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Insurance Question (Aetna)

MicheleK

By MicheleK, in Insurance & Financing

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MicheleK    8

MicheleK
Posted

I'm a little confused....my Aetna plan covers Lap Band, no problem...they also cover RNY, but not both on the same patient. Obviously, I've decided to go with Lap Band...my confusion is this...

Aetna will only cover ONE WLS surgery the life of the plan, no problem there...I understand that. However, today when I was speaking to a rep from Aetna I asked, "what if my band goes bad, or something happens to it? Will you guys pay to fix it?". Her answer was, that they will pay for any medical complications that arise from the WLS I choose.

I'm confused....if my band goes bad, or if my port flips or, I spring a leak...are they going to pay for fixing/possibly replacing my band? Or will they just say "take it out" and that's it???

I don't get it, and she really didn't explain further.

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moonandstarzz    0

moonandstarzz
Posted

im not quite sure but i have aetna, with how i read what u post i think that if something goes wrong and needs fixing that they will cover the fix. thats what it sounds right, or if just getting removed for complications.

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Flowerpurr    0

Flowerpurr
Posted

Aetna will cover band slipage if something goes wrong. If you need it removed for what ever reason they will approve another surgery with no problem. You won't have to jump through any hoops. Just an FYI make sure Aetna sends your Dr.'s office a letter before you get the surgery. They called my Dr.'s office said I was approved and didn't send a letter. I go to surgery on the 15th of next month and my Dr.'s office won't perform the surgery until the letter arrives. I just think it's one of Aetna's tricks to slow down the already very long process. GOOD LUCK!!! :thumbs_up:

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MicheleK    8

MicheleK
Posted

YAY! Thanks for the info guys :thumbs_up: I'll check on that letter today.

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Go To Topic Listing Insurance & Financing

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    • Alisa_S

      Alisa_S

      On day 4 of the 2 week liquid pre-op diet. Surgery scheduled for June 11th.
      Soooo I am coming to a realization
      of something and I'm not sure what to do about it. For years the only thing I've enjoyed is eating. We rarely do anything or go anywhere and if we do it always includes food. Family comes over? Big family dinner! Go camping? Food! Take a short ride or trip? Food! Holiday? Food! Go out of town for a Dr appointment? Food! When we go to a new town we don't look for any attractions, we look for restaurants we haven't been to. Heck, I look forward to getting off work because that means it's almost supper time. Now that I'm drinking these pre-op shakes for breakfast, lunch, and supper I have nothing to look forward to.  And once I have surgery on June 11th it'll be more of the same shakes. Even after pureed stage, soft food stage, and finally regular food stage, it's going to be a drastic change for the rest of my life. I'm giving up the one thing that really brings me joy. Eating. How do you cope with that? What do you do to fill that void? Wow. Now I'm sad.
      · 0 replies
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    • Alisa_S

      Alisa_S

      On day 4 of the 2 week liquid pre-op diet. Surgery scheduled for June 11th.
      Soooo I am coming to a realization
      of something and I'm not sure what to do about it. For years the only thing I've enjoyed is eating. We rarely do anything or go anywhere and if we do it always includes food. Family comes over? Big family dinner! Go camping? Food! Take a short ride or trip? Food! Holiday? Food! Go out of town for a Dr appointment? Food! When we go to a new town we don't look for any attractions, we look for restaurants we haven't been to. Heck, I look forward to getting off work because that means it's almost supper time. Now that I'm drinking these pre-op shakes for breakfast, lunch, and supper I have nothing to look forward to.  And once I have surgery on June 11th it'll be more of the same shakes. Even after pureed stage, soft food stage, and finally regular food stage, it's going to be a drastic change for the rest of my life. I'm giving up the one thing that really brings me joy. Eating. How do you cope with that? What do you do to fill that void? Wow. Now I'm sad.
      · 1 reply
      1. summerseeker

        summerseeker

        Life as a big person had limited my life to what I knew I could manage to do each day. That was eat. I hadn't anything else to look forward to. So my eating choices were the best I could dream up. I planned the cooking in managable lots in my head and filled my day with and around it.

        Now I have a whole new big, bigger, biggest, best days ever. I am out there with those skinny people doing stuff i could never have dreamt of. Food is now an after thought. It doesn't consume my day. I still enjoy the good home cooked food but I eat smaller portions. I leave food on my plate when I am full. I can no longer hear my mother's voice saying eat it all up, ther are starving children in Africa who would want that!

        I still cook for family feasts, I love cooking. I still do holidays but I have changed from the All inclusive drinking and eating everything everyday kind to Self catering accommodation. This gives me the choice of cooking or eating out as I choose. I rarely drink anymore as I usually travel alone now and I feel I need to keep aware of my surroundings.

        I don't know at what point my life expanded, was it when I lost 100 pounds? Was it when I left my walking stick at home ? Was it when I said yes to an outing instead of finding an excuse to stay home ? i look back at my last five years and wonder how loosing weight has made such a difference. Be ready to amaze yourself.

        BTW, the liquid diet sucks, one more day and you are over the worst. You can do it.

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