Kathleen Said:

HMO vs PPO?

We Answered:

Aetna Open Access Select is the closest you'll get to a PPO without paying for it. The major difference is that with AOAS you have to stay within network (certain list of doctors, including specialists) to obtain covered care (except for emergency & urgent care). With PPO, you can also obtain out-of-network care coverage... you'll just have to pay more.

Some people stay clear of HMO's because of the many limitations with that system. (i.e. having to go through a PCP, staying within a limited network of doctors, etc). If you are a generally healthy individual, then HMOs are great because of the lower deductibles. PPOs just provide patients with more flexibility.

Good luck!

Steve Said:

Will Aetna cover my 18-20 week ultrasound?

We Answered:

It covered mine.. no questions asked.

Claudia Said:

Does Aetna Vision Discount Program really give you 40% off frames?

We Answered:

Yes. Most of the vision plans get a significant percentage off frames from the vendors they deal with. Of course, frames are wildly over priced in the name of style.

Alicia Said:

Is a surgery considered an office visit covered by medical insurance?

We Answered:

health-quotes.talk4fun.net - here is my health insurance plan. As I remember they can provide such a service.

Andrea Said:

How to write letters to Aetna PPO to be approved for gastric bypass?

We Answered:

It's going to depend on several things:

1. Is that procedure COVERED under the policy? Aetna offers LOTS of different plans, some of which are limited benefit plans, others of which will specifically exclude or cover, depending on state law, weight loss surgeries of different types.
2. Does that policy have a rider excluding coverage for that type of procedure?
3. Does your doctor feel it is medically necessary? And is this the correct PROCEDURE for your situation? Gastric bypass is the MOST DANGEROUS weight loss surgery there is - most doctors who recommend weight loss surgery, would recommend a less dangerous type of weight loss surgery.
4. Have you met the requirements for the surgery, if the answer to all of the above are yes? Most of the time, it means you have to be morbidly obese (measured by BMI); and have ADDITIONAL life threatening issues related to your weight loss; and have participated in a medically supervised weight loss program for at least a year, with no luck.

You won't find the data/stats you're looking for, because it would MOSTLY depend on the state of residence, and which coverage options your policy has.

Virginia Said:

Does anyone understand health plans Lumenos HRA vs. Lumenos HSA vs Aetna PPO?

We Answered:

If they have the same exact cost, the same exact benefits (deductible, coverage etc...) then I'd choose the HSA to make the contributions into the HSA account. BUT, since they are not the same cost and likely have different coverages, nobody would be able to answer that question. Ask your financial advisor. That's what they're for.