Does AETNA cover gastric balloon? An attending physician who oversaw the member’s involvement in a physician-supervised diet and exercise program must document the member’s participation in the medical record. The surgical preparative regimen may include a diet and exercise program, and participation in the nutrition and exercise program may be monitored by the surgeon performing the operation or by another physician. A brief letter from a physician is not adequate verification. Medical records reflecting the physician’s contemporaneous assessment of the patient’s development throughout the nutrition and exercise program should be included in the documentation.

Most weight-loss procedures are covered by Aetna. However, most Aetna HMO and QPOS policies do not cover surgical procedures for the treatment of obesity unless they are authorized by Aetna. Make sure to check with Aetna directly to see if your policy covers weight reduction surgery.
Aetna To be eligible for weight reduction surgery and have it reimbursed by Aetna, you must satisfy the pre-approval conditions.

Does AETNA Cover Gastric Balloon?

The existence of extreme obesity that has lasted for at least the last two years (24 months), recorded in contemporaneous clinical records, is defined as any of the following for people aged 18 years or older. Aetna covers most weight-loss surgeries. However, you should note that most Aetna HMO and QPOS plans exclude coverage of surgical operations for the treatment of obesity unless approved by Aetna. Make sure you contact Aetna directly to find out if your policy includes weight loss surgery coverage.

The majority of weight loss surgeries are covered by Aetna. However, most Aetna HMO and QPOS policies do not cover surgical procedures for the treatment of obesity unless they are authorized by Aetna. Make sure to check with Aetna directly to see if your policy covers weight reduction surgery.
Another option for potential patients to help reduce the cost of the gastric balloon by up to 31% is to use FSA/HSA money to cover the cost of the operation. BMI of 40 or higher with one or more severe comorbidities.

Does AETNA Cover Gastric Balloon?: Things To Be Aware Of About Gastric Balloon

You will instruct not to drink anything for six hours and not to eat for twelve hours before the operation. You must adhere to these instructions or you may get sick once the balloon inflates. It takes around 20 minutes to complete the operation. You may give a little sedative or light anesthesia, depending on the type of balloon you pick. After the operation, it advises that you plan for transportation home. Your surgeon may prescribe anti-nausea and acid-reflux medication. When you go home, make sure you pick them up or have them ready.

You’ll feel some pain right after the balloon insert, which can last anywhere from a few days to a few weeks. Some discomfort is typical, but make sure to tell your bariatric surgeon if you experience anything unusual or unpleasant. Most people aren’t hungry during the first week following the surgery. Some people do suffer nausea, which becomes worse as they eat more food. During the first week, you may lose a substantial amount of weight. Also, during the first week, men may drop 8 to 15 pounds. During the first week, most women lose between 4 and 8 pounds. During week two, your appetite may gradually return. You should, however, feel satisfied after only a small amount of food.

How To Lose Weight With Gastric Balloon? 

After the “Does AETNA cover gastric balloon?” question; another common question about gastric balloons is: “How do gastric balloons work?”. It allows those who wish to lose weight to achieve their goal weight sooner by eating fewer amounts due to the volume it occupies in the stomach. The goal here is to guarantee that the individual prefers high nutrition. Low-calorie amounts satisfy his daily needs and that this becomes a habit. Because the gastric balloon stays in the stomach for a lengthy period of time, such as 6-12 months, it is easier to develop good eating habits. It has a significant weight-loss impact. It is a less invasive process in the treatment of obesity than bariatric surgery, and it prefers the way of treatment of obesity since it does not need surgery.

Procedures such as stomach cramps and gastric bands utilize in the treatment of obesity, but they suppose by the gastric balloon by the end of 2016. One of the most significant disadvantages of balloon therapy is that its efficacy gradually deteriorates. Those with a BMI of 25-30 and 30-35 and a risk of metabolic diseases, as well as those with a BMI of 35-40 who are unable to have bariatric surgery despite having these features.

People who do not want surgery, as well as those with a BMI of 40 (morbid obesity). Also, above who need to reduce weight before undergoing obesity surgery, are candidates for the gastric balloon procedure. If individuals who have reached the BMI value of morbid obesity and have several co-morbidities are not candidates for bariatric surgery, weight loss can achieve by inserting a balloon into the stomach to avoid the damage caused by obesity.

Who Is Suitable For Gastric Balloon?

It also uses on individuals who are 10-15 kg overweight but haven’t lost weight despite a healthy diet and regular exercise. So, it is choose because it is not a surgical approach, it does not require hospitalization. It discharge within 1-2 hours of the operation. There is no dangers associate with surgical procedures, it provides a sensation of fullness. Hence, it put to sleep with sedation, and it aids in weight loss.

Patients whose BMI reaches the morbidly obese level. Also, whose operation is in jeopardy feel enrage when tell about their predicament. This patient group with a high BMI gives a gastric balloon to help them lose weight. Enter the procedure more safely before undergoing transit bipartition (diabetic surgery) or sleeve gastrectomy (stomach reduction/tube stomach) surgeries.

Alcoholics, drug addicts, people with mental disorders, people on anticoagulants or systemic corticosteroids. People who have had major laparoscopic surgery, people with infectious bowel disease. People with gastrointestinal problems like esophagitis and ulcers are not candidates for the gastric balloon procedure. In patients with gastritis, balloon application does not use, and in patients with symptoms such as reflux. Therapy sought first, follow by the operation. It does not advise pregnant or suspected pregnant women. It indicate for nursing moms once their breastfeeding time has concluded.

Does AETNA Cover Gastric Balloon or Are There Financing Options?


In gastric balloon surgery, United States is becoming increasingly popular with clinics popping up nationwide. It is a safe and effective option for those looking to make lifestyle changes to lose weight and improve their quality of life. Many insurance plans cover this procedure as well, providing even more accessibility for those who are interested. If you are a person covered by private insurance, you may be wondering answers to questions like, “does AETNA cover gastric balloon?”

AETNA does not typically cover the costs associated with gastric balloon procedures. However, they may offer coverage if the procedure is deemed medically necessary and a covered benefit within the participant’s health plan. Before scheduling any medical procedure, it is best to check with a knowledgeable AETNA representative to confirm coverage eligibility. Ask about any pre-authorization or other requirements that may be necessary for AETNA to cover the cost of treatment. Taking these steps can help ensure that all expenses related to your healthcare needs are adequately accounted for and that your question, “does AETNA cover gastric balloon?” is answered.

There are ways to minimize out-of-pocket expenses when seeking obesity treatment. Researching available financing options can be a great way to manage costs and ensure those needed treatments are received affordably. Gastric balloon surgery has become an accessible option for many who wish to change their lives and live more healthily.