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My case was submitted the first week of January and I am still waiting for approval. I am getting nervous. It's been 12 days. I don't know what is taking so long. I read that some people got their answer within a week and then I read some had to wait the whole 30 day (which I am told they have 30 days to respond). I was hoping to have my sleeve done the 1st of February. I really want this; no, I really NEED this. I am praying for a response of approved. Prayerfully it will come this week.

Medical Policy Subject:Surgery for Clinically Severe Obesity Policy #: SURG.00024Current Effective Date: 11/18/2010Status:RevisedLast Review Date: 11/18/2010 Description/ScopeClinically severe obesity is a result of persistent and uncontrollable weight gain that constitutes a present or potential threat to life. There are a variety of surgical procedures intended for the treatment of clinically severe obesity. This document addresses those procedures. Position StatementMedically Necessary: Gastric bypass and gastric restrictive procedures with a Roux-en-Y procedure up to 150 cm, laparoscopic adjustable gastric banding (for example, the Lap-Band® System or the REALIZE™ Adjustable Gastric Band), vertical banded gastroplasty, biliopancreatic bypass with duodenal switch, and sleeve gastrectomy (open or laparoscopic) are considered medically necessary for the treatment of clinically severe obesity for selected adults (18 years and older) who meet ALL the following criteria: BMI of 40 or greater, or BMI of 35 or greater with an obesity-related co-morbid condition including, but not limited to:diabetes mellitus; or cardiovascular disease; or hypertension; or life threatening cardio-pulmonary problems, (e.g., severe sleep apnea, Pickwickian syndrome, obesity related cardiomyopathy); AND [*]The individual must have actively participated in non-surgical methods of weight reduction; these efforts must be fully appraised by the physician requesting authorization for surgery; AND[*]The physician requesting authorization for the surgery must confirm the following: The individual's psychiatric profile is such that the candidate is able to understand, tolerate and comply with all phases of care and is committed to long-term follow-up requirements; and The candidate's post-operative expectations have been addressed; and The individual has undergone a preoperative medical consultation and is felt to be an acceptable surgical candidate; and The individual has undergone a preoperative mental health assessment and is felt to be an acceptable candidate; and The individual has received a thorough explanation of the risks, benefits, and uncertainties of the procedure; and The candidate's treatment plan includes pre- and post-operative dietary evaluations and nutritional counseling; and The candidate's treatment plan includes counseling regarding exercise, psychological issues and the availability of supportive resources when needed. <br clear="all">

I am excited as well. I'm trying to stay calm, but I can't keep from smiling.

Aetna has updated their site: This CPB has been revised to state that sleeve gastrectomy is considered medically necessary when criteria are met.

Aetna updated today. VSG is no longer expiremental