oyesican

Hi Daco - I'm in the same boat. Aetna denied me because I haven't had a consistent BMI over 35 for 2 years. I am appealing through obesitylaw.com. It's a long process but hopefully within another 2 months I'll get an approval. Good luck to you!

Hi all, I have a question for those who say you no longer use a CPAP. Did you go in for another sleep study to confirm you no longer need it, or could you just tell you were sleeping ok? I'm so anxious to be able to get to the point of not needing it. I'm still waiting for insurance approval so it may be a while off yet.

Hang in there. I'm fighting mine too. Aetna denied me but obesitylaw.com is working on my appeal so I'm hoping I will be approved and have a good start to my New Year.

I faxed my appeal info in to them today and I'm waiting to see if they can handle the appeal free of charge to me. Aetna denied me because I have not had 2 concurrent years at this BMI. I really hope they accept my case and can get the denial reversed. Self - pay would be a serious hardship for me and my family but the thought of another 20 months at this weight is something I can't handle the thought of.

Hi all - Well, I'm very disappointed - I was denied by Aetna. I haven't been obese for long enough so I either have to stay at this BMI for another year and a half or go self pay. I am also looking into obesitylaw.com - has anyone here been successful using them to help in your appeal? I have 3 co-morbidities and a BMI of 35, but aetna requires a minimum bmi of 35 for 2 full years before they will approve it. Very frustrating.

James, have you heard anything new from your doctor yet? Mine said they want to submit in August and are hopeful that my 5 year hidtory of being "overweight" will satisfy the time frame requirement, even though my BMI has not been over 35 for very long. Just wondering if you're still waiting.

Hello, James, I'm in the same boat. I have Aetna and a BMI 35.6 w/co-morbidities. My advocate said that Aetna does not require weight loss, just nutritional counseling, and it can be for just 3 mos - at least on my plan. So my plan is to build muscle over the next 3 mos but basically maintain and not lose more than 3 lbs, which keeps me at 35. They also told me I have a good shot since I have sleep apnea, and evidently Aetna approves that pretty easily. I only recently went over 35 so I don't have the history either, but I'm going to try for approval anyway. Worst case I may have to be self pay. It's kind of ridiculous but I'll check all their boxes to see if I can get it approved.