Aetna - what does this mean?

[Stevee 0]

ok i have a question for you all... since my employer exludes weight loss surgery i'm checking on getting added to my partners insurance. she has Aetna. I was looking online today at the covered benefits and exclusions and limitations and this is what i found under exclusions and limitations...

"Surgical operations, procedures, or treatment of obesity, except when specifically approved by HMO."

what does this mean?!?!? i'm hoping this is a good thing! crossing my fingers!

[Alexandra 55]

That means they generally exclude all WLS procedures, but might conditionally approve them. In other words, it says a whole lot of nothing. What kind of plan is it? Is it a large company or a small group?

[Stevee 0]

its neither really. its not a huge company but its not a small company either.

[rroswelltx 1]

It probably means that they will approve on a case by case basis depending on if you have any co-morbilities. Aetna paid for mine.