Aetna Signature Administators PPO??

Brielle C.
on 4/8/11 6:00 am - pine hill, NJ
Hey everyone!
Does anyone have aetna signature administrators PPO health ins.? My mom called them today to see if they cover weight loss surgery and they told her NO! Said that obesity is something that can be controlled by her and they dont even care if the person is morbidly obese! My ins. covered my surgery first try so I never went through this! Has anyone ever been told NO by ins. company an then eventually got the surgery covered!? Please let me know thanks!
on 4/8/11 6:08 am - holt, MO
 Sometimes you can pay cash and get your surgery  for what your deductable might be.  Example In Ark BCBS (when I had it) told me that my ded was 25%.  The cost for the surgery here was neary $20000.

I went to mexico and paid $4500 for my surgery which was roughly what my deductible would have been.

ANYWAY many insurance companies always deny first and make you fight or delay.  Every time delay equals interest on money they have.  So if they can delay thousands over a year they make the interest on that money- plus many people give up fighting and the insurance company gets that money too.  Not just wls but even emergancy care and routine things.

If they do not cover wls at all I am sorry for your mom.  Maybe she could pay cash like I did?
Ronetta G.
on 4/8/11 6:25 am - NV
Sorry to hear your mothers insurance turned her down. I have Aetna PPO through my job and they offer all 3 wls (band, vsg and gastro). I was approved the first go around and I was sleeved on 4/4. I hate to hear about an insurance company that don't care about peoples weight/health but their always happy to collect the money.
on 4/8/11 6:32 am - WA
How frustrating - I have an Aetna PPO plan, too, and was approved for the sleeve right away. Good luck!!
Julie, 5' 3", age 42. Starting weight: 263, Surgery weight: 255
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on 4/8/11 6:43 am - Atlanta, GA
Me too.
Aetna PPO and easy approval!!! Have her talk to her employer and/or do a letter to the ins company with her co-morbidities. Maybe you can use an appeal letter from here as a guideline.
Do a search in the upper right corner...Insurance appeal letter...something like that.


on 4/8/11 6:54 am

Aetna sucks terribly, and I do mean terribly.

I had my surgeon apply for an RNY (which is typically more expensive than a vsg), got approval after three months, then turned around and applied for the vsg and was accepted just so they could save a few bucks.

They DO cover weight loss surgery. Hop over to the insurance boards if you need help filing an appeal letter. GL. 

[5'2": 35lbs lost pre-op. SW: 245 GW: 115 CW: 130.0]

on 4/8/11 9:10 am - MI
If it states that weight loss surgery is excluded on your mothers policy as it does on mine, there is not way Aetna will pay. I do not have coverage through my employer, I pay my own health insurance premiums. All policies are not the same.( Mine also excludes anything to do with maternity. Not that I have to worry about that anyway!)
on 4/8/11 11:44 am
I have an Aetna PPO also.  I did have to do the 4 months supervised diet as my BMI was just under 40, but then they approved it immediately after that was done.  Sorry to hear your mother is having problems.  They even gave me a nurse who called to check on me after surgery several times and will answer any questions if I have any.  Then they gave me a nutritionalist and a personal trainer who calls to coach me every week.  I hope she can get some better answers but each policy is different.

272/258/160  Goal on 8/30/2011
Currentlly below goal at 140!!
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