Waiting from approval from ins(aetna)

[dagrlnxtdoor 3]

Hi,

So I finished my 3 month pre op. The dr office called me today and said that most likely my insurance will not cover the surgery since I had gained 17pds.. I am devastated!! I explained to them that I had been taking Phentermine for over 3 years and as soon as I stopped taking it I have gained like crazy!!! I feel like I have changed my eating habits.. At times I feel like I was starving yet I still gained??? I am frustrated at this point. I was suppose to have surgery next Friday September 26. But the lady at the doctors office said she is most positive that my insurance will deny it. Has anyone had this problem where they gained weight while at pre-op and what did your insurance say?

[Kandis SupaStar Hill 39]

Hello,

I'm sorry for your situation, maybe you could postpone your surgery to give you more time to lose the weight. That way your doctor's office doesn't have to submit your current weight. I can't imagine how frustrated you must be right now, but there's got to be a way to give you more time to drop the weight. Hopefully the doctors office helps you come up with a plan to avoid the denial.

Best of luck to you!

[Jersrose43 837]

I am sorry to tell you but if you look through the threads and so a search you will find several members on here who have gained very few pounds - like 5- and been denied by Aetna

They are really strict in the no net gain from start to finish.

I have done adipex twice and horrible drug that makes you hungrier than you were before you went on it. Brings all the weight back and then some you just can't stop yourself.

You can try to appeal but not sure where that will get you. You may have to start a new 3 month cycle.

Or change insurance as open enrollment. Not Aetna

[Jersrose43 837]

Do as kandis states. Don't dubmit now. Lose the 17 pounds and start over from your high weight since your start. Try a liquid Meal Replacement maybe once a day to get it off

[Mike4132 256]

Uh oh.....I just had paperwork submitted to aetna and gained 4lbs during the 6 month trial. Do they automatically deny for weight gain? I thought I saw other posts indicating people were still approved with Aetna even with gain but now I can't find them....

If denied, what options are there?

[Jersrose43 837]

Hope your employer purchased a waiver that doesn't hold them to that

Appeal but there are other threads of that not working

Start over

[dagrlnxtdoor 3]

My dr'a staff are positive it won't get approved. However, they said if is denied we can star the program again. ????..

[Mike4132 256]

There is hope. I just got approved by Aetna today even with a 4 lb gain over the 6 month weight loss trial.

[Mike4132 256]

My dr'a staff are positive it won't get approved. However, they said if is denied we can star the program again. ..

Have you heard back from Aetna yet?

[dagrlnxtdoor 3]

No, not yet. My husband and I were suppose to do the sleeve together. We were going to be each others support. Surgery was scheduled for this upcoming Friday September 26. He already got the approval from Aetna with a 4pd weight gain. I called my ins on Friday and they stated it was still in review. My husband starts the liquid diet tomorrow and he wants me to start it too. He states everything will be okay and approved. However, I would hate to keep having hope and then Aetna comes around denying me. I have all emotions going on. I hope I get an answer soon.

[dagrlnxtdoor 3]

***UPDATE***

Just got a call from my surgeon, and I've been approved! My surgery will be this Friday September 26..

[Dana825 82]

***UPDATE***

Just got a call from my surgeon, and I've been approved! My surgery will be this Friday September 26..

Congratulations!!!

[Mike4132 256]

***UPDATE***

Just got a call from my surgeon, and I've been approved! My surgery will be this Friday September 26..

Wow, that's fast! Congratulations

[facorsig 36]

I was also approved by Aetna following a 4 pound gain over a 4 month weight loss period.

[dagrlnxtdoor 3]

Congrats, when are you scheduled?