Excited Waiting For Gastric Sleeve Surgery Insurance Approval

[mouse trap 5]

Hey Guys this is becoming a nightmare ... Just got off the phone with the Ins. and they are telling me that they want the doctors notes dating back from 2009 and 2010... crazy ..

[longer-life 139]

Hey Guys this is becoming a nightmare ... Just got off the phone with the Ins. and they are telling me that they want the doctors notes dating back from 2009 and 2010... crazy ..

I'm so sorry! If you read above that is exactly what I had to provide. Seems the insurance coordinator at your surgeons office is inexperienced and that is terrible. Aaaaaah! Have hope though. Hopefully it is all they need!

[jasleeve 440]

what insurance do u have?

Hey Guys this is becoming a nightmare ... Just got off the phone with the Ins. and they are telling me that they want the doctors notes dating back from 2009 and 2010... crazy ..

[mouse trap 5]

I have aetna ins. , So just got off the phone with the weightloss center and they said "its in medical review" it can take a couple more days.. this is a never ending sage... ahhh

[longer-life 139]

I have aetna ins. , So just got off the phone with the weightloss center and they said "its in medical review" it can take a couple more days.. this is a never ending sage... ahhh

You are getting close!

[happy1957 138]

Congratulations to all that have been approved. Aetna has denied me yet once again for that one low BMI in 2009. I will appeal again and hope that my documented weights at the beginning of the year when I was heavy and had started the training program will be enough, if not, I have to wait 6 months and start the entire process all over again. So I guess stay fat, wait another 18 month before doing something about it.. Doesn't that seem insane?

[omamilam 11]

Its not so much Aetna as an insurance company that is the problem but the policy your employer purchases for the company you work for. All companies purchase policies with certain guidelines for a fee.

Unfortunately, Aetna requires 6 months of supervised diet and exercise on the program my company purchased. My policy bulletin states you only have to have a BMI of 40 when you submit the per-determination. Your doctors office insurance department is the one that should be helping you but you need to find out on your own what the policy guidelines are for your company policy. I agree with banana Babes. Read the "Clinical Policy Bulletin" at the Aetna website under obesity surgery. It will tell you exactly what you need to know.

[omamilam 11]

I forgot to mention on my policy bulletin with Aetna states, it is required to go to a "Center of Excellence" for my surgery. If yours is like my policy, not any Bariatric doctor and facility will qualify to do your surgery. The Center of Excellence has a solid pre-op and post-op program approved by Aetna. If your facility is not a cener of excellence, I would suggest changing to one that is.

[jasleeve 440]

wow! thats bananas!

Congratulations to all that have been approved. Aetna has denied me yet once again for that one low BMI in 2009. I will appeal again and hope that my documented weights at the beginning of the year when I was heavy and had started the training program will be enough, if not, I have to wait 6 months and start the entire process all over again. So I guess stay fat, wait another 18 month before doing something about it.. Doesn't that seem insane?

[Catracks 865]

Insurance companies that in effect force people NOT to lose weight to qualify or have arbitrary disqualifications (mine says that you cannot be diabetic over age 45) should be ashamed of themselves.

Oh gee, you went from a 40 BMI to 39. DENIED! -- STUPID!!

[mouse trap 5]

finally I'm approved .... YEA!

[jasleeve 440]

congrats!! how long was the wait?

finally I'm approved .... YEA!

[longer-life 139]

Pheeew!!! Congrats Mousetrap!!!!!

[mouse trap 5]

congrats!! :smile1: how long was the wait?

an agonizing 4 weeks ...thx

[jasleeve 440]

4 weeks for approval? YIKES!!!! why so long?

an agonizing 4 weeks ...thx