Aetna Please Help!

[LisaPearce 0]

Hello everyone I have a question I have my third visit on 2/23 and was previously told my doctor office that I had 3month supv diet and that the first visit counts... now after all that they call to tell me know that I would have to do another visit that the first visit didn't count...anyone know if the first visit counts this office seems not to know things...first the told me I needed 6 months of supervised visits then I called insur co and they told me 3 months so I called the dr office back and they said "Oh well that person misspoke it is 3 months" Now I am rethinking going through them since they seem like they don't know what they are doing..

[HHHappy 225]

I have Aetna and my policy has two options: 3 month or 6 month. The 3 month is more involved but that is the one I chose. I met with the nutritionist 3 times. I think it depends on what you did on the first visit.

[Branmuffin 190]

I have Aetna and I was required 6 mos dr visits, psych eval, nutritionist visit and last two years of dr visits with weight recordings.

[ASKSARAH - Sleeve 256]

I have Aetna POS and they have a 100% no on any WLS. Be grateful you have it covered either way.

I would ask for it in writing to cover any future issues.

I personally went to MX to avoid all this.

Good Luck to you!

[LisaPearce 0]

Thanks for all the help

[lynn2win 142]

Yea I was wondering the same thing if the first visit was covered....hopefully they will say

[CrazyJaney 775]

Waiting for approval now. Had the last of 3 visits yesterday. I had my first appointment in Oct but didn't realize that the 3 appointments hade to be "consecutive" months. I had a delay in making my 2nd appointment in Nov and couldn't get in. Had to start the whole thing over in December. They want 3 appointments in 90 Days, consecutive months. You also have to have a letter from a PCP, psych eval, documented weight history for 3 years. The surgeon also required a sleep study. I'm not familiar with the 6 month plan but I know that was an option. If they approve, and I'm told they prob will (BMI 49 with comorbids) then they will pay 90%. I'm crossing every finger and toe. Your plan might be different. But Aetna is one of the few who do pay.

[lynn2win 142]

Ok so your first visit counted? because then that would be 90 days.....I have to call my insurance company to see if my first visit with dr count

[CrazyJaney 775]

The first visit to the doctor did NOT count. It was the 3 visits of supervised weight loss with the Nutritionist and the doc or in my case, nurse practitioner. I went for initial appointment in August. I have a connective tissue disorder that the surgeon needed to investigate before he'd take me on. I didn't find out until Sept that he would so then I had an appointment in early Oct. I had to get BP meds started and a sleep study and I left that appointment without scheduling the next (never do that again) and when I called in mid Nov to go back, they were full ( holidays). So the whole damn thing started over in December (except I didn't have to see surgeon again). Just make all 3 appointments and KEEP them. This practice is very busy, they can't squeeze you in unless someone is having complications.

[4mytwo 0]

I have a question. I know with the PCP you have to see him/her the same time every month. But what about the nutritionist. Do you see them the same time every month too. I've called/email my Dr's office several time with no answer. I just started my journey two weeks ago.

[Terribj 208]

I also have Aetna and I had to see a nutritionist. personal trainer and my doctor once a month for 3 months. I missed December due to scheduling, but I filed the insurance anyway. I did see the other 2 in 3 months, the doctor was 4 months. I have doubts I'll be approved as I've been told Aetna is very strict. I have a BMI of 38 with no co-morbidities. I'm not holding my breath.

[lynn2win 142]

Good luck to everyone...

[CrazyJaney 775]

I have a question. I know with the PCP you have to see him/her the same time every month. But what about the nutritionist. Do you see them the same time every month too. I've called/email my Dr's office several time with no answer. I just started my journey two weeks ago.

I didn't have to see the PCP every three months, just the nurse practitioner at the surgeon office and the Dietician. I had to have a letter of support from my PCP though.

[Terribj 208]

So after the 3 months of everything I needed to do I was denied because I don't have enough health issues to qualify. Oh well--I've been saving money for a long time just in case this was how it was going to be. March 19th - here we go :

[CrazyJaney 775]

I'm so sorry. That stinks.