Denied from Aetna

[CCastllanos22 13]

Ok sooo im soooooo upset and pissed off...I cryed myself to sleep last night!!!

8 days before my surgery date...im denied!!!!!

all because my insurance company Aetna says they need 2yrs of weights on me higher then a BMI of 40 and in 2008 I weighed less so they denied me!!!

I dont have any other problems, no high blood pressure of sleep apnea !!! but Im heavy and always have been...

has anyone went thur this and if u did please help....I want this band soooooo bad...!!!!!

[Melinco 1]

When in 2008 were you below the 40 BMI? If it were in the beginning of 2008 (such as January through June), it has now been 24 months (two years) since then, and I'd appeal their decision. If it were in the latter part of 2008 (July through December), you may just have to wait until it has been a total of 24 months since that lowest BMI.

Good luck with it!

[CCastllanos22 13]

Hi, yes my BMI in 2008 was lower then 40 and I think I went to the doc in april/08... I will have to look.. thanks

[CCastllanos22 13]

Ok soo I checked and yes it was in april 2008... but april 09/ to april 2010 is only 1 yr not 2... omg im sooo confused!!!! Help

I also gave them weights in 2005 and 2006 do u think that will help???

[ladybug on a mission 0]

Tina,

I am so sorry! I can only imagine how frustrating this is for you. I would get all my weights together for as far back as you can go and send all of it in. Definetly appeal!

[CCastllanos22 13]

My docs put in everythin on wednesday again... i dieing here i need to know if i got approved.. its killing me...

I just soo worried its gonna get deined again!!!

[migman 0]

Hi Tina,

I was denied twice before I was approved. I was just banded on July 6th. I appeal after both denial. I did everything they asked and finally got the approval. Hang in there!!!!!!

[CCastllanos22 13]

thxs guys for all ur help and concerns!!!

I just wish i would here something already!!! Im hangin in, trying to be positive!!!

[cunner 21]

I wish I could be encouraging but I am in the same situation. I got a denial on my appeal yesterday from Aetna. It seems they now have decided that my hypertension I have been taking medication for for the last 8 years is non existent and my sleep apnea which I have been on CPAP therapy for since March is now just "snoring". The high Cholesterol and GERD which are obesity related conditions in which I am also taking medication for are not even considered. They are friggin criminals !!!!

I wish you luck. I hate Atena.

[NC Dave 1]

You have to remember that insurance companies are in the business of collecting premiums and investing, not health care.

Worry the hell outta them til they say yes.

dave

[poppieswife 0]

Wow now I'm a little scared. I have Aetna too and have not even put in my paperwork yet. I have my phyc evaluation on the 16th then I'm done except for Aetna's appproval. My doctor's office said I didn't need the 2 year history but I think I will work on getting that now and have them send it anyway. Does anyone know what kind of form it needs to be on? I examples of the weight loss program that my doctor used put not sure how they expect the 2 year history.

[poppieswife 0]

look at this old post I found maybe this will help you get approved it is worth a shot.

http://www.lapbandtalk.com/f8/approved-aetna-without-complete-medical-history-55056/

[misslec 0]

I found out yesterday I was denied for my lap-band with my surgery scheduled for dec.7. The office is going to appeal the decision. I jumped through all the hoops.I dont understand why I was denied. My bmi is 41. I have high cholesterol, asthma, failed all diets, and had to have knee surgury due to my weight.......UGGGGHHHHH!!!!!!