Question:
Has any one had Aetna pay for Physc and Nutrionist pre-op tests?

My doctors are listed under providers in Atena site info. Does this mean Aetna will pay or do I have to pay up front? I keep reading that everyone pays for these pre-tests. Why are they not paid for? Thanks for any info..    — BOOMASMOM (posted on January 2, 2002)


January 2, 2002
I have Aetna Open Choice PPO and all was paid for, save for a deductible here and there for non-network providers.
   — Tracie B.

January 2, 2002
I also have Aetna and they didn't require a psych or any other testing prior to authorizing my surgery.
   — Kathy J.

January 2, 2002
I have Aetna Us Healthcare HMO and they would NOT pay for either the psych eval or the nutritionist consult, which Im not sure they even required for approval but my surgeon DID require! I called around and the prices varied greatly! I ended up paying 75.00 out of pocket for the nutritionist, but was quoted 250.00 for some, and I paid 65.00 for the psych eval, and I was quoted 200.00 from some others! I actually called Aetna myself to see if they would cover either of these and spoke with a supervisor who assured me that they would not. Rather than to hassle with it, I just paid. They ended up approving me almost immediately when the papaerwork was sent it to them, so I am happy with them in the long run! Good Luck! Donna
   — donnalawbabe

January 2, 2002
I have Aetna HMO and I self pay through cobra and yes, they paid for all my pre-op testings and exams.
   — Gwen M.

January 2, 2002
I have Aetna and I did have to pay for the nutritionist, which was $35 and I schedule the psych evaluation thru Aetna, had to pay $20 co-pay on that which is higher than my usual co-pay. I hope this helps.
   — sunsect

January 2, 2002
AETNA does not require those things, so they dont pay for them. My surgeon wanted them done. Some people get AETNA to pay for the psych evaluation, depending on what you want done, there are different tests and some are covered under your mental health benefits and you pay the 20 dollar mental health deductible, but, if they want a different type of test sometimes it is not covered under mental health at all. In some cases, your PCP can refer you to a nutritionist and then AETNA may cover it, but they will not do it as a surgery related pre-op requirement. Both cost around 100. The nutritionist can be like 40, depending on where you are. I paid out the pocket for my psych eval. It is okay, though AETNA has the best surgery approval rate of any insurance on here, so they are worth it!
   — Courtney W.

January 2, 2002
Oh---i am speaking only about AETNA HMO!
   — Courtney W.

January 2, 2002
Hi, I have Aetna POS and the did not require the psych. eval or nutritionist appointments, but my surgeon did. So, I self paid for the nutritionist and since my insurance policy does not cover mental health, I used my company's Employee Assistance Program (EAP) to see a therapist. I had to go 3 times, but I printed out tons of info. from this website and took that with me and basically educated him about WLS. He then wrote a letter to my surgeon saying I was mentally fit for this surgery. GOOD LUCK TO YOU!
   — Jean B.

January 3, 2002
i have cigna ppo now but had aetna hmo for all my pre op tests including the psyc eval and nutritionists,as far as your psyc eval aetna hmo has some type of co pay through migellin that makes the copay 20 bucks but be careful i went thinking all i had to pay 20 bucks and wasnt told about the 75 dollar fee for the test that they give you,,luckily most of em will work with you on a payment plan and as far as nutritionists my policy didnt cover it but had some type of discount program that knocked 10 bucks off each half hour.good luck!
   — TRULUV2329

January 3, 2002
I have Aetna and was told that they would cover the cost of the psych eval provided the surgery had been approved. If I had the eval done before the approval process was complete, I was going to have to pay for it myself. I just had it done a couple weeks ago, so I haven't received any EOB's yet to show what they paid. Seeing the nutrionist Feb 7 (surgery is March 5) so I don't know about that one yet. Kathy
   — Katy B.




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