Miss Piggy
Gastric Sleeve Patients-
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Everything posted by Miss Piggy
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Start my preop diet tomorrow...4 shakes a day. They told me I could add some sugar free syrup to give the vanilla some flavor. I know I can order it online but I'm hoping I can pick some up in the store. Does anyone know of any stores that carry them? Target, Walmart, GNC? Thx!!
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Thx so much! Was able to pick up some at Walmart last night. May have to check out Starbucks too! Also grabbed coffee extract to try. I had my first chocolate one this morning and liked it...thankfully... I usually don't like anything, lol
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Thx so much! Was able to pick up some at Walmart last night. May have to check out Starbucks too! Also
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Will be the first day of my new life!!!! Go on Monday for my preop consult and start my liquid diet. I'm so grateful to everyone here for their knowledge and support
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Aetna Sleevers - Share Your Approval And/or Denial Experiences Here!
Miss Piggy replied to funkeechiggen's topic in Insurance & Financing
Initially denied....approved this morning after peer to peer!!!!!!!!! 37 BMI Tons of comorbids but nothing that Aetna usually considers. So grateful!! Tentative surgery date of June 5th -
Expected it but still devastated
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Waiting for the official letter and then the doctor will try a peer to peer. If not, I have another level appeal through our benefits administrator. Fingers crossed!!!
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My BMI is under 40 and although I have a ton of co-conditions, I don't have the exact ones Aetna would approve. Going to appeal and hope for the best!!
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Who wants to play? Approved or Denied - Aetna
Miss Piggy replied to Miss Piggy's topic in Insurance & Financing
Just got off the phone AGAIN and now it's apparently with the medical director...not sure if that's good or bad, lol! -
Who wants to play? Approved or Denied - Aetna
Miss Piggy replied to Miss Piggy's topic in Insurance & Financing
Today is day 15 and its still pending...blah!!!!!!!!! -
Blah... everything submitted on April 11th. Keep calling to check for updates and was told today that they are requesting an "interpretation of my weight history". WTF? My PCP submitted my weights for the last several years in a graph form, which clearly shows the weight and date it was taken. What else do they want?? The surgeon's office said they will take care of it but I'm so irritated, lol.
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Sorry to be a post hog today Was just wondering for anyone who went through the Aetna approval process if there is anyplace online to check? I have a reference number and the representative told me I could check for any updates online but I can't find where. Do anyone have any experience with that? I looked in my portal but all I see where I can check completed claims, not pending preapprovals.
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Who wants to play? Approved or Denied - Aetna
Miss Piggy replied to Miss Piggy's topic in Insurance & Financing
P.S. I'll start... denied/April 17th -
Working myself into a frenzy that I will get denied. I have 37ish BMI consistently for 8 years. No "official" comorbidities but a lot of other conditions that are related. I will have 3 letters from 3 doctors (PCP, surgeon & ortho) stating medical necessity. I have also written a heartfelt letter (although I doubt that will make a difference, lol). My final appointment will be on April 11th and the coordinator will send everything over after that for approval. My question is... the Aetna bariatric surgery bulletin sets guidelines that I technically don't meet but I have seen other posters with a lower BMI get approved. I have heard some other posters say "it depends on your employer's plan". What exactly does that mean? Can the guidelines vary according to employer? Our plan is a PPO and we have amazing coverage. I have always been directed to the bulletin whenever I contact Aetna but I'm wondering if I should inquire with my husband's employer directly? I'm just grasping at straws... the waiting and not knowing is torture
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Just curious if anyone has submitted multiple doctor letters to insurance with their package? Is there such a thing as too many? I wrote one and also have one from my PCP, back doctor & surgeon. I don't quite fit the guidelines with "official comorbids" so I'm hoping this helps although I don't want to irritate them either, lol.
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Aetna Sleevers - Share Your Approval And/or Denial Experiences Here!
Miss Piggy replied to funkeechiggen's topic in Insurance & Financing
Bumping back up I have my psychologist, nutritionist & PT appointments tomorrow with my final appointment on April 11th and then it's off to Aetna. SOOOOOOOOOOOO beyond nervous. Any other Aetna updates -
I have Aetna and they are requiring 3 months for me... I have my 2nd this week
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I'm in the same boat... my BMI is 36-37 and I passed my sleep study . My last appointment is April 11th and that is when they will submit everything. I drafted a letter outlining my situation. My PCP, back doctor and surgeon are also submitting letters so I'm hoping that helps. I have a lot of issues but none that officially count as a cormorbidity - depression, chronic migraines, fatty liver disease, high triglycerides, spinal stenosis, herniated discs, high blood sugar. Keeping my fingers crossed!!!
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Crap... worried and disappointed
Miss Piggy replied to Miss Piggy's topic in PRE-Operation Weight Loss Surgery Q&A
Good to know... thanks!!! -
Long story short... I have (and consistently have had) a BMI of 36-37. I have Aetna insurance and was hoping that I would be diagnosed with sleep apnea to use as my comorbidity. Got the resuts of my sleep study and it was clear . I know I am continuing on with my 3 month multi disciplinary and hoping it somehow gets approved. I have started to formulate a letter listing my other conditions and hoping it will push it through. I have a history of depression (documented that it stems from my weight), spinal stenosis and herniated discs. It also appears from my most recent blood work that the I have pre-diabetes and very high triglycerides. Just hoping for some words of wisdom or suggestions I guess. Feeling pretty defeated.
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Crap... worried and disappointed
Miss Piggy replied to Miss Piggy's topic in PRE-Operation Weight Loss Surgery Q&A
Thanks everyone I just finished my letter and talked to my coordinator. She said we will make the best case we possibly can and hope for the best although there are no guarantees. So... I just have to wait... and wait... and wait. It won't even be submitted until mid-April. I have totally thought about the weights (and I would do it in a heartbeat) but I don't think that would help my case since I have never been above 40 BMI. My BMI hasn't been below 35 in over 8 years. I have records showing it between 36 - 37 for the last several years, never going below 35 and never going above 40. If your BMI is below 35, I don't think there is a chance to get approved with Aetna. They will approve at above 35 with a comorbidity though or above 40 withough a comorbid. -
Medical Withdrawal from Retirement (specifically 457)
Miss Piggy posted a topic in Mexico & Self-Pay Weight Loss Surgery
I know it's a long shot but just wondering if anyone has been able to get a medical withdrawl from their retirement plan... we have a 457 and cannot borrow but we can withdrawl for uncovered necessary medical expenses. Not sure if this would technically qualify. I'm still hoping insurance will cover it but I need a plan B (and C, D, E, etc, lol). I know I should ask our provider but I really don't want to unless it becomes necessary, KWIM? We would have to talk to my husband's employer and I am not ready to do that, lol. I'm hoping to hear other's experiences. -
Crap... worried and disappointed
Miss Piggy replied to Miss Piggy's topic in PRE-Operation Weight Loss Surgery Q&A
Thank you... the pre-diabetes is a recent find so I'm hoping that will do it. It's so hard but I'm trying not to get my hopes up.