Jump to content
×
Are you looking for the BariatricPal Store? Go now!

Aetna Copay?



Recommended Posts

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!

Share this post


Link to post
Share on other sites

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.

Share this post


Link to post
Share on other sites

thats weird it blocked out the H M O

Share this post


Link to post
Share on other sites

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?

Share this post


Link to post
Share on other sites

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

Share this post


Link to post
Share on other sites

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.

Share this post


Link to post
Share on other sites

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!

Share this post


Link to post
Share on other sites

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

Share this post


Link to post
Share on other sites

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

Share this post


Link to post
Share on other sites

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.

Share this post


Link to post
Share on other sites

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

Share this post


Link to post
Share on other sites

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.

Share this post


Link to post
Share on other sites

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.

Share this post


Link to post
Share on other sites

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.

Share this post


Link to post
Share on other sites

Create an account or sign in to comment

You need to be a member in order to leave a comment

Create an account

Sign up for a new account in our community. It's easy!

Register a new account

Sign in

Already have an account? Sign in here.

Sign In Now

  • Trending Products

  • Trending Topics

  • Recent Status Updates

    • vsg.with.sharon

      Hey everyone!
      I’m new here! Looking for some friends! 🥰
      · 0 replies
      1. This update has no replies.
    • LeighaTR

      Four days post surgery. I am sipping as fast as I can and getting NO WHERE near the goal of 60 - 80 grams of protein or the 64 oz of liquids. I just feel FULL. I don't know if it can still be the gas build up (I would think by now that would be gone) but it is a struggle to drink. And so far I have not had the nausea or spasms and don't want to wander into that territory by pushing too hard with liquids. I about passed out today as it was my most "strenuous" day. Went from second story to basement for shower and I was sure I was going to pass out. Looking back on my last few days I have had a total of less than 1000 calories. Am I just not getting enough nourishment in me? Once again a friday where I can't get ahold of the doc until Monday rolls back around so I am hoping maybe someone here has some experience on how to keep energy going. I do have fibromyalgia too and that may be where some added fatigue comes into play. How did you all fair with the goals the week after surgery?
      · 0 replies
      1. This update has no replies.
    • Doughgurl

      2 days until I fly out to San Diego to have my Bypass Surg. in Tiajuana Mexico. Not gonna lie, the nerves are starting to surface. I don't fear the surgery itself, or the fact that I'm traveling alone, but its the aftermath that I'm stressing about the most, after this 8 week wait. I'm excited to finally be here, but I am really dreading the post surgical chapter. I know its going to be tough, real tough and I think I'm just in my head to much now that the day i here. Wish me luck, Hopefully I'm one of the lucky ones, and everything goes smoothly. Cant wait to give an exciting update,. If there is anyone else have a June bypass or even a recent one, Id love to have someone to compare war stories with. Also, anyone near San Antonio Tx? See ya soon with the future me. 💜
      · 3 replies
      1. Phil Penn

        Good Luck this procedure is well worth it I am down to 249.6 lb please continue with the process..

      2. Selina333

        I'm in Houston so kind of near you and had the sleeve in Dec. Down 61 lbs. Feeling better. Was definitely worth it. I hope the everything is going well for you. Update us when you can!

      3. Doughgurl

        I am back home after my bypass surgery in Tiajuana. I'm post op day 4. Everything went great! I guess I'm one of the lucky ones who have not encountered much pain at all, no nausea thus far and I'm having no problem keeping down broths and water. Thank you for your well wishes. I cant wait to keep up this journey and have a chance at better health and simply better quality of life. I know there will be bumps in the road ahead, and everything won't be peaches and cream, but at least I have a great start so far. 😍

    • LeighaTR

      I am new here today... and only two weeks out from my sleeve surgery on the 23rd. I am amazed I have kept my calories down to 467 today so far... that leaves me almost 750 left for dinner and maybe a snack. This is going to be tough for two weeks... but I have to believe I can do it!
      · 0 replies
      1. This update has no replies.
    • Doughgurl

      Hey everyone. I'm new here so I thought I should introduce myself. I am 53y/o and am scheduled for Gastric Bypass on June 25th, 2025. I'm located in San Antonio, Texas. I will be having my surgery in Tiajuana Mexico. I've wanted this for years, but I always had insurance where bariatric procedures were excluded. Finally I am able to afford to pay out of pocket.  I can't wait to get started, and I hope I'm prepared for the initial period of "hell". I know what I have signed up for, but I'm sure the good to come will out way the temporary period of discomfort and feelings of regret. I'd love to find people to talk to who have been through the same procedure or experience before. So I look forward to meeting you all. Hope you have a great week!
      · 2 replies
      1. Selina333

        I'm so happy for you! You are about to change your life. I was so glad to get the sleeve done in Dec. I didn't have feelings of regret overall. And I'm down almost 60 lbs. I do feel a little sad at restaurants. I can barely eat half a kid's meal. I get adults meals often because kid ones don't have the same offerings at times. Then I feel obligated to eat on that until it's gone and that can be days. So the restaurant thing isn't great for me. All the rest is fine by me! I love feeling full with very little. I do wish I could drink when eating. And will sip at the end. Just a strong habit to stop. But I'm working on it! You will do fine! Just keep focused on your desire to be different. Not better or worse. But different. I am happy both ways but my low back doesn't like me that heavy. So I listened (also my feet!). LOL! Update us on your journey! I'm not far from you. I'm in Houston. Good luck and I hope it all goes smoothly! Would love to see pics of the town you go to for this. I've never been there. Neat you will be traveling for this! Enjoy the journey. Take it one day at a time. Sometimes a few hours at a time. Follow all recommendations as best you can. 💗

      2. Doughgurl

        Thank you so much for your well wishes. I am hoping that everything goes easy for me as well. We don't eat out much as it is, so it wont be too bad in that department. Thankfully. Also, I hear you regarding your back and feet!! I'd like to add knees to the list. Killing me as we speak! I'm only 5' so the weight has to go. Too short to carry all this weight. Menopause really did a doosey on me. (😶lol) My daughter also lives in Houston. with her Husband and my 5 grand-littles. I grew up in Beaumont, so I know Houston well, I will be sure to keep in touch and update you on my journey. I may need some advice in the future, or just motivation. Thank You so much for reaching out, I was hoping to connect with someone in the community. I really appreciate it. 💜

  • Recent Topics

  • Hot Products

  • Sign Up For
    Our Newsletter

    Follow us for the latest news
    and special product offers!
  • Together, we have lost...
      lbs

    PatchAid Vitamin Patches

    ×