charging 30k total for the surgery that the others in the area are charging 12-15. It's frustrating!

wow! I recently received my explanation of benefits and my insurance paid 130,000 for my surgery and hospital stay.

  • Author

What did you pay 130 for! Holy cow. Did you have any complications? All the stuff from the doctors say that it's going to be 13 even, all including anesthetic and all that jazz

my insurance paid it . Ummm... I have no idea, I just assumed that was the going rate and never questioned it cause it was paid 100% by the insurance.

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I'm nosy, i would want to know! Even if it was covered

I looked at the eob and it all looked legit. I'll have to find it and scan it in so you can see it

I looked at the eob and it all looked legit. I'll have to find it and scan it in so you can see it

Please share your eob. That is a crazy high price. Typically up 30,000 is normal.

I have Aetna open choice as well. I could have gone to Mexico for much cheaper than what I am having to contribute. My policy is a 75/25 plan and I just got off the phone with the hospital. I will need $5005.00 for just them next Thursday. I have spent over $3000. on co pays for all the lead up stuff. American health care is crazy but I have not seen a better system as of yet. American doctors put the fear of complications if you go outside te country. You better believe that I will go out of country if I decide tat I need plastic surgery.

It was 13000 just for the bills from the hospital not including the surgeons fee. I found one EOB currently looking for the other cause I'm kind of curious now.

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