Impatiently waiting for Aetna

[UberBuffaloGal 20]

I thought Aetna required a BMI of over 40 or a BMI under 40 with 2 co-morbids. But by reading this thread, it sounds like it was more complicated than that.

Hi Jensnewjourney,

I know several people who were approved quickly and easily by Aetna. Several of us have had difficulty, some did not have a weight history. Or meet all the requirements in bulletin 0157. If you meet all the requirements there you will be okay. If they do deny, you will have grounds for an appeal. Don't worry until it happens. It is taking me more time, but I know I will get there. Good luck.

[CrazyJaney 775]

Hi Jensnewjourney, I know several people who were approved quickly and easily by Aetna. Several of us have had difficulty, some did not have a weight history. Or meet all the requirements in bulletin 0157. If you meet all the requirements there you will be okay. If they do deny, you will have grounds for an appeal. Don't worry until it happens. It is taking me more time, but I know I will get there. Good luck.

Per the check list my MD group provided, if I am able to check off each item, and I'm certain I can, I'll be approved. But, anything is possible I suppose. Fingers crossed! I won't submit til Feb. nervous but mostly optimistic right now. . Thank you for your input!!!!

[paab72 0]

Hello. New to this. Haven't even called insurance yet. After reading all of this about Aetna, I'm now very worried. My BMI is about 43 and I was just put on metformin due to possibly being pre-diabetic. I'm on the Water pill for high blood pressure and I've had serious issues with back and neck pain due to muscular skeletal issue. (most likely my ginormous ta-tas) From what I'm reading, these may not be enough issues to get approval for the sleeve surgery that I really want. What kind of things will I have to do in order to get approved for this surgery? Anything I can do before even contacting the insurance company or docs? Any info would be greatly appreciated. Thank you in advance.

[sleevethefatbehind 95]

If you have a BMI over 40 documented for 3 yrs straight, you should be golden. Aetna approved me and my BMI even dropped below 40 (to gasp: 39!) 2 years back. Thank goodness for that hypertension in my history (sarcasm... kinda.)

Hello. New to this. Haven't even called insurance yet. After reading all of this about Aetna, I'm now very worried. My BMI is about 43 and I was just put on metformin due to possibly being pre-diabetic. I'm on the Water pill for high blood pressure and I've had serious issues with back and neck pain due to muscular skeletal issue. (most likely my ginormous ta-tas) From what I'm reading, these may not be enough issues to get approval for the sleeve surgery that I really want. What kind of things will I have to do in order to get approved for this surgery? Anything I can do before even contacting the insurance company or docs? Any info would be greatly appreciated. Thank you in advance.

[paab72 0]

I really hope so. What will be required of me by Aetna? I reading sleep studies and psych evals, whats a NUT eval? Thanks.

If you have a BMI over 40 documented for 3 yrs straight, you should be golden. Aetna approved me and my BMI even dropped below 40 (to gasp: 39!) 2 years back. Thank goodness for that hypertension in my history (sarcasm... kinda.)