Aetna 2015 Weight Requirements

[rwoods200 39]

Congrats!!!! Surgery will be here before you know it!

[kjsweigart 15]

Kerriedc. Did they have to submit a weight history? I am a bit worried even though my bmi is over 40 now that was not always the case.

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[SleevePerry 248]

I had the same concern. My BMI in previous years was 38 or 39. I'm not sure what it was that got me the approval, to be honest. I don't have any of the co-morbidities, but I was pre-hypertensive and pre-diabetic, with a familial history of such conditions, so perhaps Aetna thought it wise to approve surgery as a preventative measure? In any case, good luck! I hope it works out for you, too!

[SleevePerry 248]

And I believe they did submit a weight history but I think that Aetna was looking for a history of persistent obesity, not necessarily a consistent BMI number of 40 or above.

[SleevePerry 248]

@@kjsweigart I saw my insurance coordinator yesterday and asked her how she got my surgery approved, with no comorbidities and a BMI of under 40 in previous years. She specifically said that Aetna no longer needs two years of a 40 BMI. If you have a BMI of 40 now, you should be good to go.

[kjsweigart 15]

@kerriedc. So she did not submit any previous weight history ?

[handymannynyc1 82]

That's good to hear. I'm going to my last weigh in as we speak and all my post op stuff is done. Let see what they say.

[SleevePerry 248]

@@kjsweigart No, she did not, but I'm sure the surgeon noted a history of obesity in my chart when I had my initial visit with her.

[rwoods200 39]

I'm Jealous! LOL! I have no idea where I am in the approval process exceptto know I need to pay my deductible before my endo next month.

[kjsweigart 15]

That is great news. I have a letter from my pcp as well saying I have battled with obesity my entire life and that they recommend the surgery. I also wrote a letter from myself. Did you do that? Thanks for making my day. I have been so worried about my history at 38 to 39 bmi.

[kjsweigart 15]

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[SleevePerry 248]

@@kjsweigart I had a letter ready to go, but the insurance gal said it wasn't needed. I also had a letter of necessity from my PCP, and not sure if she used that or not. She said it was also not needed. Just the surgeon's and nutritionist's notes, from what I understand.

[marybowlus 17]

ALL OF MY INFO WAS SUBMITTED ON MAY 7TH AND I'M STILL WAITING TO HEAR WHETHER OR NOT APPROVED. THIS IS DEFINITELY THE HARDEST PART OF THE PROCESS (FOR ME). I HAVE CALLED EVERY DAY AND THANK GOODNESS I GET SOMEONE DIFFERENT EACH TIME BUT I JUST KEEP HOPING THAT WHEN I CALL SOMEONE WILL SAY "OH YES, YOU HAVE BEEN APPROVED!" I'M TRYING TO BE PATIENT BUT THIS IS ALL CONSUMING!

[handymannynyc1 82]

@@marybowlus I in NY and the people at work that got the surgery done said it took a week to two weeks before approval.

[handymannynyc1 82]

@@kjsweigart my cardiologist letter was not written the way the insurance likes so I have to get another one that says" as a cardiologist It is in the best interest for this" lol all these hoops they want me to go through.