Aetna Insurance Help

[rking 484]

Is there anyone out there who has gone through Aetna insurance? I just want to make sure I have all my ducks in a row because they have a lot of requirements.

Thank you in advance!

[dede0314 356]

I have Aetna. My main advice is to make sure you do not gain weight during your program. Do you have any specific questions?

[Chele H 427]

You should get the requirements for your particular plan with Aetna in writing and work with your surgeon's insurance coordinator to get through the process. The insurance coodlrdinator should know exactly what to do.

[dede0314 356]

Yes I agree you should call and make sure your plan doesn't have any special requirements. When I called they told me to look at this bulletin

http://www.aetna.com/cpb/medical/data/100_199/0157.html

[rking 484]

Thank you for the responses! I have the fine print from Aetna (not in writing but great idea). Have also talked with coordinator at doctors office. I know she knows what she is doing, but I want to make double sure. It's scary leaving it up to others . I am doing the three month pre surgery thing and I'm a little concerned about the supervised exercise program. Dr office told me the nutritionist qualifies for that, nutritionist says she's not. I am exercising and know what to do, just concerned about "supervised exercise program". Also, does she qualify for "behavior modification"? Dr office says she does. I guess I need to just trust them.

[wwboy 141]

I've got Aetna and I left it up to my case manager. Figured it would work out if it was meant to be.

I was approved for the sleeve last week. Bmi of 39 and several co morbidities

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[jembell01 129]

I'm with Aetna also. I am doing the 90 day multidisciplinary option. I've had 2 nutritionist visits, psych evaluation, initial assessment with my doctor and am waiting on the day for my EGD. I have 2 nutritionist visits left and my follow up with my doctor after the last nutritionist visit. Dr said I should be able to have surgery by the end of Christmas. Just hoping there are no issues with insurance approval ????

[Natosha Williams 3]

I have Aetna as well. I followed the 90 day track and was approved. And like dede0314 said, don't have a net gain. Good Luck!

[Lexigurl82 160]

I have Aetna and I was approved on yesterday for the gastric sleeve. It's very important that you do not gain weight during the 3 month or 6 month program. I did the 3 month process and had to have one psyc visit, 3 visits with my NUT, 4 visits with my surgeon, a sleep study, chest x-ray, EKG and PFT (Pulmonary Function Test). I don't know if Aetna requires all these exams but it was on the checklist that my surgeon's office gave me. Call Aetna and have them email or mail you the requirements for your plan because every plan is different. Good luck!

[rking 484]

Actually, I have now completed all the requirements and my paperwork will be mailed to Aetna on Monday!!! I lost at least one pound every month. I feel I will be approved. Had my EGD last Friday and showed positive for h pyloric bacteria so am on heavy antibiotics. Surgery is scheduled for November 17. I am excited and scared to death. Pre op liquid diet starts Nov 3. I am really worried about losing a ton of hair. I know not everyone does, but I was once on this medication that made my hair fall out. It has never recovered. It is kinda thin in the middle front and it thinned somewhat everywhere else. I am considering Rogain or something similar a month or two after surgery . I guess I am really vain haha. Good luck to all of you!

Lexigurl, how long did your approval take?

[Lexigurl82 160]

@@rking my approval took a week. I was really surprised that it was so quick because Aetna told me it could take 15-30 days for a decision. Good luck and keep us posted!

[Denise Morales 0]

I have Aetna, and I believe the requirements might be state specific, or the type of coverage you have with Aetna. I live in Ny and I had a 4 month weight in periods, then was approved. I started my liquid diet on 10/19/15, and my surgery was 11/4/15. To this date 3weeks later, I have lost 25lbs. Check your plan, or better yet the medical profession that will be doing the surgery will verify your coverage. Best of luck, it's worth the journey.