Jump to content
RemedySpot.com

RE: INSURANCE

Rate this topic


Guest guest

Recommended Posts

Guest guest

Bawana,

I am currently trying to get approved with Aetna HMO. The major point that they

stress is that you have either a 6 month doctor supervised weight loss attempt

in the last two years or a 3 month dietician supervised (with doctor supervision

- something that is not in their rules) weight loss attempt. The rest of the

requirements seem to be the same that the doctors look for. If you go to the

Aetna website which is www.aetna.com and log in to get a copy of their clinical

policy bulletin on Obesity Surgery. You can look the bulletins up by number and

the one you are looking for is Number: 0157. This will spell out exactly what

their requirements are. I am still in the 3 month dietician supervised weight

loss program and won't get any word on approval or not until after I finish it.

But I will keep everyone posted on my progress of getting approved. Check out

their bulletin and it will give you a good idea of what you are looking at as

far as requirements.

Dora

INSURANCE

I was wondering...I am getting Aetna insurance through work, and want

to have the wls done. Have any of you had it done with this

insurance?? Did you have the PPO or the HMO?? Any advice?? I need to

know asap, so I can choose which plan I want.

Thank you

Bawana

Link to comment
Share on other sites

Guest guest

Actually, I have been with a diatician for about 3 months already, but

I havent been on low fat/calorie, I am doing atkins... so I dont know

how that will fly. My husband is trying to get it done through Texas

Rehab. Hes had to go to the dr for a year for the diet. Hes just

getting his appt with the wls dr on the 1st of July. That has been a

rollercoaster, let me tell you. He is desperate to get the surgery, as

he cant hardly walk anymore. They have already spent over $5,000 on

him, for a wheel chair, and lift ($2500 for a non-moterized

wheelchair!!) That would have been a good chunk for the surgery!

Anyway, I am really trying to figure out once everything is done, how

hard Aetna is once all the stipulations have been met. I had already

printed out thier stipulation sheet, but I know that they can still

deny after all things are met. I know that I have a BMI of 57 so that

should be enough. (I hope)

Any advice is appreciated!

Bawana

> Bawana,

>

> I am currently trying to get approved with Aetna HMO. The major

point that they stress is that you have either a 6 month doctor

supervised weight loss attempt in the last two years or a 3 month

dietician supervised (with doctor supervision - something that is not

in their rules) weight loss attempt. The rest of the requirements

seem to be the same that the doctors look for. If you go to the Aetna

website which is www.aetna.com and log in to get a copy of their

clinical policy bulletin on Obesity Surgery. You can look the

bulletins up by number and the one you are looking for is Number:

0157. This will spell out exactly what their requirements are. I am

still in the 3 month dietician supervised weight loss program and

won't get any word on approval or not until after I finish it. But I

will keep everyone posted on my progress of getting approved. Check

out their bulletin and it will give you a good idea of what you are

looking at as far as requirements.

>

> Dora

>

> INSURANCE

>

>

> I was wondering...I am getting Aetna insurance through work, and want

> to have the wls done. Have any of you had it done with this

> insurance?? Did you have the PPO or the HMO?? Any advice?? I need to

> know asap, so I can choose which plan I want.

>

> Thank you

> Bawana

>

>

>

>

Link to comment
Share on other sites

Join the conversation

You are posting as a guest. If you have an account, sign in now to post with your account.
Note: Your post will require moderator approval before it will be visible.

Guest
Reply to this topic...

×   Pasted as rich text.   Paste as plain text instead

  Only 75 emoji are allowed.

×   Your link has been automatically embedded.   Display as a link instead

×   Your previous content has been restored.   Clear editor

×   You cannot paste images directly. Upload or insert images from URL.

Loading...
×
×
  • Create New...