bluegirly 343 Posted September 13, 2012 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
vmarlau 207 Posted September 13, 2012 So sorry honey! Share this post Link to post Share on other sites
lapbandct07 23 Posted September 13, 2012 I'm really sorry Share this post Link to post Share on other sites
dhg 4 Posted September 13, 2012 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
Sojourner 2,446 Posted September 13, 2012 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
Tomander 614 Posted September 13, 2012 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
FLORIDAYS 3,040 Posted September 14, 2012 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
bluegirly 343 Posted September 14, 2012 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! 1 shelly513 reacted to this Share this post Link to post Share on other sites
lucie159 89 Posted September 14, 2012 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
bluegirly 343 Posted September 14, 2012 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
maxeen29b 0 Posted September 14, 2012 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