donnag53 72 Posted March 6, 2015 I just got my approval from my ins co (Aetna). My Nut had told me at our first meeting, Aetna uses the starting weight from my first consult with my surgeon. I could not weigh more than that or Aetna would not paid for surgery. At that time my BMI was 38. I was able to lose a few pounds and my BMI is now at 37. I have high blood pressure and sleep apnea, which made me qualify. Before I met with my surgeon, I called Aetna and asked about their requirements. Good luck starting the process. I am sure it will all work out for you. Keep us posted on your progress. Share this post Link to post Share on other sites
bncbabe2015 11 Posted March 6, 2015 I have my initial consult on Thursday and I am worried about the same thing. I have Anthem BCBS. Can't wait to get all of my questions answered! I hope everything goes okay for you! Share this post Link to post Share on other sites
KS123 31 Posted March 6, 2015 I'm in a similar boat. I now have my PCP support and his recommendation. My insurance also requires 6 months dr supervised diet. They will also accept Weight Watchers if I have my stamps and doctor support to do WW. I had 4 months of WW April - Aug last year and we're trying to get it to count. Then he wants me to see his nutritionist for 2 months and focus on some of the new eating rules now. Meaning quitting diet soda, fast food, and sweets. Getting used to Protein first now (and water) during this 2 month period. I think this is a good plan. Good luck and let's keep moving in our new right direction. Share this post Link to post Share on other sites
portuguesegal10 16 Posted March 9, 2015 @@IMS1985 I wanted the lap band at first too! But after going to the seminar and hearing what they had to say and also hearing a lady that was there talk about how she had the band and it was awful and didn't work made me change my mind and want the sleeve instead! Not looking forward to the wait but I can't wait to get started! I meet my surgeon tomorrow!! Yay! Share this post Link to post Share on other sites
portuguesegal10 16 Posted March 9, 2015 @@donnag53 that's good. I don't have any comorbidities (yet) so my BMI has to be above 40 (which it is, 43) I have my very first appointment tomorrow so I'll ask him all that good stuff. @@bncbabe2015 I can't wait either! I wrote down all the questions I could think of to ask him! I hope all goes good for you too! Share this post Link to post Share on other sites
portuguesegal10 16 Posted March 9, 2015 @@KS123 wow that's a great idea I didn't think of that! I was part of weight watchers last year too so I'm going to try to see if my insurance accepts that as part of my 6 months. I contacted weight watchers and got my records so I could bring them in with me to my appointment tomorrow. I hope that it can count towards my 6 months that would be awesome! Thanks soo much for the suggestion!! Has your insurance accepted the weight watchers for you? Share this post Link to post Share on other sites
donnag53 72 Posted March 9, 2015 @@portuguesegal10 Good luck tomorrow. Let me know how you do. I'm off the Cardio for my last test. Hope he will clear me for surgery today. Share this post Link to post Share on other sites
portuguesegal10 16 Posted March 9, 2015 @@donnag53 thank you! Wow that's soo exciting! Good luck! Share this post Link to post Share on other sites
samuelsmom 670 Posted March 9, 2015 Good Luck. Your surgeon's office will probably have an insurance specialist. They are usually very helpful. Insurances commonly count from when you start the program, however, not all do- so you are wise to find out all the facts now. Share this post Link to post Share on other sites
IMS1985 1 Posted March 9, 2015 That is awesome girl I can't wait either! I actually meet mine tomorrow too, I decided to go with MGH so I cancelled my apt with the other surgeon today. I have already met with the nutritionist and psychologist there too! Share this post Link to post Share on other sites
portuguesegal10 16 Posted March 10, 2015 @@IMS1985 yay! I hope you like your surgeon! You're more ahead of me I haven't done any of that. Only thing I did was go to the seminar. And meeting my surgeon at 3:30 today, that's it. Hopefully I can schedule a bunch of stuff today though! Share this post Link to post Share on other sites
IvyLeagueNP 31 Posted March 11, 2015 You need to call your insurance company and ask them. They all vary in requirements. Mine does not care if you lose or gain during the 6 months... the BMI submitted for approval (at the end of 6 months) has to be at least 35 with comorbidities or 40 without. Share this post Link to post Share on other sites
portuguesegal10 16 Posted March 11, 2015 @@IvyLeagueNP ok I will do that thank you! Share this post Link to post Share on other sites
moonlitrose25 13 Posted March 11, 2015 When I first went to get my weight and BMI, I had a BMI of 42 and had the same fear as you. The nurse told me that she wanted me to stay about 40 BMI and gave me a goal of only losing 10 lbs and told me that you just need to show that you are making an effort and that even just few lbs lost and maintaining should be enough. I just did my second CO test this morning and passed so I am all done with all appointments and I just started my 2 week pre-op diet this morning to shrink my liver. I get sleeved on the 3/25 and I'm very excited. Good luck to everyone!!! Share this post Link to post Share on other sites
portuguesegal10 16 Posted March 11, 2015 @@moonlitrose25 wow that's awesome! I'm so excited for you! I can't wait until I get there! Let us know how surgery goes! Good luck! Share this post Link to post Share on other sites