Carpenters Health and Security Plan
90% Network Only Services and Supplies Must Be Received From a Network Provider Services and Supplies Must Be Precertified The Bariatric Surgery Benefit Is Not Available Under Retiree Coverage
Surgical procedures for morbid obesity including Roux-en-Y gastric bypass (RYGB), FDA-approved adjustable gastric banding, or sleeve gastrectomy are covered at network providers only. All procedures must be precertified and are subject to the criteria set forth in Aetna Clinical Policy Bulletin (CPB) 0157. Aetna will also review the pre-surgical treatment plan to ensure the patient meets the plan's medical criteria. Aetna will provide coordination and facilitation of treatment plan components as necessary. To initiate the precertification process, your physician must contact Aetna.
Last Updated: 06/13/2019