Aetna - Approved!!!!

[MaggieB 6]

I have Aetna POS and just had to post that I have been approved. After everything I had read on this board and what the doctors office told me - I had my doubts that it would happen.

My current BMI is 40 (and heaviest) and was just diagnosed this year with sleep apnea while going thru all of preliminary stuff Aetna makes us do. My BMI for 2007/08 was 38 (no other health problems) & I did not have a documented weight for 2009. So there is hope for you guys out there in a similiar situation.

My preop is scheduled for June 1, I start my preop "full liquid" diet on June 7 and my Lab Band surgery is scheduled June 10th.

I'm so excited!!!:smile2:

[Blaze21 5]

Congratulations and good luck on your journey.

[AmberK 5]

How long did it take for Aetna to approve you? I have my last appt with my PCP of my 6 month diet and then the surgeons office will be submitting for approval to Aetna so Im curious to know how long it took. Drs office told me they have 30 days but Aetna usually approves in 2 - 2.5 weeks. Im wondering if I call and gently nudge them if they will approve sooner???

[MaggieB 6]

My info was submitted April 30. I called Aetna May 12 - they told me the info was received on May 11. I was approved May 18. Received approval letter May 24.

My doctor office told me Aetna had up to 90 days to approve/deny request.

[wisaluv 0]

congrats! you have had surgery now as today is june 16. I was wondering, what does POS mean?

[MaggieB 6]

No idea what POS means - its listed on my card.

Edited June 17, 2010 by MaggieB

[Namovicz 0]

Wow I thought it would take 6 months to jump through all the hoops. I go to the informational meeting tonight and start the process. I am hoping to get the surgery about 9/1. It sounds like that MAY happen.

CONGRATS!:biggrin:

[MaggieB 6]

Wow I thought it would take 6 months to jump through all the hoops. I go to the informational meeting tonight and start the process. I am hoping to get the surgery about 9/1. It sounds like that MAY happen.

CONGRATS!:biggrin:

It did take about 6 months to go thru the requirements. I started the required appointments in January - sleep study, psych eval, 3 monthly visits with nutritionist & 4 monthly visits with doctor.

Good Luck!

[Namovicz 0]

Thanks for the reply. I am already on a CPAP for severe apnea so that is one less issue to tackle. It is good to hear a little about the process.

[jprice332009 0]

I was denied by my insurance (Aetna). My Dr. requesting me to have an sleep study done. Have anyone out there been through this? I you have can you please tell me the process? What happens after the sleep study, do they resubmit and how long does that take? I have everything else done... thanks Jprice33

[Namovicz 0]

The sleep study will require an overnight stay in a sleep lab. I had it done 10 years ago so things may be a little different. It was done at Johns Hopkins in Baltimore and was the worst night's sleep I think I have ever had. I am thankful now that I did it because the apenea that I have is pretty bad. I have been using the mask for about 5 years (I was resistant the first 5 years). As for the part about being resubmitted to Aetna I do not know. The whole Aetna/lap band thing is new to me.

[MaggieB 6]

Sorry - I don't know about the denial and appeal process with Aetna.

My sleep study required an overnight stay - in the lab at 10pm out the door at 530am. I also had the worst night of sleep - still can't understand if results are accurate because I felt I didn't sleep at all. About a week later I had to go back to be fitted for a mask/CPAP machine. Basically the same thing happened - in by 10 out at 530am. Got my CPAP machine about a week after the last appointment.