Question:
Aetna HMO ever paid for a DS?

Has anyone ever gotton Aetna HMO to pay for a DS? Even if you had to go to another state to get it? Thanks    — phxbbw6ft1 (posted on August 4, 2001)

August 4, 2001
Aetna has a website --it's Aetnaushc.com--punch in your state and search for roux-en-y. It'll come up with the guidelines for your state. In California they specifically prohibit the DS as an "experimental" surgery.
   — sandieguy

August 4, 2001
Try checking the "Insurers" link at the top of this page. Click on your state and you can see a list of others who have been approved with specific insurers.. Good luck to you...
   — [Deactivated Member]

August 5, 2001
Hi Melissa, I have Aetna US Healthcare MCN(Managed Care Network). My husbands policy had an exclusion on the DS as Aetna claims it's still investigational(it's not). However, I had an open BPD/DS on 4-11-01. For me the RNY was potentially lifethreatening due to surgery in Aug. 2000 for Acid Reflux. I was approved for RNY but my surgeon called the medical review board Dr. and told him he would only do the DS on me. My surgeon said "he talked his mouth off" and we finally got the approval. I love my DS and all the normalcy that goes with it. I only had to pay my $15 co-pay. Aetna paid everything else!!!
   — Linda M.

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