Aetna PPO in California . . .

[Guest guest]

Does anyone out there have Aetna PPO for insurance and live in

California (and go to cranial Technologies in Burbank for the DOCband)?

Here is why I ask: Cranial Techologies is " out of network " under

Aetna (and all insurance companies). Therefore, under our insurance

plan, we will have to pay the deductable first. Then, Aetna pays 80%

of the USUAL AND CUSTOMARY COST of the band for the specific area we

live in (i.e., Los Angeles). Then, we pay the remaining 20% AND

whatever amount Cranial Tech didn't get from Atena. Now, here is the

kicker: Aetna won't tell me what the usual and customary cost is for

the band!! Therefore, there is no way for us to figure out how much

the band is going to cost us! The band costs almost $4000 out here,

so if the usual and customary cost is, lets say, $100, then we pay:

(1) our deductable, (2) 20% of $100, and (3) the remaining amount owed

to Craninal Tech! Aetna pays, in my example, only $80!!

Anyone else have this problem??

Any help is appreciated!

p.s. - I did call Cranial Tech to see if they could give me some idea

and they are calling me back. I will let you know what I find out.

Daughter Emilie with Tort and positional plagio - 5 months and

awaiting results of x-rays. Assume she will need the band, so

investaging now.

[Guest guest]

I don't have Aetna but we have had a lot of parents that did-and they could probably give you better insight-interesting they aren't in network-are there any providers out there that are reasonably accessible to you that are considered in network because if they aren't then I would fight that. The only thing I know about Aetna is they have this publication about the use of the helmets Click here: Aetna: Cranial Remodeling Band/Helmet

Beck Mom to

doc grad

TN