Guest guest Posted May 6, 2000 Report Share Posted May 6, 2000 Dear L. I was so excited when I read your post. I have Aetna U.S. Healthcare as well. Did they give you a hard time? My plan specifically sais that it will not cover surgery for Obesity of any kind. I haven't been rejected yet but I know it's comming I was going to switch companies,but you have given me hope. I am very happy for you...Good luck..I hope to be there soon. Susie0805@... ________________________________________________________________ YOU'RE PAYING TOO MUCH FOR THE INTERNET! Juno now offers FREE Internet Access! Try it today - there's no risk! For your FREE software, visit: http://dl.www.juno.com/get/tagj. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 6, 2000 Report Share Posted May 6, 2000 Hi Call me MJ I to have Aetna US Healthcare (NyCare) I have not read my plan yet do you no if it is the same. Could you tell me also how long did it take for you to be approved. And did they approved you the first time or did you have to appeal. MJCLARK521@... please email me thank you MJ RN of land Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 6, 2000 Report Share Posted May 6, 2000 Dear Art, We are in the same boat. I have Aetna Us Healthcare as well. My contract specifically states that it will not cover Surgery for Obesity. However....Jennefer L posted and they approved her ...So there is hope. Good luck to us both Susie0805@Juno .com ________________________________________________________________ YOU'RE PAYING TOO MUCH FOR THE INTERNET! Juno now offers FREE Internet Access! Try it today - there's no risk! For your FREE software, visit: http://dl.www.juno.com/get/tagj. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 6, 2000 Report Share Posted May 6, 2000 Artie: How did you find all this informationo. I have BCBS Preferred Plus in Michigan and I have not found anything on the internet. {{{{{HUGS}}}}} in Michigan Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 6, 2000 Report Share Posted May 6, 2000 I Also have Etna US Healthcare the PPO plan. I filed a week ago and they claim they never got my papers. I found that funny because I called 2 days after they were sent and someone else said they had received them and it would take a week to process them. I was also given a name and a fax number to send them to someone that would be taking care of this type of procedure. If you visit Etna's Site on the web it gives you the coverage for that procedure. Artie ----------------------------------------------------- Click here for Free Video!! http://www.gohip.com/freevideo/ Re: Re: Aetna Us Healthcare Hi Call me MJ I to have Aetna US Healthcare (NyCare) I have not read my plan yet do you no if it is the same. Could you tell me also how long did it take for you to be approved. And did they approved you the first time or did you have to appeal. MJCLARK521@... please email me thank you MJ RN of land ------------------------------------------------------------------------------ ------------------------------------------------------------------------------ This message is from the Mini-Gastric Bypass Mailing List at Onelist.com Please visit our web site at http://clos.net Get the Patient Manual at http://clos.net/get_patient_manual.htm Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 6, 2000 Report Share Posted May 6, 2000 I Also have Etna US Healthcare the PPO plan. I filed a week ago and they claim they never got my papers. I found that funny because I called 2 days after they were sent and someone else said they had received them and it would take a week to process them. I was also given a name and a fax number to send them to someone that would be taking care of this type of procedure. If you visit Etna's Site on the web it gives you the coverage for that procedure. Artie ----------------------------------------------------- Click here for Free Video!! http://www.gohip.com/freevideo/ Re: Re: Aetna Us Healthcare Hi Call me MJ I to have Aetna US Healthcare (NyCare) I have not read my plan yet do you no if it is the same. Could you tell me also how long did it take for you to be approved. And did they approved you the first time or did you have to appeal. MJCLARK521@... please email me thank you MJ RN of land ------------------------------------------------------------------------------ ------------------------------------------------------------------------------ This message is from the Mini-Gastric Bypass Mailing List at Onelist.com Please visit our web site at http://clos.net Get the Patient Manual at http://clos.net/get_patient_manual.htm Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 6, 2000 Report Share Posted May 6, 2000 I copyed the page from there site for you to read. I read it like we are coverd if we meet what they ask for? Artie Number 157 Subject: Surgical Treatment of Obesity Policy Aetna U.S. Healthcare covers the surgical treatment of obesity when the following criteria are met: (These criteria were adapted from the NIH Consensus Conference on Surgical Treatment of Morbid Obesity.) 1.. Presence of morbid obesity, defined as a body mass index (BMI)* exceeding 40 or greater than 35 in conjunction with severe co-morbidities such as cardiopulmonary complications or severe diabetes; AND 2.. documented history of repeated failure of physician-supervised medical/dietary therapies. Medical Director approval for coverage of the surgical treatment of obesity is required on a case by case basis. *BMI is calculated by dividing a patient's weight (in kilograms) by height (in meters) squared. To convert pounds to kilograms, multiply pounds by 0.45 To convert inches to meters, multiply inches by .0254 Candidates for revision of gastric restrictive surgery must have a complication of the original procedure, such as obstruction or stricture. In addition, revision of gastric restrictive or bypass surgery, which has failed due to dilation of the gastric pouch, is appropriate if the original procedure resulted in weight loss prior to the pouch dilation. Note: As a high incidence of gallbladder disease (28%) has been documented after surgery for morbid obesity, Aetna U.S. Healthcare covers routine cholecystectomy in concert with elective bariatric procedures. Background Accepted surgery for morbid obesity, termed bariatric surgery, includes gastric restrictive procedures and gastric bypass. The gastric restrictive procedures include vertical banded gastroplasty and gastric banding which attempt to induce weight loss by creating an intake-limiting gastric pouch by segmenting the stomach along its vertical axis. The process of digestion is more or less normal. Gastric bypass combines gastric segmentation along its horizontal or vertical axis with a Roux-en-Y procedure, such that the food bypasses the duodenum and proximal small bowel. Because the normal flow of food is disrupted, there are more metabolic complications compared to gastric restrictive surgeries, including iron deficiency anemia, vitamin B-12 deficiency and hypocalcemia, all of which can be corrected by oral supplementation. Several studies have suggested that gastric bypass is a more effective weight loss procedure than vertical banded gastroplasty. While appropriate surgical procedures for morbid obesity primarily produce weight loss by restricting intake, intestinal bypass procedures produce weight loss by inducing a malabsorptive effect. Biliopancreatic bypass, also called the Scopinaro procedure, consists of a subtotal gastrectomy and diversion of the biliopancreatic juices into the distal ileum by a long Roux-en-Y procedure; the result is a 200 cm long alimentary tract, a 300 to 400 cm biliary tract, and after these two tracts are joined at the distal anastomosis, there is only a 50 cm common absorptive alimentary tract. It was designed to address some of the drawbacks of the original intestinal bypass procedures which resulted in unacceptable metabolic complications of diarrhea, hyperoxaluria, nephrolithiasis, cholelithiasis and liver failure. Although this procedure is reported to have a higher rate of weight loss, it is rarely performed in the United States due to the high risk of various metabolic complications. Application to products: Unless indicated otherwise above, this policy applies to all fully insured Aetna U.S. Healthcare HMO, POS and PPO plans and to all other plans, unless a specific limitation or exception exists. For self-funded plans, consult individual plan sponsor benefit descriptions. If there is a discrepancy between this policy and a self-funded customer's plan of benefits, the provisions of the benefits plan will govern. With respect to fully insured plans and self-funded non-ERISA (e.g., government, school boards, church) plans, applicable state mandates will take precedence over either. Unless otherwise specifically excluded, Federal mandates will apply to all plans. With respect to Medicare and Medicaid members, this policy will apply unless Medicare and Medicaid policies extend coverage beyond this Coverage Policy Bulletin. HCFA's Coverage Issues Manual can be found on the following website: http://www.hcfa.gov/pubforms/06_cim/ci00.htm ICD-9 Codes/CPT Codes: ICD-9 Code: 278.1 Morbid obesity CPT Codes: 43820 -- gastrojejunostomy; without vagotomy 43842 -- Gastric restrictive procedure, without gastric bypass, for morbid obesity; vertical-banded gastroplasty 43843 -- Gastric restrictive procedure, without gastric bypass, for morbid obesity; other than vertical-banded gastroplasty 43846 -- Gastric restrictive procedure, with gastric bypass for morbid obesity; with short limb (less than 100 cm) Roux-en-Y gastroenterostomy 43848 -- Revision of gastric restrictive procedure for morbid obesity (separate procedure) Deny the following CPT Code for biliopancreatic bypass as investigational: 43847: Gastric restrictive procedure, with gastric bypass for morbid obesity; with small bowel reconstruction to limit absorption Place of Service: Inpatient The above policy is based on the following references: 1.. National Institutes of Health Consensus Development Conference Statement. Gastrointestinal Surgery for Severe Obesity. March 25-27, 1991; 9: 1-20. 2.. KB et al. Roux-Y gastric bypass: An effective anti-reflux procedure. Obesity Surg 1993; 1: 295-298. 3.. Amaral JF, WR, Caldwell MD et al. Prospective hematologic evaluation of gastric exclusion surgery for morbid obesity. Ann Surg 1985; 201: 186-193. 4.. DATTA Evaluation. Gastric restrictive surgery. 1989; 261: 1491-1494. 5.. Catona A, Gossenberg M, La Manna A, Mussini G. Laparoscopic gastric banding; Preliminary series. Obesity Surg 1993;3:207-09. 6.. Viste A, Aas T, Bassoe HH, Svanes K. The effect of gastric banding on weight loss in patients with morbid obesity. Obesity Surg 1991;1:283-5. 7.. Kuzmak LI. A review of seven years' experience with silicone gastric banding. Obesity Surg 1991;1:403-08. 8.. Lovig T, Haffner JFW, Kaaresen R et al. Gastric banding for morbid obesity: Five years follow-up. Internat J Obesity 1993;17:453-57. 9.. Sugarman HJ, Starkey JV, Birkenauer R. A randomized prospective trial of gastric bypass versus vertical banded gastroplasty for morbid obesity and their effects on sweets non-sweets eaters. Ann Surg 1987;205:613-624. 10.. Sugarman HJ. Surgery for morbid obesity. Surgery 1993;114:865-7. 11.. McLean LD, Rhode BM, Sampalis J, Forse KA Results of the surgical treatment of obesity. Am J Surg 1993;165:155-59. 12.. Scopinaro N, Gianetta E, Friedman D et al. Biliopancreatic diversion for obesity. Problems Gen Surg 1992;9:362-79. 13.. Grimm IS, Schindler W, Haluszka O. Steatohepatitis and fatal hepatic failure after biliopancreatic diversion. Am J Gastroenterol 1992;87:775-79. 14.. Langdon DE, Leffigwell T, Rank D. Hepatic failure after biliopancreatic diversion. Am J Gastroenterol 1993;88:321. -------------------------------------------------------------------------------- © 2000 Aetna U.S. Healthcare® Inc. Coverage Policy Bulletins are developed to assist in administering plan benefits and constitute neither offers of coverage nor medical advice. This Coverage Policy Bulletin contains only a partial, general description of plan or program benefits and does not constitute a contract. Aetna U.S. Healthcare does not provide health care services and, therefore, cannot guarantee any results or outcomes. Participating providers are independent contractors in private practice and are neither employees nor agents of Aetna U.S. Healthcare or its affiliates. Treating providers are solely responsible for medical advice and treatment of members. This Coverage Policy Bulletin may be updated and therefore is subject to change. ----------------------------------------------------- Click here for Free Video!! http://www.gohip.com/freevideo/ Re: Aetna US Healthcare Dear Art, We are in the same boat. I have Aetna Us Healthcare as well. My contract specifically states that it will not cover Surgery for Obesity. However....Jennefer L posted and they approved her ...So there is hope. Good luck to us both Susie0805@Juno .com ________________________________________________________________ YOU'RE PAYING TOO MUCH FOR THE INTERNET! Juno now offers FREE Internet Access! Try it today - there's no risk! For your FREE software, visit: http://dl.www.juno.com/get/tagj. ------------------------------------------------------------------------------ ------------------------------------------------------------------------------ This message is from the Mini-Gastric Bypass Mailing List at Onelist.com Please visit our web site at http://clos.net Get the Patient Manual at http://clos.net/get_patient_manual.htm Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 6, 2000 Report Share Posted May 6, 2000 I copyed the page from there site for you to read. I read it like we are coverd if we meet what they ask for? Artie Number 157 Subject: Surgical Treatment of Obesity Policy Aetna U.S. Healthcare covers the surgical treatment of obesity when the following criteria are met: (These criteria were adapted from the NIH Consensus Conference on Surgical Treatment of Morbid Obesity.) 1.. Presence of morbid obesity, defined as a body mass index (BMI)* exceeding 40 or greater than 35 in conjunction with severe co-morbidities such as cardiopulmonary complications or severe diabetes; AND 2.. documented history of repeated failure of physician-supervised medical/dietary therapies. Medical Director approval for coverage of the surgical treatment of obesity is required on a case by case basis. *BMI is calculated by dividing a patient's weight (in kilograms) by height (in meters) squared. To convert pounds to kilograms, multiply pounds by 0.45 To convert inches to meters, multiply inches by .0254 Candidates for revision of gastric restrictive surgery must have a complication of the original procedure, such as obstruction or stricture. In addition, revision of gastric restrictive or bypass surgery, which has failed due to dilation of the gastric pouch, is appropriate if the original procedure resulted in weight loss prior to the pouch dilation. Note: As a high incidence of gallbladder disease (28%) has been documented after surgery for morbid obesity, Aetna U.S. Healthcare covers routine cholecystectomy in concert with elective bariatric procedures. Background Accepted surgery for morbid obesity, termed bariatric surgery, includes gastric restrictive procedures and gastric bypass. The gastric restrictive procedures include vertical banded gastroplasty and gastric banding which attempt to induce weight loss by creating an intake-limiting gastric pouch by segmenting the stomach along its vertical axis. The process of digestion is more or less normal. Gastric bypass combines gastric segmentation along its horizontal or vertical axis with a Roux-en-Y procedure, such that the food bypasses the duodenum and proximal small bowel. Because the normal flow of food is disrupted, there are more metabolic complications compared to gastric restrictive surgeries, including iron deficiency anemia, vitamin B-12 deficiency and hypocalcemia, all of which can be corrected by oral supplementation. Several studies have suggested that gastric bypass is a more effective weight loss procedure than vertical banded gastroplasty. While appropriate surgical procedures for morbid obesity primarily produce weight loss by restricting intake, intestinal bypass procedures produce weight loss by inducing a malabsorptive effect. Biliopancreatic bypass, also called the Scopinaro procedure, consists of a subtotal gastrectomy and diversion of the biliopancreatic juices into the distal ileum by a long Roux-en-Y procedure; the result is a 200 cm long alimentary tract, a 300 to 400 cm biliary tract, and after these two tracts are joined at the distal anastomosis, there is only a 50 cm common absorptive alimentary tract. It was designed to address some of the drawbacks of the original intestinal bypass procedures which resulted in unacceptable metabolic complications of diarrhea, hyperoxaluria, nephrolithiasis, cholelithiasis and liver failure. Although this procedure is reported to have a higher rate of weight loss, it is rarely performed in the United States due to the high risk of various metabolic complications. Application to products: Unless indicated otherwise above, this policy applies to all fully insured Aetna U.S. Healthcare HMO, POS and PPO plans and to all other plans, unless a specific limitation or exception exists. For self-funded plans, consult individual plan sponsor benefit descriptions. If there is a discrepancy between this policy and a self-funded customer's plan of benefits, the provisions of the benefits plan will govern. With respect to fully insured plans and self-funded non-ERISA (e.g., government, school boards, church) plans, applicable state mandates will take precedence over either. Unless otherwise specifically excluded, Federal mandates will apply to all plans. With respect to Medicare and Medicaid members, this policy will apply unless Medicare and Medicaid policies extend coverage beyond this Coverage Policy Bulletin. HCFA's Coverage Issues Manual can be found on the following website: http://www.hcfa.gov/pubforms/06_cim/ci00.htm ICD-9 Codes/CPT Codes: ICD-9 Code: 278.1 Morbid obesity CPT Codes: 43820 -- gastrojejunostomy; without vagotomy 43842 -- Gastric restrictive procedure, without gastric bypass, for morbid obesity; vertical-banded gastroplasty 43843 -- Gastric restrictive procedure, without gastric bypass, for morbid obesity; other than vertical-banded gastroplasty 43846 -- Gastric restrictive procedure, with gastric bypass for morbid obesity; with short limb (less than 100 cm) Roux-en-Y gastroenterostomy 43848 -- Revision of gastric restrictive procedure for morbid obesity (separate procedure) Deny the following CPT Code for biliopancreatic bypass as investigational: 43847: Gastric restrictive procedure, with gastric bypass for morbid obesity; with small bowel reconstruction to limit absorption Place of Service: Inpatient The above policy is based on the following references: 1.. National Institutes of Health Consensus Development Conference Statement. Gastrointestinal Surgery for Severe Obesity. March 25-27, 1991; 9: 1-20. 2.. KB et al. Roux-Y gastric bypass: An effective anti-reflux procedure. Obesity Surg 1993; 1: 295-298. 3.. Amaral JF, WR, Caldwell MD et al. Prospective hematologic evaluation of gastric exclusion surgery for morbid obesity. Ann Surg 1985; 201: 186-193. 4.. DATTA Evaluation. Gastric restrictive surgery. 1989; 261: 1491-1494. 5.. Catona A, Gossenberg M, La Manna A, Mussini G. Laparoscopic gastric banding; Preliminary series. Obesity Surg 1993;3:207-09. 6.. Viste A, Aas T, Bassoe HH, Svanes K. The effect of gastric banding on weight loss in patients with morbid obesity. Obesity Surg 1991;1:283-5. 7.. Kuzmak LI. A review of seven years' experience with silicone gastric banding. Obesity Surg 1991;1:403-08. 8.. Lovig T, Haffner JFW, Kaaresen R et al. Gastric banding for morbid obesity: Five years follow-up. Internat J Obesity 1993;17:453-57. 9.. Sugarman HJ, Starkey JV, Birkenauer R. A randomized prospective trial of gastric bypass versus vertical banded gastroplasty for morbid obesity and their effects on sweets non-sweets eaters. Ann Surg 1987;205:613-624. 10.. Sugarman HJ. Surgery for morbid obesity. Surgery 1993;114:865-7. 11.. McLean LD, Rhode BM, Sampalis J, Forse KA Results of the surgical treatment of obesity. Am J Surg 1993;165:155-59. 12.. Scopinaro N, Gianetta E, Friedman D et al. Biliopancreatic diversion for obesity. Problems Gen Surg 1992;9:362-79. 13.. Grimm IS, Schindler W, Haluszka O. Steatohepatitis and fatal hepatic failure after biliopancreatic diversion. Am J Gastroenterol 1992;87:775-79. 14.. Langdon DE, Leffigwell T, Rank D. Hepatic failure after biliopancreatic diversion. Am J Gastroenterol 1993;88:321. -------------------------------------------------------------------------------- © 2000 Aetna U.S. Healthcare® Inc. Coverage Policy Bulletins are developed to assist in administering plan benefits and constitute neither offers of coverage nor medical advice. This Coverage Policy Bulletin contains only a partial, general description of plan or program benefits and does not constitute a contract. Aetna U.S. Healthcare does not provide health care services and, therefore, cannot guarantee any results or outcomes. Participating providers are independent contractors in private practice and are neither employees nor agents of Aetna U.S. Healthcare or its affiliates. Treating providers are solely responsible for medical advice and treatment of members. This Coverage Policy Bulletin may be updated and therefore is subject to change. ----------------------------------------------------- Click here for Free Video!! http://www.gohip.com/freevideo/ Re: Aetna US Healthcare Dear Art, We are in the same boat. I have Aetna Us Healthcare as well. My contract specifically states that it will not cover Surgery for Obesity. However....Jennefer L posted and they approved her ...So there is hope. Good luck to us both Susie0805@Juno .com ________________________________________________________________ YOU'RE PAYING TOO MUCH FOR THE INTERNET! Juno now offers FREE Internet Access! Try it today - there's no risk! For your FREE software, visit: http://dl.www.juno.com/get/tagj. ------------------------------------------------------------------------------ ------------------------------------------------------------------------------ This message is from the Mini-Gastric Bypass Mailing List at Onelist.com Please visit our web site at http://clos.net Get the Patient Manual at http://clos.net/get_patient_manual.htm Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 6, 2000 Report Share Posted May 6, 2000 Susie G, Good news...my plan also specifically said it did not cover WLS. However, I was approved with no question in less than a week. I work for Microsoft and they have thier own department at Aetna which is probably why it happened so fast. I wish you all the luck in the world. My sister is also insured with Aetna through another employer. She sent a letter from her PCP that said she needed the surgery, so maybe that would also help you. Good Luck! Re: Aetna Us Healthcare > Dear L. I was so excited when I read your post. I > have Aetna U.S. Healthcare as well. Did they give you a hard time? My > plan specifically sais that it will not cover surgery for Obesity of > any kind. I haven't been rejected yet but I know it's comming I was > going to switch companies,but you have given me hope. I am very happy > for you...Good luck..I hope to be there soon. Susie0805@... > ________________________________________________________________ > YOU'RE PAYING TOO MUCH FOR THE INTERNET! > Juno now offers FREE Internet Access! > Try it today - there's no risk! For your FREE software, visit: > http://dl.www.juno.com/get/tagj. > > ------------------------------------------------------------------------ > Save up to 54% on Quest & Kelty tents, backpacks, sleeping bags and > outdoor gear. FREE Shipping and a 30 Day Money-Back Guarantee at > screaminghotdeals.com > http://click.egroups.com/1/4012/2/_/453517/_/957596428/ > ------------------------------------------------------------------------ > > This message is from the Mini-Gastric Bypass Mailing List at Onelist.com > Please visit our web site at http://clos.net > Get the Patient Manual at http://clos.net/get_patient_manual.htm > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 6, 2000 Report Share Posted May 6, 2000 Susie G, Good news...my plan also specifically said it did not cover WLS. However, I was approved with no question in less than a week. I work for Microsoft and they have thier own department at Aetna which is probably why it happened so fast. I wish you all the luck in the world. My sister is also insured with Aetna through another employer. She sent a letter from her PCP that said she needed the surgery, so maybe that would also help you. Good Luck! Re: Aetna Us Healthcare > Dear L. I was so excited when I read your post. I > have Aetna U.S. Healthcare as well. Did they give you a hard time? My > plan specifically sais that it will not cover surgery for Obesity of > any kind. I haven't been rejected yet but I know it's comming I was > going to switch companies,but you have given me hope. I am very happy > for you...Good luck..I hope to be there soon. Susie0805@... > ________________________________________________________________ > YOU'RE PAYING TOO MUCH FOR THE INTERNET! > Juno now offers FREE Internet Access! > Try it today - there's no risk! For your FREE software, visit: > http://dl.www.juno.com/get/tagj. > > ------------------------------------------------------------------------ > Save up to 54% on Quest & Kelty tents, backpacks, sleeping bags and > outdoor gear. FREE Shipping and a 30 Day Money-Back Guarantee at > screaminghotdeals.com > http://click.egroups.com/1/4012/2/_/453517/_/957596428/ > ------------------------------------------------------------------------ > > This message is from the Mini-Gastric Bypass Mailing List at Onelist.com > Please visit our web site at http://clos.net > Get the Patient Manual at http://clos.net/get_patient_manual.htm > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 6, 2000 Report Share Posted May 6, 2000 I just surfed there site and found all of this stuff on there.. Art ----------------------------------------------------- Click here for Free Video!! http://www.gohip.com/freevideo/ Re: Re: Aetna US Healthcare Artie: How did you find all this informationo. I have BCBS Preferred Plus in Michigan and I have not found anything on the internet. {{{{{HUGS}}}}} in Michigan ------------------------------------------------------------------------------ ------------------------------------------------------------------------------ This message is from the Mini-Gastric Bypass Mailing List at Onelist.com Please visit our web site at http://clos.net Get the Patient Manual at http://clos.net/get_patient_manual.htm Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 6, 2000 Report Share Posted May 6, 2000 I just surfed there site and found all of this stuff on there.. Art ----------------------------------------------------- Click here for Free Video!! http://www.gohip.com/freevideo/ Re: Re: Aetna US Healthcare Artie: How did you find all this informationo. I have BCBS Preferred Plus in Michigan and I have not found anything on the internet. {{{{{HUGS}}}}} in Michigan ------------------------------------------------------------------------------ ------------------------------------------------------------------------------ This message is from the Mini-Gastric Bypass Mailing List at Onelist.com Please visit our web site at http://clos.net Get the Patient Manual at http://clos.net/get_patient_manual.htm Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 19, 2000 Report Share Posted May 19, 2000 Does anyone know if AEtna covers this surgery? Any tips, etc? MGB wannabe... W Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 19, 2000 Report Share Posted May 19, 2000 - I have Aetna US Healthcare through Pepsi. I was approved within 24 hours. But you need to check your specific policy for exclusions. If it says anytype of treatment for weight loss is excluded then it wnt be covered---unless it says " unless a medical necessity " -then you will be if your BMI is over 40. > Does anyone know if AEtna covers this surgery? Any tips, etc? > > MGB wannabe... > W Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 19, 2000 Report Share Posted May 19, 2000 Thank you Dona...I can't find any exclusions in our policy. It is through my husbands company Rexam. He says they furnish their own coverage thru AEtna so I don't really know yet. My BMI is 41...so hopefully they will anyway! Thanks again, W > > Does anyone know if AEtna covers this surgery? Any tips, etc? > > > > MGB wannabe... > > W Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 20, 2000 Report Share Posted May 20, 2000 In a message dated 5/20/00 4:20:25 PM Central Daylight Time, a1soldit@... writes: << o to Obesity.net. click on Insurance.You can go through state by state. I found Many with coverage that went through Aetna.(the insurance we US >> I clicked onto obesity.net and all I got was a thing about depression. Nothing about ins???? Are you sure that is the right address???? Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 20, 2000 Report Share Posted May 20, 2000 In a message dated 5/20/00 4:20:25 PM Central Daylight Time, a1soldit@... writes: << o to Obesity.net. click on Insurance.You can go through state by state. I found Many with coverage that went through Aetna.(the insurance we US >> I clicked onto obesity.net and all I got was a thing about depression. Nothing about ins???? Are you sure that is the right address???? Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 20, 2000 Report Share Posted May 20, 2000 --- Go to Obesity.net. click on Insurance.You can go through state by state. I found Many with coverage that went through Aetna.(the insurance we USED to have and they*claim* it is the*same* coverage now) Good luck. /web only(ie if you want an individual response feel free to email me) preop on hold due to anemia In MiniGastricBypass (AT) e, " W " wrote: > Does anyone know if AEtna covers this surgery? Any tips, etc? > > MGB wannabe... > W Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 20, 2000 Report Share Posted May 20, 2000 --- Go to Obesity.net. click on Insurance.You can go through state by state. I found Many with coverage that went through Aetna.(the insurance we USED to have and they*claim* it is the*same* coverage now) Good luck. /web only(ie if you want an individual response feel free to email me) preop on hold due to anemia In MiniGastricBypass (AT) e, " W " wrote: > Does anyone know if AEtna covers this surgery? Any tips, etc? > > MGB wannabe... > W Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 20, 2000 Report Share Posted May 20, 2000 --- Go to Obesity.net. click on Insurance.You can go through state by state. I found Many with coverage that went through Aetna.(the insurance we USED to have and they*claim* it is the*same* coverage now) Good luck. /web only(ie if you want an individual response feel free to email me) preop on hold due to anemia In MiniGastricBypass (AT) e, " W " wrote: > Does anyone know if AEtna covers this surgery? Any tips, etc? > > MGB wannabe... > W Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 20, 2000 Report Share Posted May 20, 2000 Thank you ...that is a great help. My husbands company just changed ins back in Jan...so who knows...but I am hoping!!! > > Does anyone know if AEtna covers this surgery? Any tips, etc? > > > > MGB wannabe... > > W Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 20, 2000 Report Share Posted May 20, 2000 , My sister and I both have Aetna with two different employers. My sister was approved and she has an HMO that specifically had an exclusion. She is now post-op and Aetna payed it all. I have Aetna PPO and was approved in 1 day. I also had an exclusion in my handbook. Good Luck Re: AEtna US Healthcare > Thank you ...that is a great help. My husbands company just > changed ins back in Jan...so who knows...but I am hoping!!! > > > > > > > Does anyone know if AEtna covers this surgery? Any tips, etc? > > > > > > MGB wannabe... > > > W > > > ------------------------------------------------------------------------ > Up to 60% OFF food! > Buy Now and Shipping is Free. > http://click.egroups.com/1/4016/2/_/453517/_/958871522/ > ------------------------------------------------------------------------ > > This message is from the Mini-Gastric Bypass Mailing List at Onelist.com > Please visit our web site at http://clos.net > Get the Patient Manual at http://clos.net/get_patient_manual.htm > > Quote Link to comment Share on other sites More sharing options...
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