Guest guest Posted December 20, 2001 Report Share Posted December 20, 2001 Terry, I saw a couple of the posts regarding your insurance woes. That must be the most terrifying of all. When I stoped working not that long ago I had 1 week left on my insurance. Luckily, my wife had signed us up for medicade in advance. The cost of the pain patches I'm on would be $450.00 a month. I always thought that as long as you had existing insurance a company would take you. I don't know where i got that idea but I thought that. Are you eligible for government coverage? I in on this issue with you. I may have to also pay for the cobra so I can see my GI, he is not a participating doc in the states plan. however I did get the state to let me see a surgeon at s Hopkins. Now I hope they will let me get the surgery. Logically it would not make sense to let me see the surgeon if he is not going to do surgey, but there is nothing to do with logic in the system. I was thinking of looking into getting a major medcial where they pay %80 but you can pick any doc. I'm so confused any coverage these days is a nightmare if you have a chronic illness or need a specific doctor. I hope you have some options. Let me know how things are going. It sounds as if you are going through are particularly rough patch. I'll keep you in my prayers and anything I can do just let me know. Rob Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 22, 2004 Report Share Posted June 22, 2004 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 Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 22, 2004 Report Share Posted June 22, 2004 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 > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 22, 2004 Report Share Posted June 22, 2004 Anyway, I am really trying to figure out once everything is done, how hard Aetna is once all the stipulations have been met. [Dora Boyd] I don't know yet either. I have asked around but I am not sure that anyone has tried it on here with Aetna HMO. I agree that the PPO might be easier, but I am not sure. I will probably have an answer for you in August when they are going to make my determination. August 2 is my last visit to complete my 3 month program. The kicker is that the program has to involve diet and exercise as a pre-surgery regimen. They are pretty picky about it. But I called them up and asked for them to explain specifically to me what I needed to do to meet their requirements. Good luck and I let you know as soon as I get to that stage. Dora Quote Link to comment Share on other sites More sharing options...
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