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

Aetna Sleevers - Share Your Approval And/or Denial Experiences Here!



Recommended Posts

Denied by atena 39.5 bmi high cholestral n high blood pressure peer to peer was thurs no word yet

What's involved in a peer to peer?

Share this post


Link to post
Share on other sites

Approved...today by Aetna...Surgery on Tuesday. ..

Share this post


Link to post
Share on other sites

Thanks!

Share this post


Link to post
Share on other sites

Initially denied....approved this morning after peer to peer!!!!!!!!!

37 BMI

Tons of comorbids but nothing that Aetna usually considers. So grateful!!

Tentative surgery date of June 5th

Miss Piggy,

Would you mind sharing with me some of your comorbids that Aetna doesn't usually consider. I have none on their "list," but lots of orthopedic problems related to excess weight. Thanks for any info. Feel free to private message me if that makes you more comfortable.

Share this post


Link to post
Share on other sites

My bmi was 49 with no comorbities and I was initially denied by Aetna twice. I was only required to undergo three months of nutritional counseling but ultimately went though 12 months. I was denied the first time because my surgery was outside of process by 4 days due to a holiday weekend, and told to go through three more months of nutritional supervision.

I'm fought with Aetna for 18 months before hiring a healthcare advocate at great cost, who threatened to sue and go to the media. She also wrote a scathing letter to the Chief Medical Officer stating the same and detailing the huge liability to Aetna based on my medical history. I had a knee replacement, spinal/neurosurgery, and several of procedures which were mostly weight related. i received a call from the medical review and appeals department overturning the denial one week after the letter was received by the CMO. I was finally sleeved on 2/19/13 and I am down 80 lbs so far.

Share this post


Link to post
Share on other sites

so you can use the weight from a hospital procedure? I might need to do that-- for bcbs MI

Share this post


Link to post
Share on other sites

Appppppprovvvvedddddd

Share this post


Link to post
Share on other sites

Appppppprovvvvedddddd

Congrats. How long did it take, what is your surgery date, and with what Dr? So exciting!!!

Share this post


Link to post
Share on other sites

Congrats. How long did it take' date=' what is your surgery date, and with what Dr? So exciting!!![/quote']

well my original dtae was may 21 ive been fighting since then no date yet cause i called atena and found out couldnt wait any longer for letter ill update on surgery date i was denied the day before surgery

Share this post


Link to post
Share on other sites

Doc. submitted paper work on Friday 7/12/2013. Still waiting to hear something from Aetna. If approved I think my surgery date will be 8/12/2013. Will be so happy to get this done and hope to get off my BP meds, CPAP machine, Fluid pills, and hope my Knees feel better. I pray that the Lord guides the Doctors hands while he preforms this surgery on everyone having the surgery. NO LEAKS!! AMEN

Share this post


Link to post
Share on other sites

Aetna takes up to 15 days...

Share this post


Link to post
Share on other sites

Well found out today that Aetna denied my surgery due to not completing the 90 days.

I counted up and I had completed 97 days. Doc will appeal and there will be a Pier to Pier review.

Sure hope it doesn't take to long for them to approve this. Surgery was scheduled for Aug. 12, 2013.

Can hardly wait to get this weight off and new improved health. Come on AETNA help me make this happen. :unsure:

Share this post


Link to post
Share on other sites

Well found out today that Aetna denied my surgery due to not completing the 90 days.

I counted up and I had completed 97 days. Doc will appeal and there will be a Pier to Pier review.

Sure hope it doesn't take to long for them to approve this. Surgery was scheduled for Aug. 12' date=' 2013.

Can hardly wait to get this weight off and new improved health. Come on AETNA help me make this happen. :unsure:[/quote']

Someone had there dates wrong!!! Call them yourself they will answer any questions you have.

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

    • LadyVeteran1

      Sleeve surgery is on April 14th.  I am counting the days!!  Can't wait!
      · 3 replies
      1. Brookie2shoes

        Me too girl!! Are you in the full liquid diet right now? It’s sooooo hard!

      2. LadyVeteran1

        Not yet. I was told I only have to do 24 hours of a liquid diet. But I have my pre-op tomorrow so I’m going to confirm if I need to do longer.

      3. buildabetteranna

        Your so close now! It's gonna be great :) Wishing you a speedy recovery and looking forward to seeing how it goes!

    • buildabetteranna

      Down 33 lbs and slightly stalled, but I'm gonna reevaluate and push through. I started back to work last week after 2 years of being disabled due to mental health as well as my weight. It's a great job and I'm just so happy to have this opportunity at a second chance at life. Hope everyone is having their best journey ❤️ Together, we got this!
      · 2 replies
      1. DaisyChainOz

        Great work Anna! Keep it up 😁

      2. buildabetteranna

        Thank you ❤️

    • Bashbee91

      Hey guys new to the process looking forward to this new life. 
      · 0 replies
      1. This update has no replies.
    • Bugg

      Hi everyone! I’m brand new here. I just went through all my pre-op requirements per my insurance company and now everything has been submitted and I’m just waiting for final approval and my surgery date. I’ve been doing research, watching YouTube videos, TikTok’s, ect.. trying to prepare my mind and what to expect so I’ll be ready for the surgery. I was so sure and so set and so ready and excited. However, now that I’ve done everything & it’s almost here, I am sooooooo scared! I know why I want it bc I’ve tried everything and I just don’t feel like I can lose weight by myself. I’m tired of being overweight my entire life. I’m miserable, but I keep psyching myself out afraid of GERD bc I know how that can be and I don’t want to have to get a bypass after already gaining the courage to even get VSG. I’m scared of complications like I’mgoing to regret doing it and be depressed that I didn’t just be more disciplined and try again to lose the weight on my own even sitting here typing this knowing in my mind i just can’t and don’t possess the discipline. I’m also afraid I won’t be able to handle the restrictions of the sleeve. What do I eat? I don’t know how to eat healthy really and don’t enjoy healthy food. I don’t know how to do this! I feel so defeated!Someone tell me they felt anything similar to this or am I not ready? I thought I was. I am so tired of being sick and tired and so tired of myself and so tired of being stuck and stuck in this body and somebody different on the outside from what I feel inside. I just want to ball up and cry.
      · 1 reply
      1. stevieoriole

        Am feeling this right now. My surgery date is 4/1. Sign the consent tomorrow. I feel like I overloaded myself with too much info, too many opinions. Got to the point where I was wondering if I should do this. Then I thought of my reasons for taking this step and that settled my nerves. Still get moments of doubt but am striving forward. Am just going to follow my book from the surgeon. Joined this because I was told by my dietician that I should do this for support

    • buildabetteranna

      over 20 lbs down since4 the pre surgery diet and surgery on the 14th
      · 1 reply
      1. Selina333

        Yay!! Congrats. I know how good that feels. 🤩

  • 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

    ×