OMG It may finally be my time!!!

Apr 14, 2012

So much has changed in my life in the past year. I've met an AMAZING, wonderful man who asked me to spend the rest of my life with him. I love him more than I thought I could ever love anyone . Our wedding will be in October, and after that I will finally have insurance again :)  I have contacted Aetna (his insurance) and have also found out that his insurance DOES cover the sleeve!! I could cry. Future hubs says he loves me just the way I am, but will be behind me in whatever option I choose. 

So here's the email I got from Aetna :)


"Thank you for using your secure member website to contact Aetna.  To
help protect your confidential information, please continue to use our
online form to contact us.  The online form provides greater security
than standard Internet e-mail.

Are weight loss surgery procedures covered?
Your plan includes coverage for weight loss surgical procedures when it
is considered medically necessary.

We determine coverage based on your plan benefits and clinical criteria.
For details on clinical criteria, see Clinical Policy Bulletins, which
can be found online at www.aetna.com.
1.  Go to www.aetna.com.
2.  From your home page, select 'Health Care Professionals'.
3.  Select "Policies & Guidelines" on the left hand side of the page.
4.  Next choose "Clinical Policy Bulletins".
5.  Select 'Medical CPB'.
6.  Click the "I accept" box to proceed.
7.  In the box entitled 'Search CPBs', enter policy number '0157'

Please review and discuss the clinical policy bulletin with your doctor.

Is precertification required?
Yes, the procedure must be precertified by your doctor with Aetna's
Patient Management department.  If your doctor does not precertify this
procedure, your benefits could be denied. 

Please have your doctor contact Aetna's Patient Management area at the
toll-free number for precertification listed on your member ID card. 

Your claim payment
After the procedure, and before any claims payment, our clinical claim
review area will review your surgeon's submitted claims to ensure they
meet our clinical criteria and that the specific procedure Patient
Management precertified was actually performed.

The information provided above is not a guarantee of coverage.  Coverage
is based on all the terms and conditions of your plan as well as
eligibility at the time services are received.

Please make sure to visit Ann, our Virtual Assistant.  She can guide you
to the information and tools you're looking for on your secure member
website, Aetna Navigator.  Ann is here to help you, any time, day or
night, 365 days a year.

If you have questions, you can reach Member Services by logging on to
www.aetnanavigator.com and selecting the "Contact Us" feature.  You may
also call the toll-free number on your member ID card, if applicable.

Sincerely,
Internet Response Team
Aetna
23080088"

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