ask: Baratric surgery and Aetna insurance, what do I need to gualify for Aetna PPO to cover my surgery
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kashara2010,
Thanks for your question.
Unfortunately, some insurance companies will not cover a surgical procedure such as Lap Band (or Bariatric surgery) and there is nothing we as patients can do about it. I did find this site that will help you figure out if and how much your insurance will cover if you choose to have bariatric surgery performed. http://www.lapband.obeseinfo.com/lap-band-insurance.htm
It does list insurance companies that will cover partial or complete surgery costs but Aetna is not listed as one.
I also found a forum with others interested in Aetna's approach to surgery coverage and many say that with Aetna POS, they will cover 90% of surgery ONLY after a 3-6 month disciplinary approach has been completed-- meaning: They will ask you to diet for 3-6 months before considering you a candidate for bariatric surgery coverage. http://www.lapbandtalk.com/f8/aetna-insurance-questions-help-please-64509/
I hope this helps a bit. I know Insurance Companies can certainly give you the runaround when it comes to coverage, especially when it is a surgical procedure.
March 23, 2010 - 1:07pmGood Luck!
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This is incorrect. Aetna does cover Gastric Bypass. And Lapband. You have to be overweight with a BMI of more than 40. You also have to do 6 months weigh ins and show you are willin to lose weight. If your not with a bmi of 40 you have to have sleep apnea, high blood pressure or diabetes to qualify. You also must be 18 years of age as well for it to be approved.
December 15, 2010 - 2:55amI agree. I have Aetna and it fully covered my lapband
May 24, 2012 - 4:53pm