My wife had severe OAB. It started maybe 2 years ago and got to the point she had to go every 15 minutes. After trying medication therapy that didn't work, the Urologist recommended Interstim. He assured us our Aetna insurance covered it, and the hospital admissions office told us our responsibility would be the balance of our out-of-pocket for the year (I insisted on knowing our "bottom line" responsibility).
Now Aetna refuses to pay, and our bills are over $100,000! the doctor says "don't worry", but easy for him to say, and his insurance staff will not return my calls. Apparently, they did not pre-certify the procedure, and to make matters worse, the doctor's paperwork says this problem started 3 weeks before he saw her - entirely untrue.
Has anyone else had this problem? I'd be interested to know which insurances pay for this procedure (I know Medicare does), and specifically if Aetna has ever paid it.
Had we known in advance, we could have cancelled Aetna and gone on Medicare. We are both Medicare-eligible.