Question for Aetna patients

[majorsmama 91]

For those of you who are doing the 90 day weight loss regimen, what all are you doing? What kind of diet? What kind of exercise? Who is keeping track of it all for the insurance company?

[LifeWhichIsMine 14]

I went through a weight loss clinic. Each month I went in and they did the weigh ins and kept track of that. I was put on a high Protein 1600 cal diet for the 3 months. They showed me exercises to do, but nobody kept track of that.

Are you going through someone who specializes in weight loss or just a reg doc?

[majorsmama 91]

I am using the nutritionist at my surgeons office. I called Aetna and they said that's fine as long as she documents my weight loss, exercise, and behavior modifications. But aside from the weight loss, I can really just make up the other stuff so it just seemed odd to me that they are trusting what I tell the nutritionist. She's just told me cut out carbs for the most part.

[vsg4missy 19]

I'm also meeting with the NUT ay my surgeons office. They offer the full multi disciplinary program mentioned in Aetnas clinical policy. I'm doing low carbs, I increased my Protein and veggie intake and cut out a lot of sugars.

[majorsmama 91]

How do you have to document your exercise and behavior modifications?

[vsg4missy 19]

My NUT documented it. Weightloss, how I've changed my diet, what excercises I'm doing (which isn't much, bad knees). They provide all patients with a pedometer (I switched to fitbit) so she asks how many steps I'm averaging? She put it all in my file.

[BeautifullyCreated1982 168]

I went through a weight loss clinic. Each month I went in and they did the weigh ins and kept track of that. I was put on a high Protein 1600 cal diet for the 3 months. They showed me exercises to do, but nobody kept track of that.

Are you going through someone who specializes in weight loss or just a reg doc?

I have Aetna and chose to deal with a clinic that specializes in Bariatric cases.

[Chele H 427]

I have Aetna, my BMI was just 40 and I had no co-morbities. I did the entire process with the bariatric surgeon's office and his insurance coordinator. They are very knowledgeable of the process.

I had to complete a patient history form documented all previous weight loss attempts. I had to have 3 months of consecutive visits with my bariatric surgeon with my weight documented, a nutritionist visit and a psych evaluation.

I did not have to show any proof of current weight loss attempts or exercise. I was told not to lose weight because I just squeaked by the required BMI.

Each plan is different even within the same insurancs company, it depends on what your employer chooses.

Get a copy of your particular plan's requirements in writing.

[majorsmama 91]

Well I have my plans requirements and I know what I need to do. I just find it odd that they have these specific 90 day requirements and at the end of the day, they are simply taking your word for the changes you are making.

[BeautifullyCreated1982 168]

Well I have my plans requirements and I know what I need to do. I just find it odd that they have these specific 90 day requirements and at the end of the day, they are simply taking your word for the changes you are making.

I too am required to do a 90day program for Aetna. I have monthly visits with the Nutritionist and weigh ins every time I go. I think the main purpose is to set us up for success by prepping prior to surgery and by us learning new habits. Surgery is just a tool. I know a few people who have had it, but because they never took the prepatory program seriously they were shocked at how challenging it was post op. A few have regained most of thier weight back. I have been sticking to program , not perfectly but I have some new habits such as brisk walking 5x a week, more consistent Water intake, more vegetables and Protein in my diet, all of these habits will help me post op.

Edited February 1, 2015 by BeautifullyCreated1982

[CheleLynn45 615]

I have Aetna also, but I had to do a 6 month doc supervised diet as one of my requirements. I started seeing my PCP in Feb 2014 and saw her every month for 6 months to have my weight checked.

My bariatric office had given me forms which they said the doc could use or she could use something of her own. We used the forms. So she would weigh me and then talk to me about what I had/had not done that month, recommend changes and then document.

I then took all the forms to my bariatric office the day I had my last weigh in and that is what they used to submit to my insurance. They never said I had a required amount of weight to lose or anything.