Insurance Question (Aetna)

MicheleK · 06-26-2008, 01:22 PM

I'm a little confused....my Aetna plan covers Lap Band, no problem...they also cover RNY, but not both on the same patient. Obviously, I've decided to go with Lap Band...my confusion is this...

Aetna will only cover ONE WLS surgery the life of the plan, no problem there...I understand that. However, today when I was speaking to a rep from Aetna I asked, "what if my band goes bad, or something happens to it? Will you guys pay to fix it?". Her answer was, that they will pay for any medical complications that arise from the WLS I choose.

I'm confused....if my band goes bad, or if my port flips or, I spring a leak...are they going to pay for fixing/possibly replacing my band? Or will they just say "take it out" and that's it???

I don't get it, and she really didn't explain further.

moonandstarzz · 06-26-2008, 02:43 PM

im not quite sure but i have aetna, with how i read what u post i think that if something goes wrong and needs fixing that they will cover the fix. thats what it sounds right, or if just getting removed for complications.

Flowerpurr · 06-27-2008, 08:39 AM

Aetna will cover band slipage if something goes wrong. If you need it removed for what ever reason they will approve another surgery with no problem. You won't have to jump through any hoops. Just an FYI make sure Aetna sends your Dr.'s office a letter before you get the surgery. They called my Dr.'s office said I was approved and didn't send a letter. I go to surgery on the 15th of next month and my Dr.'s office won't perform the surgery until the letter arrives. I just think it's one of Aetna's tricks to slow down the already very long process. GOOD LUCK!!!

MicheleK · 06-27-2008, 08:46 AM

YAY! Thanks for the info guys :) I'll check on that letter today.