Aetna Insurance Approval Process

TRL · June 25, 2010

Hello, I'm a new member to this website and just recently had a consultation for the sleeve. I curious if anyone has been in my situation before regarding insurance approval.

I'm finding difficulities in finding records to show my BMI over 35 for 08. This particular "era" I had gone on a major diet & exercise program and lost 50+ lbs. Yay for me! Except, as soon as I jumped off the wagon I gained the 50 back + and extra 15. Wahoo!

Anyway, so the only doc visit records for 08 describe my bmi under 35. The insurance lady at the doc office said to find records from 07 then with the BMI of 35 or 40 which I was able to locate one with 35 BMI & currenlty I'm at 42 BMI & have sleep apnea.

Is there anyone out there who has been in this situation & got approved? I just didn't want to continue scrounging around for all this information & paying more co-pays if its likely not to be approved...

Please help!

settebee · August 26, 2010

I am going through the same problem. I didn't have my weight or bmi documented for 2009, but I ended up going to my gym and asked them to type a letter on their letterhead stating my weight during that time. Maybe you could do that or pull together logs of you weight and weight loss during that year? I hope this helps a little. :001_tt2: Good luck!

Denille · September 14, 2010

Hi TRL, I have aetna as well. I know that it can be nerve racking I am doing the same thing. What you can do is have your surgeon go to bat for you if you get turned down the first time. Mine said he would do that since my BMI is a 39, sleep apnea too. They have a peer to peer consult. It's an option that I know of. Now that I realize that this is late to your posting I feel a bit dumb but I know my words may help someone else. Oh, and my date is for 10/12/10. (crossing fingers).

Denille