Can you help?

[Guest guest]

Hello everyone. I'm still new here and learning the ropes but I've

got my DS surgery scheduled for December 19th.

My husband carries Aetna US Healthcare (PPO) through his company

policy as our primary insurance. I've been covered by Medicare since

1992 because of my disabilities. Aetna has denied precertification at

this point, which we understand is normal. We have done a lot of

research and are forwarding all this information to Aetna.

We are also lobbying for a change in their policy which claims that

the DS is " investigational " by showing them peer reviews in medical

literature showing that the DS is safe, first of all, and has been

performed on thousands of people successfully. DS is the best answer

to all my other physical problems including diabetes.

My dear husband is handling this, talking to their doctor in charge of

my case and faxing all the great data available. This doctor has told

us that Aetna will cover the surgery if we can prove that Medicare

covers it. Aetna would be required to cover it as our primary if

Medicare as a secondary will cover it. We know Medicare pays for the

DS surgery but we need something in writing.

What we need is written proof of Medicare paying for the DS surgery.

You know those forms that Medicare sends you after they cover

something. If you could just fax a copy of that form you received

right after your surgery, it would help immensely. If you don't have

that, if you have a copy of your doctor's bill showing that Medicare

covered the DS surgery, a copy of that would suffice. My fax number

is .

Take whatever measures you need to protect your privacy, like deleting

your name or your address or both from the forms (you can copy them

first so that your deletions don't mess up your forms for your

records) and then send them to me.

Please help! My husband has worked so hard to make things right and

he will be so worried about me if we don't get this coverage that I'll

be worried about him.

Thank you to all of you who have kept us preops so informed!!!!

[Guest guest]

,

Although I can't offer any assistance on your situation, I just wanted to

comment how fortunate you are to have such a supportive husband! Good luck

in your battle with the insurance company!

Bev

Pre-op, Dr. Sudan