Question:
THIS IS OF A DIRE EMERGENCY!!!

AS OF JAN. 1 2006 MY INSURANCE WILL CHANGE AETNA HMO I USED TO HAVE UNITED HEALTHCARE PPO. I WAS SEEING DR. JOHN ALEXANDER, HE WAS TRYING TO GET MY REVISION DONE BEFORE THE END OF THE YEAR AND MY REVISION HAD GOTTEN APPROVED BUT NOT UNTIL THIS LAST WEEK OF 2005. HIS OFFICE SAYS THAT AETNA HMO MAY WANT TO FIND A DOCTOR WITHIN 50 MILE OF IRVING (where I live) TO PERFORM BUT I DON'T KNOW OF ANY AND TO TELL YOU THE TRUTH I WANT TO KEEP DR. ALEXANDER SEEING THAT HE HAS ALREADY DONE ALL OF THE TESTS NECESSARY TO DETERMINE IF I NEED THE REVISION. MY POUCH IS BULGING, I HAVE DEVELOPED A FISTULA, AND I HAVE A LEAK. PLEASE IF SOMEONE CAN HELP ME...... I'M AFRAID AETNA HMO WON'T APPROVE IT AND THIS WILL BE AN ONGOING PROBLEM.    — MsLovely (posted on December 27, 2005)

December 27, 2005
Since you have already obtained approval from another insurance company, you may want to contact AETNA to see if your current physician is on their list. Or they could hurry up and perform the surgery in the next few days before AETNA kicks in. Go to AETNA's website and see what information you can find out -- don't panic -- clouds thinking and judgment. God's speed.
   — the7thdean

December 27, 2005
Lecia, first of all...calm down. Don't be afraid. There is always a way, you may have to take a detour, but there is always a way. Now, I go to Dr. Rodoriguez in Dallas...he is close enough to Irving, and he is wonderful. The center there is ranked the top in the state. I am in Ft. Worth and I go to him. My sister also had surgery with him last year. If you need his info, or if you need to talk, email me @ [email protected] Aaetna is harder to work with than many, but it isn't impossible, especially with leaks, etc...because that is medically necessary for health, not just weightloss. Good luck to you, and if you want, email me, I'd love to support you in any way I can. Sandra
   — Sandra.M

December 27, 2005
You MUST find out if "pre-existing conditions" are exempt from coverage for the first year or two. This happens with so many insurance companies, so do check it out first. You can call United HealthCare to see if you can privately purchase continuing coverage for a month or more out. Do NOT assume anything until you have the final word from someone fairly high up the food chain. Theresa
   — SouthTX LapBand

December 27, 2005
there have been people to get approved before their policy ends, and have surgery after it ends since the approval was done before the policy actually ended. I hope it works out. God bless
   — PhD

December 27, 2005
Can you schedule surgery immediately?
   — Novashannon

December 28, 2005
Thank you everyone for your support. I did try to get the surgery scheduled this week but the doctor is out, of course because of the holidays. But I will definitely keep praying and looking for other alternatives to this. I guess what I will have to do is just wait for 2006 to kick in before I can contact Aetna about any alternative. But I will keep in touch. Thank you again so much.
   — MsLovely

December 31, 2005
Not sure if it will be any help, but it was with my insurance carrier. Bypass the Customer Service area and contact the Medical Review Department of Aetna. For my company, they are the ones that make the decisions for approvals of qualifying for benefits. Once I got ahold of the manager of that department and explained the circumstance for what we needed, we were approved within a very short time. Just a little help to cut the red tape.
   — ratkinson

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