Aetna approval 2nd time around

[mst 1]

I am awaiting my approval (fingers crossed) with Atena. They turned me down the first time becuase I had no co-morbities. I finished the 3 month diet/excercise program with my doctor on Monday and they are resubmitting the request. Has anyone had an approval the 2nd time around with Aetna? My BMI is 35, so I'm worried about that as well.

[CoCoA-RN 1]

Hey I have Aetna also. Just wondering...you said that they turned you down the first time because you had no co-morbidities? So had you gone through the diet process and everything and they turned you down, or was it at the beginning? How much wieght did you loose on the diet program? What was your starting BMI? My best friend and I both have Aetna but we also both have co-morbidities and BMI's over 40 so it made it a little easier. I wish you luck. Will certainly keep my fingers crossed for you as well.

[Lady_Dragyn 2]

Hey I have Aetna also. Just wondering...you said that they turned you down the first time because you had no co-morbidities? So had you gone through the diet process and everything and they turned you down, or was it at the beginning? How much wieght did you loose on the diet program? What was your starting BMI? My best friend and I both have Aetna but we also both have co-morbidities and BMI's over 40 so it made it a little easier. I wish you luck. Will certainly keep my fingers crossed for you as well.

I have Aetna and have several comorbidities and a bmi over 40 and got approved through Aetna the first time through. But I researched it a lot prior to going, which included going to their website and talking with their reps to see what they required to consider/approve the surgery. My doctor's office is also fantastic at making sure everything is done just so to help "gaurantee" an approval.

Best of luck to you both!

[SIPS in Seattle 344]

I am awaiting my approval (fingers crossed) with Atena. They turned me down the first time becuase I had no co-morbities. I finished the 3 month diet/excercise program with my doctor on Monday and they are resubmitting the request. Has anyone had an approval the 2nd time around with Aetna? My BMI is 35, so I'm worried about that as well.

I have Aetna, I was denied on the initial and on the first appeal. Obesitylaw.com helped me with my appeals, and my second appeal was finally approved. My surgery is tomorrow!

Good luck!

[mst 1]

Hey I have Aetna also. Just wondering...you said that they turned you down the first time because you had no co-morbidities? So had you gone through the diet process and everything and they turned you down, or was it at the beginning? How much wieght did you loose on the diet program? What was your starting BMI? My best friend and I both have Aetna but we also both have co-morbidities and BMI's over 40 so it made it a little easier. I wish you luck. Will certainly keep my fingers crossed for you as well.

I had not gone thru the diet process yet when they turned me down the first time. I took a sleep apnea test and they said I was borderline, but not "bad" enough to qualify. I only lost 12 lbs on the 3 month diet process. Mainly becuase I suck at going at it on my own! lol hence why I want the band My starting BMI was 35, it is down to 34 now. I'm hoping for the best, but preparing for the worst!

[mst 1]

I have Aetna, I was denied on the initial and on the first appeal. Obesitylaw.com helped me with my appeals, and my second appeal was finally approved. My surgery is tomorrow!

Good luck!

Congrats! That makes me pretty hopeful. Did you also have co-morb's? Just curious. Good luck with your surgery!!!

[SIPS in Seattle 344]

Congrats! That makes me pretty hopeful. Did you also have co-morb's? Just curious. Good luck with your surgery!!!

Hiya,

I did the sleep study but wasn't considered bad enough. According to the guidelines I didn't have any others. Although I have pretty bad asthma and have already had spinal fusion surgery when I was 32... If I don't drop the excess I'll eventually end up losing another disc ;(

If you are havin problems with approval I totally recommend obesitylaw.com. They're advocates that help with appeals... Best part is Allergan the makers of lap band footed the bill!!!

Good luck all

[mst 1]

Hiya,

I did the sleep study but wasn't considered bad enough. According to the guidelines I didn't have any others. Although I have pretty bad asthma and have already had spinal fusion surgery when I was 32... If I don't drop the excess I'll eventually end up losing another disc ;(

If you are havin problems with approval I totally recommend obesitylaw.com. They're advocates that help with appeals... Best part is Allergan the makers of lap band footed the bill!!!

Good luck all

Sweeeeet! If i am denied this time I will definatly give them a try. Thanks so much for your advice!

[SIPS in Seattle 344]

Sweeeeet! If i am denied this time I will definatly give them a try. Thanks so much for your advice!

My surgeons office actually told me about them... So if it does happen your surgeons insurance dept can probably give you more info

[CoCoA-RN 1]

Hey,

So before you submitted you information the first time...you had only had the sleep study and your BMI reference of 35? I was reading over the Obesity Surgery Bulletin by Aetna Insurance and they have their criteria clearly defined. It looks as though if it's 40 or more they will do it or if its above 35 with 2 or more comorbidities. I am hoping that your appeal works so that you can continue on your way with the process.

I had not gone thru the diet process yet when they turned me down the first time. I took a sleep apnea test and they said I was borderline, but not "bad" enough to qualify. I only lost 12 lbs on the 3 month diet process. Mainly becuase I suck at going at it on my own! lol hence why I want the band My starting BMI was 35, it is down to 34 now. I'm hoping for the best, but preparing for the worst!

[mst 1]

Just found out I was denined again I guess I will try obesitylaw.com....if not, I guess I will be saving all my pennies for the next 3 years and do it on my own.