Jump to content
×
Are you looking for the BariatricPal Store? Go now!

Recommended Posts

I just found out that it doesn't look like Aetna is going to approve my surgery. My BMI is 35, but I don't meet the comorbidities. Apparently, my sleep apnea is not severe enough, it's considered mild. I don't have high blood pressure or diabetes....yet. I am beyond disappointed. My three year old is asking why I am crying. I hate insurance!

Share this post


Link to post
Share on other sites

So sorry honey!

Share this post


Link to post
Share on other sites

I'm really sorry

Share this post


Link to post
Share on other sites

Ins really sucks. My BMI is only 33.3 so I am going to Mexico to have my lap band done. $6500.00 includes everything except airfare to San Diego. Don't have a date yet but I can't wait.

Share this post


Link to post
Share on other sites

I can only imagine how you feel...and I also dislike having to "jump through hoops" to prove the medical necessity for the surgery.

Do your best to focus forward and set some goals for yourself to achieve in your journey towards improved health...exercise helps to improve your mood and burn calories. Emotionally it is much healthier to feel empowered to do something positive for yourself than to sit back and ruminate.

Best wishes...

Share this post


Link to post
Share on other sites

Sorry to hear that.

The band is not covered here in Canada.

I was self-pay. WORTH every penny.

Good luck

Tom, Toronto

Banded July 6 06

Wt. Loss: 156 lbs

Share this post


Link to post
Share on other sites

Talk to your doctor there may be some creative solutions for self pays

I was a bmi of 55 and Aetna wouldn't cover it... My dr and the hospital had an arrangement for self pays ..1/2 down and the other 1/2 was interest free for 2 yrs. the at 2 months post op they called to tell me what a great customer I was...and offered me $.50 on the dollar to payoff my account. It cost me less than if I went to Mexico like I though about.

Good luck to You!

Share this post


Link to post
Share on other sites

Thank you so much guys!! My husband told me today that if we have to self pay, that's what we will do. I am EXTREMELY blessed to have such a supportive and understanding spouse. Now I am going to look into self pay options with my surgeon. Hopefully they offer some sort of interest free payment plan for at least a year or so!

Share this post


Link to post
Share on other sites

I know how bad you feel... I have been denied over the years about 5 times.... unfortunately I wasn't ever able to go the self pay route.. I had to keep trying with insurance company after insurance company.. Every time they renewed our insurance for the year I would look into it.. well... Finally, I was approved... I was banded on 8-1-12.... I pray for you that you will be able to get the surgery through the self pay... that you will find a way... but if you don't.... DON'T give up... NEVER give up!!! Everything happens in God's time. Your fighting for you life.. NEVER give up!

Share this post


Link to post
Share on other sites

Thanks luci! I've been doing a ton of praying! My husband said before the bad news that God would work it out, and I do believe that. Even if we do have to go out of pocket, I believe there is a reason. Like you said, I am fighting for my life, and I am not going to give up!

Share this post


Link to post
Share on other sites

Aww, I'm so sorry to hear that. We hear ya. But I'm so glad to hear that your husband is so supportive! Give him a pat on the pack, he deserves it.

Share this post


Link to post
Share on other sites

Create an account or sign in to comment

You need to be a member in order to leave a comment

Create an account

Sign up for a new account in our community. It's easy!

Register a new account

Sign in

Already have an account? Sign in here.

Sign In Now

  • Trending Products

  • Trending Topics

  • Recent Status Updates

    • Goyafigs

      I had VSG 11.20.24 with Miguel Burch, MD Cedars-Sinai and I am 1 month post-op. 
      · 0 replies
      1. This update has no replies.
    • DaisyChainOz

      🥳 Jan 1 2025 - Day 1 of Pre Op, surgery on the 16th! 😬😅
      · 0 replies
      1. This update has no replies.
    • Alisa_S

      Just been waiting until time for my consult with my bariatric surgeon. It's scheduled for Jan 9th. Turns out I won't actually be seeing him. Apparently it'll be with his P.A.             Not sure what to expect. I thought this is where the surgeon would discuss the best surgery option for me. For years I had my heart set on the sleeve, but I've read so many people have issues with reflux - even if they've never had it before - that they've had to be revised to the bypass. I already deal with GERD & take 40 mg of Omeprazole daily, so I started studying about bypass and honestly, it seems like it might be the better choice for me. How can we discuss surgery options if the surgeon is not there?
      What happened at your first consult? Trying to get an idea of what to expect, or maybe I should say, what NOT to expect.
      · 0 replies
      1. This update has no replies.
    • rinabobina

      I would like to know what questions you wish you had asked prior to your duodenal switch surgery?
      · 0 replies
      1. This update has no replies.
    • cryoder22

      Day 1 of pre-op liquid diet (3 weeks) and I'm having a hard time already. I feel hungry and just want to eat. I got the protein and supplements recommend by my program and having a hard time getting 1 down. My doctor / nutritionist has me on the following:
      1 protein shake (bariatric advantage chocolate) with 8 oz of fat free milk 1 snack = 1 unjury protein shake (root beer) 1 protein shake (bariatric advantage orange cream) 1 snack = 1 unjury protein bar 1 protein shake (bariatric advantace orange cream or chocolate) 1 snack = 1 unjury protein soup (chicken) 3 servings of sugar free jello and popsicles throughout the day. 64 oz of water (I have flavor packets). Hot tea and coffee with splenda has been approved as well. Does anyone recommend anything for the next 3 weeks?
      · 1 reply
      1. NickelChip

        All I can tell you is that for me, it got easier after the first week. The hunger pains got less intense and I kind of got used to it and gave up torturing myself by thinking about food. But if you can, get anything tempting out of the house and avoid being around people who are eating. I sent my kids to my parents' house for two weeks so I wouldn't have to prepare meals I couldn't eat. After surgery, the hunger was totally gone.

  • Recent Topics

  • Hot Products

  • Sign Up For
    Our Newsletter

    Follow us for the latest news
    and special product offers!
  • Together, we have lost...
      lbs

    PatchAid Vitamin Patches

    ×