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Thread: Aetna Insurance - NY/Medicaid

  1. #1
    Join Date
    Feb 2008
    Location
    Brooklyn, NY
    Posts
    4

    Aetna Insurance - NY/Medicaid

    Hello,

    I am in a very tough situation now and wanted to know if anyone would know anything about this. I currently have medicaid insurance and that is not accepted by Dr. Neuwirth. He only takes Aetna. I was looking to apply for HealthyNY with Aetna, but I am afraid that they won't approve the situation. They said that the Dr. needs to pre-certify the surgery, but they can not say for sure that it will be approved.

    As of now he gave me a number if I had to pay for the surgery on my own without insurance and offered me a payment plan. He said that the hospital takes my insurance, but I am afraid that there are going to be additional charges or fees that may arise.

    Does anyone know if this is the case? Does anyone know if the anesthesiologist is covered by the insurance or in the cost that the Dr. is charging me?

    What isn't covered by insurance? Thank you all so much.

    Best,
    Lori

  2. #2
    Join Date
    May 2005
    Posts
    672
    Hi, two things I can think of right off the bat: we had to pay up front for my son to donate blood for his surgery (somewhere around $300) and seek reimbursement from insurance. They said they would only reimburse if the blood was actually used during his surgery.

    The second was the anesthesiologist billed separately from the hospital & dr. fees. The insurance was only going to cover a "portion" of each hour anesthesia was used. This came to about 15 min. per hour ! We had to seek financial aid from CA Childrens Services to help cover the costs insurance wouldn't pay.

    I'm sure others will chime in with advice, sorry that's all I can think of right now (head is still foggy as I recover from the flu). Best wishes to you-

    Renee

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