brandyrn73

My coordinator submitted to Aetna today for the second time. I was denied last year for a BMI <40 with no co-morbidity. I'm now 39+ BMI with sleep apnea. Yay for sleep apnea! Lol here's hoping for an approval this time!!

I'm a Diet Coke addict as well....I've thought about trying to quit before surgery, but the more I think about it the more I think going cold turkey might be the only way to go for me.

Absolutely gorgeous!

I'm sorry to hear that! Do you have a plan B?

PIckerington,Oh here! Working with the docs at OSU...hoping to hear on my appeal sometime soon! I was diagnosed with sleep apnea so hoping for an approval now.

I was in the exact same position with Aetna as you. I was denied. I'm now being told I have sleep apnea and my BMI has climbed to almost 40. I'm hoping with this information my appeal will go through and I'll be approved. Good luck to you!

If you don't mind me asking, why did Aetna deny you? I was denied by them last week as well...

To say I'm frustrated is an understatement! I've spent the last 7 months doing EVERYTHING that was asked of me by the medical center/Aetna and I found out today that I was denied because I haven't been morbidly obese for at least 2 years (I've been 100 lbs or more overweight for MANY years) and I have no comorbidities. I am 5'5'" 232 lbs. I have GERD, a hiatal hernia, high cholesterol and rediculous hypothyroidism since my thyroidectomy 10 years ago. My previous case manager at the bariatric surgery clinic led me to believe these would be sufficient for Aetna, hence why I went through the long, tedious process to be approved. The case manager in charge of my case now apologized but what good does that do me?! What ticks me off is that my husband and I work hard in this life, and we pay $$$ for our insurance coverage. But when I go to actually use it I'm told I'm not qualified. WTH! Apparently being 100+ lbs overweight isn't fat enough?! They would rather wait until I'm sick from hear disease, hypertension, etc then help me get healthy NOW. It just doesn't make sense to me. Self pay isn't an option for me. I'm waiting to hear if I can just pay for the band when I get my hernia repaired. Hopefully I'll know tomorrow. The case manager said we can appeal and that could take 30-60 days. I have a feeling that will be denied too.

I haven't even seen the surgoen yet much less got a surery date! Tomorrow I will speak with my surgeon's secretary and find out if I can go ahead and schedule my hernia repair. This insurance game is STUPID.

This sounds a little familiar... http://wlsappeals.com/winning-bariatric-surgery-insurance-appeals/

I'm a nurse and work in the hospital setting.

New here.. I've completed my entire "work up" for the band at Ohio State and was told by the coordinator that my file will be sent to Aetna for approval...I'm confused by all the talk of the 6 month supervised diet...my coordinator has NEVER mentioned this to me! I had to take a 3 month course on healthy living, eating well, etc etc but that's it...no 6 month diet. I really hope they aren't missing something here! My BMI is 38+ and my co-morbids are high cholesteral, severe hyopthyroidism, depression and GERD. I'm nervous enough as it is that I'm not going to approved! Thoughts anyone?