Question:
Aetna - Any problems with Aetna paying for Plastic Surgeries?
I have lost 153lbs since last June. It's time to start some much needed skin repairs! I have Aetna US Healthcare and have been getting a lot of run around since May! The letters have been faxed and pictures sent 3 times. Still when I call there is nothing on file! Has anyone had any problems with them paying? Any advise to share? Thanks in advance! — Lucy B. (posted on July 13, 2001)
July 13, 2001
I haven't started looking into reconstructive surgery yet, but will soon (1
year post op and down 130 pounds). However, what you are going through now
with Aetna is almost exactly what I went experienced with them getting my
RNY approved. Every time I called the paperwork hadn't been received, or
it wasn't in the file, or we had sent it to the wrong person. (we sent the
stuff exactly where they said to sent it.) It took from February to June to
get approval and I think the surgeon's office must have sent the paperwork
to at least 6 different individuals within Aetna. Good luck.
— Sharyle L.
July 13, 2001
Try sending the letter and pictures via certified mail, return receipt.
That way you can tell them exactly who signed for it and when.
— Gina E.
July 17, 2001
I have Aetna USHC, federal plan. My PS submitted the information to Aetna
for my breast reduction on June 29 and received approval on July 10. I
have now decided to get the arms done so I went in yesterday to have the
pictures done. The arms are covered because of the massive weight loss to
restore normal appearance. Check out the recommended criteria for third
pary payer coverage at :
http://www.plasticsurgery.org/profinfo/postpap/skin.htm
— blank first name B.
July 30, 2001
Got the same run-around to get surgical approval. We all knew what the
criteria was, but each of THEM (4) had a little different twist to it. I
ALWAYS wrote down their name qnd extension,. called them by name, had my
spouse's HR person call...after I threatened toi picket naked in front of
the tv station where he works, and my doc cc'd the attorney gneral on his
letter. Approval in 2 hours. Funniest thing!
Persistence and insistence! You must have the means to PROVE what you
sent. They are not all in the same office or even in the same city. They
don't always know of each other, either. Good luck. Corrine
— [Anonymous]
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