insurance problems

Hello. I am new to this forum, and I am really glad to meet all of you. I called my insurance earlier and asked them was Bariatric surgery covered under my insurance. They told me no. I have Atnea. I have heard nothing but good things about them, until now. So my question is, does the bariatric surgery's office that I will be going to, some how get around this, or is that the end of my quest? It is really upsetting to here them say that. The surgery office doesn't know this, yet.I haven't filed anything or done any paperwork. I was just wordering if they office will be saying it is medically nessicary, if that makes any difference? thanks to all of you for helping

Hi, I have Aetna too, and I am desperately waiting for approval!!! I cant sleep or concentrate, its all I think about. The girl who submits the paperwork at the docs office said she hasnt had a problem at all with Aetna, but she never submitted for a "revision" (te*****ally, I am a revisision from a previously failed WLS, but I think that is kinda dumb, causae I am reight back to where I was before surgery!) Anyway, I found this on Aetna's website---read it! Maybe the person on the phone was wrong: http://www.aetna.com/cpb/medical/data/100_199/0157.html

I am sorry for the disappointment that you feel. The main thing to focus on in the link that the previous poster provided is the first few sentences of the Web site.  You should check with your plan's documents (sometimes referred to as a summary plan description or explanation of coverage) to get the details on the coverage for bariatric surgery.  If you find that the surgery is covered, you can go back to the aforementioned Web site and read about the requirements to be approved for the surgery. Also, please note that most surgical procedures can be covered by health insurance companies if medical necessity is demonstrated.  For example, even though a plan might not outright cover the removal of vocal nodules to correct improper vocalization methods (not medically necessary), it would cover the removal of nodules if the they presented an chronic source of intense pain (medically necessary) and were not responsive to other forms of treatment.  In essence, it depends on the case. I hope I was able to provide a suitable answer for you.

All insurance companies have many different plans that a person can be on.  Sometimes certain things (like bariatric suregery) can be excluded from your plan.  This is ususally due to your employed not wanting to pay higher premiums for a plan that covers it.  Sometimes there are appeals or other ways around it.  You should contact your surgeons office because you msot likely are not the first person to have you insurance comapny state that it is not covered.