What should I expect from Aetna?

[Ice_Prince 4]

Well last night I went to the free seminar at Lap Band Solutions Center here in Dallas. I felt that I was given a lot of information. One thing the center office kept talking about was the hoop the insurance company make you go through. Well I have Aetna's Aexcel Plus Choice POS II plan. Which covers the surgery but I have to meet certain stipulation so far they only told me about the 3 month doctor supervised diet. What else should I be expecting my Consultation is next Friday the 14th and I guess I want to be some what inform so I wont be surprised.:tongue2:

[Lady Lap Band 71]

I went to my seminar on Dec. 8th 2008 and originally was told Aetna was one of the harder insurances to get to cover this surgery. I'm not really sure why I was told that though, I had no problems at all. The hospital submitted my request for surgery after I had completed the 3 months, and then Aetna requested a few more pieces of paperwork (which I was told was normal) and then I got the letter saying that I was approved.

I paid absolutly nothing out of pocket, nothing for any visits or anything. I feel like Aetna gave me this amazing free gift lol and I love them so much for it haha.

I know plenty of other people who have Aetna as well and had no problems getting them to cover the lap band. You do however have to have a BMI of at least 40 or a minimum of 35 with other co morbitities.

Feel free to contact me if there are any other questions you think I can answer for you. Check out my blog too because you might find some other answers to questions you might have!!!! Good Luck!!!!

[Julia_N 2]

It might depend on which type of Aetna you have. Mine required a 6-month preop diet and lots of consultations, which I was able to complete in a month. I should have gotten banded sooner than I did, but I got pneumonia in February and was delayed a few months. I had paid all my out-of-pocket deductible during the February stay, so I paid nothing for my Lapband procedure. If you've already been dieting and have records of it, such as visits to your doctor for weight loss, then that counts toward your preop diet.

Good luck!

[Ice_Prince 4]

Thanks I will keep you all informed. Wish me luck!!!!!!!!

[thomplk 0]

HI, I'm also just starting the process for lapband I went to the lapband soultions seminar in Houston, and my first consultation was monday 08/10/09, and I also have the same exact plan with Aetna, so have u heard anything back from them?

[Ice_Prince 4]

Hey All-

Well today i had my consultation, everything went well. My EKG was normal I'm going to Quest tomorrow for my blood work. Well they contacted Aetna I have to be on a 90 day diet and see a nutritious. The only thing i am worried about is Aetna also want 2 years of my recorded weight showing my BMI over 40 well 2008 I have but I dont remember if i went to the doctor in 2007 so I hope I find it.:thumbup: I never had a PCP. All in all i am so excited. I am ready to for a change.

I will keep you all posted my next appointment is 09-15-09.

[Lady Lap Band 71]

Did you do weight watchers or anything else that would have recorded your weight in that time period? If you did I am pretty sure insurance accepts things like that. Cant wait to hear about your appt on 9/15!

[48Cyns 0]

I agree with Breanne, alot of people say Aetna is just impossible but mine was really, really fast. They have changed their policy in the last couple of months because now you can do the 90-day surgical prep instead of the 6-months of doctor visits. My doc submitted the paperwork on July 31st and on August 4th I had an approval - surgery is next week. YIKES! :biggrin:

[pixieinyourpocket 0]

I have Aetna PPO and had several questions regarding what was expected of me during the process. When I asked about Weight Watchers being a recorded weight history for all the times I had gone and followed their program it wasn't enough. Along with all the other programs that I had tried to loose weight with during my struggle of being a "fat" person. I still needed to be seen by a PCP and a nutritionist during my 90 day period. I am almost done with having all my ducks in row. Yeah... good luck with yours as well.

[fatmom 0]

I have Aetna too. What I did was just called the number on my card and told them I was considering the surgery and I wanted to ALL the prerequisites for being approved. The nice lady gave me a web address to go to that listed what my particular policy required.

I will say for the most part everything went smoothly for me. Except this past weekend I received a letter saying they hadn't rec'd my documentation of the 6 month diet. Well, I hand carried that from my PCP to the surgeon, so Monday bright and early I called them and told them so. I was informed my approval was pending. DUH! I said, yes, because you're claiming you don't have the paper work that I'm telling you, you do have. So she went away for a minute and came back and said I was approved. I said, I am? She said, yes. You were approved last Friday, but we couldn't get a hold of your surgeon's office. Don't worry about the letter, everyone gets them.:sad:

All I know is, I'm approved, I go under the knife 9/14 and I'm scared stiff.

Good luck!