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Beware of exact coverage-- Aetna



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My surgery was Oct 8th. I followed 3 mo. plan required w/Aetna.

I"m just now seeing figures on my Aetna acct online for expenses.

They're still denying the psych consult costs because now they said I needed a preapproval thru ANOTHER company.

There was nothing in any papers, phone conversations, medical plan booklets, etc that said I needed preapproval thru another source for psych consult.I dont know how they expected me to pull the name & number out of the air as to who I was supposed to get approval thru. I read what was sent to me regarding requirements for weight loss surgery. It tells what is required in order to have the surgery but does NOT mention they dont pay for nutrition or psych consults.

To be honest, the drs office told me their cost would cover all of my medical expenses & requirements for the sugery. My mistake for not getting what "all costs" were in writing.

I'm lookin at a bill of over $500 but I'll appeal/fight it if/when it's denied.

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I also have Aetna and wanting to get the lap band. I am going to follow the 3 month plan. I have attended a seminar in my area and meeting with the dietician on tues 11/17 my concern is that the center I'm going to says they are not familiar with the Aetna's 3 month plan only the 6 month. If you can give me some information on what you did, I would greatly appreciate it. I would hate to go through this and be told that I didn't follow their requirement and have to start all over again. thank you

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Yvette,

If you go on the Aetna navigator and download the requirerments it does say 6 months not 3, however my doctor was able to get approval with his 3 month nutrition counseling. Check with your sugeon's office they are good at working the system.

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