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

Recommended Posts

I've had LOTS of experience dealing with Aetna for banding, none of it good.

The two most important questions you have to have answered are:

Is banding covered under your contract?

Are you medically qualified for banding or other bariatric surgery?

If both of these are yes, you will be able to get Aetna to pay for it but there are hoops they'll make you jump through. But if either of these are no, you will have a problem.

Share this post


Link to post
Share on other sites

Aetna told me that I would have to do a three month doctor supervised diet prescribed by a nutritionist. It had to be documented in my chart and THEN they would approve the surgery. Currently, I am waiting on approval. Hope this helps. Sheila

P.S. I have Chickering which is a sub-company of Aetna. Chickering is the student form of Aetna so maybe the reqs are tighter. Good luck.

Share this post


Link to post
Share on other sites

I have Aetna and it was relatively easy to get approved. However, I have Aetna PPO not HMO so that may have made the difference.

There were certain criteria I had to meet in order for the surgery to be deemed medically necessary. I had been working on my weight with 2 different doctors for over 2 years so I had the medically supervised diet taken care of. I had to have a BMI of at least 35 with co-morbidities (I have high blood pressure, insulin resistance, high triglycerides, BMI of 39.9) or a BMI of 40. They also required a psych eval and a nutrition eval. I also included a letter of support from my PCP and I think that helped. There are also blood tests that need to be submitted.

First I would call customer service and make sure Lap Band is covered by your specific benefits and document who you talk to in case you run nto problems later. Start making appointments to get your blood drawn and evals done and request you records.

Good luck on your journey!! Let us know how it goes...

Share this post


Link to post
Share on other sites

I have Aetna as well. I am doing my 2 month of supervised diet. I am a light weight so I hope not to lose too much. My BMI is 38 and I am tired of dieting and 'regaining' more weight.

Share this post


Link to post
Share on other sites

I have aetna ppo also. I know they cover the surgery. i qualify, i have diebetes and at 40bmi. but, when u call they won't tell u the criteria. so, they tell u your dr. should know. my surgeon appt is in March. Hr said if i get denied after they put it in.. they will corporate then.. to find out exactly. I think insurance is going to hold me back. good luck.

Minnie:):)

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

    • Mr.Kantos

      Just signed up. Feeling optimistic.
      · 0 replies
      1. This update has no replies.
    • Frugal

      Welcome to Frugal Testing, where we are committed to revolutionizing the software testing landscape with our efficient and affordable solutions. As a pioneering company in this field, we understand the challenges faced by startups, small to medium-sized businesses and any organization working without budget constraints. Our mission is to deliver top-notch testing services that ensure the highest quality of software, all while keeping your costs in check.
      Frugal Testing offers a comprehensive suite of testing services tailored to meet diverse needs. Specializing in different types of testing including functional testing, automation testing, metaverse testing and D365 testing, we cover all bases to guarantee thorough software quality assurance. Our approach is not just about identifying bugs; it's about ensuring a seamless and superior user experience.
      Innovation is at the heart of what we do. By integrating the latest tools and technologies, many of which are cutting-edge open source solutions, we stay ahead in delivering efficient and effective testing services. This approach allows us to provide exceptional quality testing without the high costs typically associated with advanced testing methodologies.
      Understanding each client's unique needs is fundamental to our service delivery. At Frugal Testing, the focus is on creating customized testing strategies that align with specific business goals and budget requirements. This client-centric approach ensures that every testing solution is not only effective but also fully aligned with the client's objectives.
      Our team is our greatest asset. Composed of skilled professionals who are experts in the latest testing techniques and technologies, they bring dedication, expertise and a commitment to excellence in every project. This expertise ensures that our client’s software not only meets but often exceeds the highest standards of quality and performance.
      Frugal Testing is more than just a service provider; we are a partner in your success. With a blend of quality, innovation and cost-effectiveness, we are here to help you navigate the complexities of software testing, ensuring your product stands out in today's competitive market. 
      · 0 replies
      1. This update has no replies.
    • ChunkCat

      I have no clue where to upload this, so I'll put it here. This is pre-op vs the morning of my 6 month appointment! In office I weight 232, that's 88 lbs down since my highest weight, 75 lbs since my surgery weight! I can't believe this jacket fit... I am smaller now than the last time I was this size which the surgeon found really amusing. He's happy with where I am in my weight loss and estimates I'll be around 200 lbs by my 1 year anniversary! My lowest weight as an adult is 195, so that's pretty damn exciting to think I'll be near that at a year. Everything from there will be unknown territory!!

      · 3 replies
      1. AmberFL

        You look amazing!!! 😻 you have been killing it!

      2. NickelChip

        Congratulations! You're making excellent progress and looking amazing!

      3. BabySpoons

        So proud of you Cat. Getting into those smaller size clothes is half the fun isn't it?. Keep up the good work!!!!

    • BeanitoDiego

      I changed my profile image to a molecule of protein. Why? Because I am certain that it saved my life.
      · 1 reply
      1. BabySpoons

        That's brilliant! You've done amazing!! I should probably think about changing my profile picture at some point. Mine is the doll from Squid Games. Ironically the whole premise of the show is about dodging death. We've both done that...

    • eclarke

      Two years out. Lost 120 , regained 5 lbs. Recently has a bout of Norovirus, lost 7 pounds in two days. Now my stomach feels like it did right after my surgery. Sore, sensitive to even water.  Anyone out there have a similar experience?
      · 0 replies
      1. This update has no replies.
  • 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

    ×