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Pre-op Gastric Bypass Gastric bypass surgery dates, insurance issues, emotional preparation, etc.

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Old 08-16-2006, 05:50 PM   #11 (permalink)
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I had Aetna Proferred Choice, which we were told by our insurance rep was the same at the Open Access we had been on, only cheaper. Unfortunately, that was not quite accurate. When I called Aetna last fall, I found out I was not covered under that plan. I had to wait until January to switch to the Aetna HMO and I got approval 3 days after the doctor submitted. I had always been very anti-HMO, but I have to say with all the testing I went through and my two recent hospital stays, that the HMO has saved me money big time and I have had all the same doctors I used on my PPO. Approvals for all the tests came quickly.
I'm not trying to be negative, but Dr. C's office told me that the Aetna PPO was one of the hardest to get approval on. They can be real nitpickers, but as others have said, I don't think he would be sending it off if he did not feel fairly confident that the paperwork was in order. I have been very impressed with how well run the office is. They will post on your patient log when they fax it over to your insurance.

Best of luck and remember, if need be, Aetna's HMO might be an option.

Sandie
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Old 08-16-2006, 08:15 PM   #12 (permalink)
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Thanks for the info. It gives me a heads up. Unfortunately my employer does not offer HMO. According to aetna all open access means is you don't need a referral to see certain doctor's and you don't have to be assigned by to a medical group but I still have to see doctor's in aetna's network but I can choose my own.
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