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sks_sleeved

Pre Op
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About sks_sleeved

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  1. sks_sleeved

    Denied by Aetna POS II

    Even though I told my doctor’s office it seemed like I couldn’t have a net gain they assured me it would be fine. Low and behold I was denied for a 5 lb net gain. I am 250 currently at 5’6 and they have suggested I do the six months again and this time just stay at 250 to ensure I am at 40 BMI since I only have mild sleep apnea and no other issues. My question is—at the end of the new six months will Aetna deny me bc I still didn’t lose the original 5 lbs or should I get back down to 245 even though that puts my BMI at 39.5? We considered doing a peer to peer and having the doctor say water weight etc., but felt it would be better to do six more months which is really only five based on counting April’s weigh in. Timing actually works out on my favor with surgery now I’m Sept, so I’m not worried about that, but I don’t want to get to September and be denied again.

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