female only Denied by aetna any advice?

[Red_lips_and_confidence 148]

So I was denied because atena is looking at my medical records from 4 years ago ( I recently got insurance back so I haven't been at the doctors) in that mean time I gained back 70 lbs and was diagnosed with PCOS and countless other issues so now they think I'm "skinny" when I'm bmi 43 and 278lbs! Now I have to go through this appeal process uhg and get doctor letters and stuff my bmi has fluctuated between 38-43 I'm so nervous they will deny me again!!!! Any advice? Has anyone else been denied too for this issue? Or their bmi but still was approved!???? !! I'm terrified right now

[ASKSARAH - Sleeve 256]

Go to Mexico

I have Aetnea POS and they flat out won;t do it.

So I was like F you and wen tot Mexico. BEST decision of my life.

[Red_lips_and_confidence 148]

I have polycystic ovarian syndrome which is triggered worse by my weight, I can't have kids because of it, my cysts rupture everyday, my knees and hip dislocates , I'm flat flooded with a bad back, constant Migraines and headaches from my PCOS , pre diabetic not to mention hypertension, heart disease and morbid obesity runs crazy in my family like 500+ lbs!!! I'm on depo and other pills to control my PCOS which ha caused me to gain SO Much weight! I can't work out like I'd like because I'm in so much pain.. Wonder if they'll take that into consideration and it'll be enough! I've never been below 200 in my life so it's not like I just got fat ya know if I don't get this I am doomed idk what I'm going to do

[Red_lips_and_confidence 148]

How much was it to go to Mexico

[ashleep 22]

It depends on the dr you choose to go with. Mine was $5200 plus airfare.

[BKLYNgal87 503]

Well... I have fluctuated the last 2 years between 38-40 BMI. Aetna approved me because I have obstructive sleep apnea. Not all obese people have sleep apnea but it wouldn't hurt to get a sleep study done to rule it out. Many people have gone to get surgery down in Mexico but you need to be careful which surgery practice [and surgeon] you go for. Make a well informed decision. Wishing you the best, PCOS is awful.

[Nuchnuch 120]

I would check with your surgeon to see if he would do a peer review with the insurance company, which basically your surgeon explains to them why you should have the surgery.

[Red_lips_and_confidence 148]

I don't think I'd ever go to Mexico or my family would allow it... And yes i just about this peer thing I'm totally gonna talk to my surgeon an see what he says

[cjjenkins 2]

I have Aetna. They had a 3-6 month multi disciplinary regimen to follow. They asked for a two year history of weight tracking, my Rhuemy had it. No issues with coverage at all. Feel free to message me.

[cjjenkins 2]

Also, they have clinical policy bulletin you can find and print. Gives you their entire requirement crap for coverage.

[SassySenior 111]

I would try to find a doctor who has a track record of success with insurance companies.

That's ridiculous that you're being denied. Good luck.

[Sdm479 1]

I don't think I'd ever go to Mexico or my family would allow it... And yes i just about this peer thing I'm totally gonna talk to my surgeon an see what he says

Hi, I have Aetna too, and they kept requesting more information, but, I think if you (and your surgeon's coordinator) are persistent, you can be successful! Hang in there and good luck!

[Corky6984 134]

Aetna only needed 2 years of weight history from me. 4 years seems kinda weird. I had no co-morbidities, but my BMI was well over 40 and I was approved. Good luck in getting them to approve this!

Sent from my iPhone using VST

[sherri scheffler 10]

So I was denied because atena is looking at my medical records from 4 years ago ( I recently got insurance back so I haven't been at the doctors) in that mean time I gained back 70 lbs and was diagnosed with PCOS and countless other issues so now they think I'm "skinny" when I'm bmi 43 and 278lbs! Now I have to go through this appeal process uhg and get doctor letters and stuff my bmi has fluctuated between 38-43 I'm so nervous they will deny me again!!!! Any advice? Has anyone else been denied too for this issue? Or their bmi but still was approved!???? !! I'm terrified right now

You can re submit it 3 times &usually get spproved. It c as lled a rebutal/just paperwork

[Ms skinniness 3,003]

I have polycystic ovarian syndrome which is triggered worse by my weight' date=' I can't have kids because of it, my cysts rupture everyday, my knees and hip dislocates , I'm flat flooded with a bad back, constant Migraines and headaches from my PCOS , pre diabetic not to mention hypertension, heart disease and morbid obesity runs crazy in my family like 500+ lbs!!! I'm on depo and other pills to control my PCOS which ha caused me to gain SO Much weight! I can't work out like I'd like because I'm in so much pain.. Wonder if they'll take that into consideration and it'll be enough! <img src='http://www.bariatricpal.com/public/style_emoticons/<#EMO_DIR#>/sad.png' class='bbc_emoticon' alt='' /> I've never been below 200 in my life so it's not like I just got fat ya know <img src='http://www.bariatricpal.com/public/style_emoticons/<#EMO_DIR#>/sad.png' class='bbc_emoticon' alt='' /> if I don't get this I am doomed idk what I'm going to do <img src='http://www.bariatricpal.com/public/style_emoticons/<#EMO_DIR#>/sad.png' class='bbc_emoticon' alt='' />[/quote']

You will have no problem being sleeved. U have HBO and that is a com morbidity.