Your Insurance: Aetna

Aetna started covering lipedema in the Fall of 2019. About forty women have had their surgeries covered, and Aetna has paid or reimbursed very well. Aetna also covers skin excisions along with liposuction, per their policy. In our experience, Aetna has been one of the best for lipedema surgery coverage.

However, we have encountered a few troubling developments. Recently, Aetna has denied a few coverage requests and seems to be focusing on documentation for conservative measures. They also have not done a great job training their staff on lipedema, so often reviewers know little or nothing about the disease. Aetna has also started pushing back on out-of-network surgeon requests. In certain states like California, Florida, and Ohio, it’s not possible to see an out-of-network surgeon. In other states, you will need to work with us to find the closest surgeon (in or out of network) to your home so Aetna doesn’t argue that if you can travel for an out-of-network surgeon, you can travel for a network one. As with most insurers, having a cooperative employer or being in a regulated state can help us push Aetna to focus on quality of care regardless of whether the surgeon is in-network.

Although Aetna has been one of the best insurance companies for lipedema coverage, getting covered is still not easy. We have created processes that give Aetna members the best opportunity to be covered with the full benefits of their insurance plan.

 

This page was updated on 16 July 2021

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