anybody eles with Aetna insurance?

[Caligirl530 6]

I am just looking for some information on the process through Aetna. Like how long they required the supervised diet and how long to get approved. I am 2 months into my journey and just looking for some uplifting hopefull news

[TrophyWife 11]

I have Aetna insurance and have just finished my pre approval requirements and am waiting to see if I get approved (fingers crossed). Aetna required 3 consecutive months of supervised diet/fitness and MD visits and also 2 yrs of weight history and any co-morbitities.

The last is my big if. I lost weight a few years ago and worry that it put me under the high end of BMI. I have put weight on over this last year and was the reason behind my surgery decision now. Ironically the fact that I am to healthy, even at a 46 BMI, may require me to work harder to get approval. I should be hearing back my the middle of the week and will check back in with my status. Good luck. Aetna has always been great to us and easy to work with. I hope that trend continues and I hope we both have good luck.

[TrophyWife 11]

By the way. I live in WA, but my husbands company is out of California, so I would think is may be similiar to what you have.

[Caligirl530 6]

I have Aetna insurance and have just finished my pre approval requirements and am waiting to see if I get approved (fingers crossed). Aetna required 3 consecutive months of supervised diet/fitness and MD visits and also 2 yrs of weight history and any co-morbitities.

The last is my big if. I lost weight a few years ago and worry that it put me under the high end of BMI. I have put weight on over this last year and was the reason behind my surgery decision now. Ironically the fact that I am to healthy' date=' even at a 46 BMI, may require me to work harder to get approval. I should be hearing back my the middle of the week and will check back in with my status. Good luck. Aetna has always been great to us and easy to work with. I hope that trend continues and I hope we both have good luck.[/quote']

Thank you so much for your help! I also lost some weight 2years ago during a medically supervised diet however once I stopped the pills they provided I gained back twice the weight:(.... please keep me posted with your progress and I will do the same

[Kelly33 4]

I am just looking for some information on the process through Aetna. Like how long they required the supervised diet and how long to get approved. I am 2 months into my journey and just looking for some uplifting hopefull news

I have Aetna and my doctor's office just sent off my packet last Friday. I was diagnosed with sleep apnea as well. I am just waiting to see if I get approve. I don't know if I have to do all the other supervised diet plans being the fact that I have sleep apnea. I pray that all goes well, I'm just so anxious to find out. I don't know if its to early to call Aetna to find out.

[sueob1968 3]

I am waiting on approval from Aetna. I have been seeing a doctor for wl for years. We turned everything in on 2/22. They asked for additional information on 3/4 (apparently there were some missing records in 2011 and 2012). I was able to get the information the next day. So, now I am waiting again. I am hoping to get an answer early this week. Aetna said my doctor has my surgery scheduled for 3/18- so I should have an answer this week. I'll keep you posted. I used the instant messenger function on the Aetna website and they were most helpful. I don't know if I am bugging them, but, I have had to stay on top of things to keep them moving along.

[ChrisBthin 44]

I havent heard anything about the stuff you guys are talking about my surgeon gave me a date I am doing my diet exercise and nutritional required things but I havent been told I need to worry. ..

[Caligirl530 6]

I am so exited. .. I received a call from my doctor and I did 6 months of supervised weight loss program about a year ago and they are going to use thar to submit to my insurance! Wish me luck y'all! I will br submitting to insurance on tbe 21st... I will keep all my Aetna peeps posted

[sueob1968 3]

I was denied by AETNA due to a BMI under 35 during the 2 years prior to now. I wasn't aware you had to maintain 35 for 2 years. I have submitted an appeal but I am not optimistic. If I have to wait, then I will. I really want to go to my surgeon, and don't have the cash to pay the 15K-20K. Geez...what a process!

[Caligirl530 6]

I was denied by AETNA due to a BMI under 35 during the 2 years prior to now. I wasn't aware you had to maintain 35 for 2 years. I have submitted an appeal but I am not optimistic. If I have to wait' date=' then I will. I really want to go to my surgeon, and don't have the cash to pay the 15K-20K. Geez...what a process![/quote']

Wow... what was your BMI when you submitted? Did you have any health problems with your weight?

[Caligirl530 6]

Wow now I am nervous. I did a medically supervised diet within the twp years and got down to a BMI of 30 at the lowest. .. although that didn't last long. ... crossing my fingers!

[TrophyWife 11]

That makes me nervous. I to got down to a BMI of about 31 and now I am back to a BMI of 46 after a 2 1/2 yr gain. That would crush me if I am denied and my appeal is denied. I am trying really hard not to be to pessimistic about it, but it just so stressful.

[flmama 105]

I have an Aetna plan...the requirements will be different based on what your employer selected.

Originally, they told my coordinator that I didn't have any requirements...just had to have "tried and failed" to lose in the past. When the coordinator submitted all of my paperwork, they told her I would be denied, because I didn't complete a 6 month diet.

We went ahead and submitted any way, so I could appeal once we had a denial in writing. It went to the physician director who did a peer-to-peer review with my surgeon and PCP and it was approved as medically necessary, without the diet.

[sueob1968 3]

Wow... what was your BMI when you submitted? Did you have any health problems with your weight?

I submitted at 35 BMI. I have been from 31-35 for the last 2 years because I was working with a Specialist (doctor) in weight management. I have been working with him 4 years, but my BMI was 38 when I started with him. I do have degenerative disc disease in back and neck, sleep apnea, arthritis and a few other health issues. The Specialist said I would probably have pre diabetes if I hadn't been seeing him for 4 years. He thinks the SLEEVE is a good next step, but since he isn't the surgeon, I am not sure how to get him more involved.

I have filed an appeal, but don't know my backup plan if denied again. Back to waiting and brainstorming.

[sueob1968 3]

That makes me nervous. I to got down to a BMI of about 31 and now I am back to a BMI of 46 after a 2 1/2 yr gain. That would crush me if I am denied and my appeal is denied. I am trying really hard not to be to pessimistic about it' date=' but it just so stressful.[/quote']

My advise is be prepared for a denial, so you aren't crushed. I think if you have proof for 2 years, that your BMI was 35+, you will be ok.....BUT you have to have documented proof. If not, that is a loophole they can use. Maybe it will just be a matter of waiting....I hope you get approved...It really shocked me, as I thought I had everything covered. I felt like all the efforts and DR visits over the last few years, were my detriment.

I will be hoping for you!!!!