Hi Everyone,

Does anyone out there who lives in the US have Aetna HMO for their medical insurance?

I just found out that my employer is changing from Blue Cross to Aetna in March and am concerned about coverage for ostomy supplies. There doesn't seem to be anywhere on their web page that describes their benefits, and the only response I've gotten from work is to wait and go to the meeting being set up to ask my questions. Unfortunately, the meeting has not yet BEEN set up, and no insurance carrier in the past has had any idea what I was talkingabout when I've asked about this sorta thing.

-Rae

-Rae

Hi Rae,
I have Aetna also. They have covered my surgery well, but my husband spent the better part of one day calling, trying to find any ostomy product company or a local medical supply/pharmacy who accepts Aetna insurance. None did. They all refered us to Byram Healthcare. They do accept Aetna. I do not know how much is covered though. We are in Ct, and they have warehouses in NJ and Mass too. Give them a try. Good luck!
Monique

Coverage is set up between the Insurance company and your benefits person at work. Even if Aetna does cover ostomy supplies it doesn't mean the plan you work has signed up for does. I went through this with my employer two years ago. A rep from the insurance company and your benefits rep sit down and go line by line to determine what they will cover (ostomy supplies, needles for diabetics etc). Whoever is your benefits rep at work should be able to answer it, but if they are not being open about it then your best bet is to ask about Ostomy supplies at the meeting. If they are confused tell them they are categorized under Durable Medical. Currently I am still covered at 90% and I am so thankful for that! I know that UHC is pushing to stop covering our supplies for us and I think it really stinks (and it will stink if I have to use a zip lock bag for an appliance if they halt coverage )

I have Aetna as well, though not an HMO. My supplies are 90% covered. The company I use is called Sterling Medical, which is located in NJ. They've got ostomy experts to answer any questions and have helped me out a lot during my adjustment phase. Very quick delivery of supplies, too!

I also have Aetna,I get my ostomy supplies through Byram. Byram has been great to deal with, they are very polite and helpful if you have any questions, they are really fast in getting supplies to you, I have never waited more than 2 days. My wife is diabetic and I was also for several months when I was on presidsone, Aetna does not cover any diabetic supplies. But They cover just about all of my ostomy costs. I get a 3 month supply from Byram, which comes to $900.00 and Aetna covered all but $30.00.