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Aetna 2 year/24 mo. look back--does it mean 24 mo??



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I have seen this question asked but not answered so I am hoping by posting fresh I can get answers from those on Aetna that were "on the line" of the 40 BMI.

I applied with Aetna and jumped through all the hoops last year only to be denied because my BMI didn't actually hit 40 until just before I started the process. I have none of their listed comorbidities--I have joint and mobility issues do to the weight and that isn't covered.

So I will be reapplying when I have 2 years of records with 40 BMI. But is it really only 2 years of proof, or is it technically 24 months? In other words I was weighed at 40 BMI in July of 2009. I am still at 40 BMI (and will make sure I stay there!) and get weighed in every time I see my Dr--we have a wink wink deal that I go in for any ache or sniffle every few months so that I can also have a weight recorded.

So I have proof that I was at 40 BMI in 2009 and in 2010 and will apply again in 2011. I would love to actually start my pre op diet the end of this year and reapply in Jan 11 and get the surgery scheduled and done. But the CPB does say: obesity that has persisted for at least the last 2 years (24 months)

Does this mean that I really need to wait until July of 2011 so that it will be exactly 24 months from when I can prove my 2009 BMI???

Of course they won't even tell you the answer to this or provide a "partial" approval until you spend the money for the nut. visits and dr. visits. I have already paid all that once and will have to again. I really don't want to have to pay it all a third time if I am denied in Jan 11 and have to wait until July.

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My surgeon's office just sent them my medical records from a doctor's appointment in March 2008 and their own records from an appointment at their office in September 2009.

Just 2 weights. One from 2008 and one from 2009 and this was sufficient. So, I think the answer is 2 years.

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