Aetna Insurance - Is this do-able before 12/31/2010?

[sarytyr 0]

I apologize in advance for my long leadup to my question.

I had an appointment with my PCP today concerning switching meds for my RLS and told him of my plans to pursue WLS with the LAP-BAND - he was very supportive. I am attending a seminar tomorrow evening. My BMI has been over 35 for most of the past 20 years and I have tried repeatedly to lose weight only to gain it back plus more. My BMI is currently over 40, I have been on medication for HBP for at least 13 years, I have obstructive sleep apnea and have used a CPAP since January of 2006 and am having a test done to see whether the air pressure needs to be increased due to my weight gain and daytime sleepiness.

In 2007-2008 I trained hard for and completed 2 sprint triathlons and 2 mini-sprint triathlons but only lost 15 lbs in over a year. I had gallbladder surgery in 2009. I had foot surgery earlier this year because of the repetitive stress of the weight during that triathlon training. I have gained 25 pounds back. I have had expensive (unsuccessful) procedures trying to manage my lower back pain and physical therapy for knee tendonitis and a torn meniscus ligament (which does not need surgery at this time).

So my question is: I have Aetna NAP Choice POS II insurance which covers the procedure and am expecting to get the requirements in the email any day. Needless to say, it has been an expensive year, medically speaking. I am less than $300 away from my annual out-pocket-maximum and I really need to have this surgery before December 31st. Is this doable, even with a 3 month supervision requirement?

I am 50 years old can't wait to be able to be more active again. I am not afraid of exercise but diet is my weakness and need this help to get to a healthy weight and stay there for the rest of my life!!!!!

[timandmich 3]

I have the same ins- my first actual appt was April 8... And I was banded on Aug 13. It's tight... But if you get an appt soon, I DO think it's possible. I had to do 4 weightloss visits- if you have to do only 3, you should be fine.

Good luck!!

[Bryn 3]

I too have Aetna and was concerned about wondering if i went through everything, if i could have the surgery before the new year. my first consultation with the surgeon is in one week (made the appt. 2 weeks ago thinking i would get in asap, but that was the next available :thumbup: )

i would like to have it before the new year so that :

1) i would be on break from school and work during the holiday season so people wouldn't be suspicious

2) i wouldn't have to worry about any changes in my plan that my employer may make. not saying they will make changes (past two years they have not) but ya never know. i work in health care and come october, changes are coming in health care and employees will feel it.

but if you time everything, three months from now is early december, so it is possible :thumbup: good luck!

[sarytyr 0]

I just attended my seminar this evening and one of the people there suggested that my best change to reach that date is to start the 90 day program ASAP and to not wait for my 1st surgeon's appointment. She gave me the website of the nutritionist/psychologist who does their surgical group's 90 day pre-op programs and I have an appointment with her on Monday.

Still don't know whether things will happen in time, but I am going to try like hell!