Crap... worried and disappointed

[Miss Piggy 30]

Long story short... I have (and consistently have had) a BMI of 36-37. I have Aetna insurance and was hoping that I would be diagnosed with sleep apnea to use as my comorbidity. Got the resuts of my sleep study and it was clear . I know I am continuing on with my 3 month multi disciplinary and hoping it somehow gets approved. I have started to formulate a letter listing my other conditions and hoping it will push it through. I have a history of depression (documented that it stems from my weight), spinal stenosis and herniated discs. It also appears from my most recent blood work that the I have pre-diabetes and very high triglycerides.

Just hoping for some words of wisdom or suggestions I guess. Feeling pretty defeated.

[annabelle 76]

the fact that your bmi is over 35 and your pre-diabetic you would think that was enough for you to pass, fingers crossed for you that you will get it x

[Miss Piggy 30]

Thank you... the pre-diabetes is a recent find so I'm hoping that will do it. It's so hard but I'm trying not to get my hopes up.

[*Dean* 1,594]

Stay positive. You can't do more than you're doing and unfortunately you don't have any control over the insurance companies.

I have to say your health system over there sounds stinky!

[Takingcontrol 467]

I have Aetna & had no comorbitites! I did have to appeal & wrote a letter like your talking about! I also listed my family history which is Very high in diabetes, hypertension, & heart disease! I also pointed out the fact that high triglycerides & cholesterol are indeed considered cardiac disorders! I was approved within a week!

[Amie 90]

Ankle weights, I'm not joking.

[vsginnj 415]

Perhaps you should have your dr remeasure your height (slouch a bit and remove your shoes) 1 inch makes a substantial difference in BMi .

[stafhill 12]

I also have atnea and was approved 2 weeks ago and my date is march 20 start diet tomorrow; my bmi is 36 and I also wrote a letter and was approved the first time; I think they are no as hard to get approved as most insurance; just write a letter why u want this and all the different diet plans u have done and explain that the injections are painful and phentermine gave u heart palps. And just make it sound real good; hope this helps

[sstrick 5]

I have a question for those of you who wrote to Aetna. Had your BMI >35 been documented by physicians for 2 years or more? I decided to self pay because the coordinator at my surgeons office wouldn't even submit to Aetna because my physician-documented weights didn't show BMI >35 in 2011. I'm wondering if I should have tried harder to get approved before throwing in the towel and paying

[Miss Piggy 30]

Thanks everyone I just finished my letter and talked to my coordinator. She said we will make the best case we possibly can and hope for the best although there are no guarantees. So... I just have to wait... and wait... and wait. It won't even be submitted until mid-April.

I have totally thought about the weights (and I would do it in a heartbeat) but I don't think that would help my case since I have never been above 40 BMI.

I have a question for those of you who wrote to Aetna. Had your BMI >35 been documented by physicians for 2 years or more? I decided to self pay because the coordinator at my surgeons office wouldn't even submit to Aetna because my physician-documented weights didn't show BMI >35 in 2011. I'm wondering if I should have tried harder to get approved before throwing in the towel and paying

My BMI hasn't been below 35 in over 8 years. I have records showing it between 36 - 37 for the last several years, never going below 35 and never going above 40. If your BMI is below 35, I don't think there is a chance to get approved with Aetna. They will approve at above 35 with a comorbidity though or above 40 withough a comorbid.

[PaperBullets 53]

You may want to look at your triglycerides and colesterol levels and see if they're high. If they are, and you have an apple sort of shape then you have "metabolic syndrome" which is considered a co-morbidity by just about everyone. Rofl, that's what got bcbsnc to approve mine since I also flunked the sleep apnea test! Good luck!

[Miss Piggy 30]

You may want to look at your triglycerides and colesterol levels and see if they're high. If they are, and you have an apple sort of shape then you have "metabolic syndrome" which is considered a co-morbidity by just about everyone. Rofl, that's what got bcbsnc to approve mine since I also flunked the sleep apnea test! Good luck!

Good to know... thanks!!!