Pre-Op Anxiety and Stress with Aetna

[a_new_me_finally 2]

Currently, I am participating in the 3 month diet program required by Aetna. I have read on here, and various other forums, that they are very strict with their Pre-Op program and the weigh-ins. I have read that people have been denied because they have gained 2lbs or less! I am so worried I will be denied if my weigh fluctuates any higher than what it is. Has this happened to anyone who had Aetna and/or has been approved and/or denied. I definitely need some help because I am SO worried and stressing about my next weigh in and it is taking a toll on my body and mental health. Any help or advice would be greatly appreciated.

[Mommabird 367]

I have Aetna but am on the six month diet program. I've heard that if you gain weight you can be denied. That being said, their Clinical Policy Bulletin 0157 about WLS says no net gain. To me that says that if you lose more than you gain, you should be ok. I, however, have two more weigh-ins and am not going to take any chances.

[MrsB2007 90]

Ive seen other posters that say they gained a few lbs and still approved by aetna.. Maybe if you lose more than you gain you will be okay??? But remember too.... Many have been denied for losing too much weight,, ins sees it as you can do it on your own. My pcp even told me shes seen this happen a lot.

[a_new_me_finally 2]

Thank you MrsB I'm just so nervous!!! I know this will help me long term and I really need this tool, I am just so scared of getting denied its destroying me

[Mommabird 367]

Thank you MrsB. That takes some pressure off. I was hoping that was the case from the wording of Aetna's policy. I've lost 25 pounds with 2 weigh-ins to go, but the amount I'm losing each month gets smaller and smaller. I have to admit that the stress of it all is starting to get to me somewhat.

[a_new_me_finally 2]

I agree mommabird. I am trying to remain the same or alteast lose some weight; however, my dietician is moreso going over things with me for after the surgery. It was never mentioned that gaining weight could have me denied from from getting the procedure done. I'm glad I read some posts on here, otherwise I never would have known because my doctors office never mentioned it to me. Overall so frustrating and stressful