So frustrated. :(

[flmama 105]

So I had pulled requirements from my insurance companys website and was prepared to do the 3 or 6 month Aetna pre-op stuff.

When my surgeon's office called to pre-verify everything before even scheduling my first visit (which took WEEKS, when it should've just taken minutes...first batch of time wasted), they stated that the insurance company said I just had to have "tried and failed" to lose weight in the past. But couldn't say anything about specific diets and there were "no specific requirements." I asked multiple times if they were sure. I called my insurance company and asked and they said to follow my surgeon's instructions.

So here I am, on March 4, after wasting yet another month for PCP/surgeon to get all of their paperwork together and get it submitted, and I find out that YES, I have to have a 6 month physician supervised diet.

I didn't see my PCP at all in February, because I saw the surgeon and my surgery was supposed to be this month.

I'm so freaking frustrated. I was mentally prepared to do the 3/6 month thing, and then they told me I didn't have to. And now here I am again, and I do have to. And I can't even count my January visit, since I didn't see him in February. And I'm not going to count my February visit with the surgeon, because I'm not making a 9 hour roundtrip drive once a month for 6 months.

I'm FURIOUS.

[joatsaint 2,814]

Do they require documented evidence that you had a supervised diet? My bariatric surgeon only asked me if I had been on one - same with the psychiatrist, but never required the paperwork. My insurance never questioned it either.

[sramos89 260]

It is a long journey- It can take months. But unless you are self pay, what are your other choices? In six months you could be approved and preparing for surgery or you could be overweight and unhappy.

Surgery is a huge undertaking and I didn't mind all of my appointments or "hoops" I had to jump threw- I was happy to do it and I am happy to have had the surgery. I say stick with it if you really think this surgery will help you. This is not a quick fix and neither is the process.

[Native 17]

I felt like all of my appointments, including sleep studies, endoscopies, psychiatric evals, ekgs, so on and so forth that spanned for 3 months was like having a part-time job. LOL. My friend was self-pay and got it done in 2 weeks ........ with only an endoscopy .......... but she paid like $10,000 out of pocket.

[flmama 105]

Do they require documented evidence that you had a supervised diet? My bariatric surgeon only asked me if I had been on one - same with the psychiatrist, but never required the paperwork. My insurance never questioned it either.

Yes, they require documentation from the physician and I have to keep a food/exercise journal.

[flmama 105]

It is a long journey- It can take months. But unless you are self pay, what are your other choices? In six months you could be approved and preparing for surgery or you could be overweight and unhappy.

Surgery is a huge undertaking and I didn't mind all of my appointments or "hoops" I had to jump threw- I was happy to do it and I am happy to have had the surgery. I say stick with it if you really think this surgery will help you. This is not a quick fix and neither is the process.

Yes, it is a long journey. One I've been preparing for for several years. I've been in therapy for my eating disorder for quite some time. It is a major set back to be told you're going to be an "easy" case insurance-wise and you're ready to go when you've been mentally preparing for years.

[Jacqueline Marie 73]

I have aetna as well, I was required only 3 months even though I have seen a nutionist in the past. You will have to go through hoops and jumps but in the end it will be worth it. As long as you stay positive the process will go by fast.

[Kristina J. 581]

Oh no!!! I am sooo bummed for you and I know how frustrated you must be right now!!!! I was really hoping the next I would hear from you was your confirmed and approved surgery date! It is so frustrating when we more than meet the strictest requirements and then there are these specific steps that have to be taken a certain way to officially qualify. It's not that I don't understand their necessity, but they can be very frustrating to someone like you who has been through so much already to prepare for this.

The only comfort I can offer you is that at least there are hoops to jump through, as frustrating as they may be. I begged for hoops and was simply told no. No matter my BMI or health issues, WLS is never covered by my otherwise great insurance. But I do know that's small comfort when you're just flat out frustrated!!

I'm so sorry Mama. But... Your time will come and you will so this. You were mentally prepared before and you will be again soon.

You get 3 days for a pity party... Then, you hunker down and start planning for your diet!! Deal?!? Hang in there!!!

[flmama 105]

Oh no!!! I am sooo bummed for you and I know how frustrated you must be right now!!!! I was really hoping the next I would hear from you was your confirmed and approved surgery date! It is so frustrating when we more than meet the strictest requirements and then there are these specific steps that have to be taken a certain way to officially qualify. It's not that I don't understand their necessity, but they can be very frustrating to someone like you who has been through so much already to prepare for this.

The only comfort I can offer you is that at least there are hoops to jump through, as frustrating as they may be. I begged for hoops and was simply told no. No matter my BMI or health issues, WLS is never covered by my otherwise great insurance. But I do know that's small comfort when you're just flat out frustrated!!

I'm so sorry Mama. But... Your time will come and you will so this. You were mentally prepared before and you will be again soon.

You get 3 days for a pity party... Then, you hunker down and start planning for your diet!! Deal?!? Hang in there!!!

Don't I know that! We hoped and prayed for this job for YEARS, because we knew that they covered WLS. Ugh. I just had no idea when we got here there would be hoops and hoops and hoops. Of course, I KNOW that their desire is to avoid paying for the surgery if at all possible.

I already cussed at my hubs on the phone...he took the brunt of my frustration. I'm hoping on some hand that his phone call to them accusing them of being intentionally misleading will somehow equal an approval, but I doubt that's going to happen. We are due a really really large tax refund, so I am looking into MX too, just in case. It was supposed to buy us another vehicle, but who needs 2 cars?

When does my 3 days start? Tomorrow?

[Kristina J. 581]

Don't I know that! We hoped and prayed for this job for YEARS' date=' because we knew that they covered WLS. Ugh. I just had no idea when we got here there would be hoops and hoops and hoops. Of course, I KNOW that their desire is to avoid paying for the surgery if at all possible.

I already cussed at my hubs on the phone...he took the brunt of my frustration. I'm hoping on some hand that his phone call to them accusing them of being intentionally misleading will somehow equal an approval, but I doubt that's going to happen. We are due a really really large tax refund, so I am looking into MX too, just in case. It was supposed to buy us another vehicle, but who needs 2 cars? <img src='http://www.bariatricpal.com/public/style_emoticons/<#EMO_DIR#>/tongue.png' class='bbc_emoticon' alt='' />

When does my 3 days start? Tomorrow? <img src='http://www.bariatricpal.com/public/style_emoticons/<#EMO_DIR#>/tongue.png' class='bbc_emoticon' alt='' />[/quote']

Lol nice try, no!!! 3 days, starting today!! lol

I know Mexico isn't for everyone, but with no insurance option, it's my only choice to get this lap band out and fix this mess. I've had surgery out of the country before and I was terrified, and almost ran back to the airport in tears the night before surgery lol but I did it and the care was excellent. Medical Tourism caters to US patients. Things look older and can be a little scary, but the level of care is wonderful and honestly, my surgeon has done more revisions then the specialists in my area. I feel more comfortable with his experience level. But, I know your concerns with coverage when you return, as my insurance is the same. I know it's a risk, and maybe a foolish one, but at this point, I don't see another option for me! So the hubs in on board and off we go!

And 2 cars? Eh... Once you lose weight you can just plop the kids in a wagon and pull them around town! Hahahaha

[flmama 105]

Lol nice try' date=' no!!! 3 days, starting today!! lol

I know Mexico isn't for everyone, but with no insurance option, it's my only choice to get this lap band out and fix this mess. I've had surgery out of the country before and I was terrified, and almost ran back to the airport in tears the night before surgery lol but I did it and the care was excellent. Medical Tourism caters to US patients. Things look older and can be a little scary, but the level of care is wonderful and honestly, my surgeon has done more revisions then the specialists in my area. I feel more comfortable with his experience level. But, I know your concerns with coverage when you return, as my insurance is the same. I know it's a risk, and maybe a foolish one, but at this point, I don't see another option for me! So the hubs in on board and off we go!

And 2 cars? Eh... Once you lose weight you can just plop the kids in a wagon and pull them around town! Hahahaha [/quote']

I'm not afraid to go out of country other than the insurance exclusion...ive been out of country for Medical Tourism unrelated to obesity. It was a good experience!

[Kristina J. 581]

Oh that's awesome! I know that was a huge help for me. That first experience was crazy nerve wracking, but this time around I'm not nervous about the location, just the surgery itself!

But I understand your dilemma totally. I would be torn too! You could realistically be looking at another 9-12 months, vs heading out after you get back from Easter, but adding the risk... I would talk it over with hubby. You need to do what is best for your health. Money is definitely important, but your health is too! Thinking of you!!