Question:
Anyone get Aetna to approve any Plastic surgery? Of any kind?

I had Blue Choice when I had my RNY however my insurance is now Aetna and I was wondering if they ever cover plastics? I'm going to need breast work, possible arms and tummy possibly before I'm done. What kind of documentation did you need?    — FaithMills (posted on December 14, 2004)

December 13, 2004
You can go to the Aetna website and read their coverage policy bulletins. They will tell you exactly what documentation you need. I think they have the procedures listed alphabetically.
   — SarahC

December 14, 2004
I just got word yesterday of my approval from Aetna for a panniculectomy after my first try. I have back problems and my pannus hangs below my pubic region. I have full support of my primary care doctor and my plastic surgeon and they wrote detailed letters explaining which medical conditions would be alleviated by a tummy tuck. Good luck to you!
   — Yolanda J.

December 14, 2004
I switched to Aenta (had BCBS for my surgery) an Aenta covered my Abdomioplasy (didnt have any trouble - but I guess it would have been hard for them to deny since BCBS had already approved it.. I just ran out of time to get it. Aetna did not 'want' to pay for my breast reduction. They wanted to much tissue to remove (almost double what other carriers require) lucky for me my Aetna is 'self funded' and my company has the last review on all denials and overrode their decision and covered it. The best thing is to go on line and look at their requirements. They use these 'guidelines' as - a check list... doesnt matter if your doctor doesnt think you need something on it... they want it.. for ex they require Physical therapy, both my pcp and the pt said it was a waste of time and money, aenta insisteded and they paid for PT that was a total waste.... so just go down the list, do everything, or get everything, then you shouldnt have a problem. IF you do, hopefully you are self funded and can get them to pay anyways.
   — star .

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