Making the steps to get approved through Aetna!!

[MommyTawnie 0]

Well after seeing pictures of me at our family Christmas this past year. I realized I was larger then I thought I was hitting the scales at a big fat 255. I was never "fat" as a child, and never really had weight issues as a teen "other then the normal pick on your self" I was a fit and active 140 lbs at the age of 20. Then I became pregnant with my daughter and boom the weight started adding up. I realize you gain weight during pregnancy, but I gained a total of 95 lbs in 8 months. My prengnacy was a high risk pregnancy and I was on bedrest pretty much the first 5 months. After her birth I started back with daily walks, and workouts at home. But it was doing nothing for me. The weight had made the decision to stick around. Then the excuses started well she's only 3 months it can take up to a year to loose baby weight. Then 9 months hit and I told my husband the same thing. After new years 07 we started a hard core low carb diet loosing 28 lbs in the first month. I was thrilled the weight was coming off so quickly. Then I became pregnant with our son. After his birth and 30 lbs later I was right back where I started 240lbs. It was devestating to know I worked so hard to get what weight I could off just to have it come back. Don't get me wrong I was thrilled to have our son, but the weight why couldn't it just fade away? I tried everydiet out there to the point of drinking the Apple Cider Vinager "Nasty Nasty Nast" nothing was working. Finally I decided I wasn't that big, and I would be ok. Besides I just had a baby a few months before I was fine. Then he turned 1 and the weight was still there. I realized I had to try to get it off. I started diet pills and working out, but it just wasn't going away. This past Christmas when I seen a real picture of me from my daughter's point of view I realized I have to change my life. I have to loose this weight, and if diets aren't going to work for me then I have to move to the next step. Going through our plan coverage I realized "AETNA COVERS WEIGHT LOSS SURGERY" I called Aetna that day just to confirm what I had just read, and ask what the first step was for the surgery. The lady "her name was Carol" gave me the name and number of a weight loss surgeon in my area that took my insurance, and that I could go through them to figure out my next steps. As soon as I hung up I was making the next call setting up my appointment for a consultation. I went in on March 1st and met with Dr. Felix Spiegel he explaned to me what would happen during in surgery, and the diet to follow after the surgery. They set me up with a case worker to get the insurance verified, and get me on my way. 2 days later she called to tell me insurance will cover the surgery, but I have to follow the steps to get it approved. step 1. 3 months of a charted diet/exercise program through my pcp

step 2. meet with a dietician

step 3. meet with a pyschologist for the pysch eval.

I meet with my doctor on the 9th to start charting my weight. I joined a gym 4 weeks ago. I meet with the pyschcologist on the 10th and the dietician the following week.

I am excited about the journey ahead. I look forward to the day when I can run and play with my children without getting out of breath. I can't wait to walk into a room and no longer feel like I am the fatiest person around, or looking for someone fatter then me so I can feel better about the way I look. Aetna has been wonderful helping me find doctors that take the insurance. I can't wait for June to get here so we can send off our request for approval. Please keep me in your thoughts as I go through this and I will post as I find out what's next..:smile2:

[btrieger 21]

Welcome aboard and good luck.

I had no problem getting approved through Aetna.

I've seen a few other patients of Dr Spiegel posting here.

[ainnjay 1]

I have Aetna as well!! I'm on my 2nd month of the supervised diet....will be done with my 3 months around April 19th or so. I've met with the Psychiatrist, dietician, and met pretty much all of the other requirements.

Btrieger - Hope you don't mind if I ask you a few things...I've seen a few of your other posts and they've been very helpful. How long did it take Aetna to approve your surgery once you completed your 3 months supervised diet? Also...tell me about coffee (aka caffeine). Is it imperative we give that up? I've really been trying to read as much information as possible so I am fully prepared once I get my band that I've been focusing on what I'm going to have to give up instead of the positives... I know in my heart the positives outweigh the things I will be "giving up" by a long shot!!

Any feedback you have would be greatly appreciated. Thanks! Ang

[btrieger 21]

I have Aetna as well!! I'm on my 2nd month of the supervised diet....will be done with my 3 months around April 19th or so. I've met with the Psychiatrist, dietician, and met pretty much all of the other requirements.

Btrieger - Hope you don't mind if I ask you a few things...I've seen a few of your other posts and they've been very helpful. How long did it take Aetna to approve your surgery once you completed your 3 months supervised diet? Also...tell me about coffee (aka caffeine). Is it imperative we give that up? I've really been trying to read as much information as possible so I am fully prepared once I get my band that I've been focusing on what I'm going to have to give up instead of the positives... I know in my heart the positives outweigh the things I will be "giving up" by a long shot!!

Any feedback you have would be greatly appreciated. Thanks! Ang

I was approved after 10 days by Aetna.

The nurse at my surgeon's office said that caffeine is a diuretic and causes your body to retain fats and Fluid. I don't know the exact science to it. It was the first time I had ever heard this. I've been told numerous times by nutritionists that black coffee and tea were fine to drink on diets.

The one thing I am positive of is that caffeine raises your blood pressure and that was enough for me to give it up.

I just googled it and this was the top response: WikiAnswers - Does caffeine hinder weight loss

I'm not a picky eater and notice no difference between real coffee and caffeine free. I did notice the difference in Diet Coke but since I am not drinking carbonated beverages again, it doesn't matter.

Don't FOCUS on the negatives and what you have to give up. Look at it is a positive light.

A much better outlook is, "If I drink decaffeinated coffee, my blood pressure will be lower and I will be healthier."

Good luck!!

We now return you to your regularly scheduled thread. :biggrin:

[ainnjay 1]

Good morning!!! Thanks so much for the great information!!! Have a wonderful day!!

[mimi1512 0]

I was approved in 4 days by Aetna - this may be due to the fact that I called every day to check on the status of the pending authorization.

[ainnjay 1]

That is ONEderful (would love to be there someday!!) to hear!!!

Thanks!!! Ang