Aetna PPO

[MileHighGreen 0]

Well my surgeons office just called me they are submitting my paper work tomorrow for approval. Boy am I getting nervous. Maybe I shouldn't read so much on here and other forums. Keeping my fingers crossed. :rolleyes

[rredding 0]

Did you have any hoops to jump through?

[MileHighGreen 0]

Oh yea. I am trying for the 3 month approval program. It required 3 months medically supervised diet, behavior modification and exercise. Plus I had to meet the criteria to qualify as candidate for surgery. This is first submittal so I am hoping for the best. Do you have Aetna?

[rredding 0]

Yeah, just getting started myself, Aetna seems to suck...

[MileHighGreen 0]

If it is any consulation I have read about worse companys on here. LOL.

[vallin 0]

My paperwork was just sent Aetna POS II ,,I had to do the 3 month multi Dic*** jump thru hoops thing ,,well I hope Aetna POS is different.

[vallin 0]

OMG Aetna will not pay for fills in Texas!!!!!!!!!!!!!! they will pay for the band?

[MileHighGreen 0]

Do you mind my asking why they won't pay for fills?

[vallin 0]

I just called Aetna and they are saying it is inclusive to thier surgery rate. to break that down ,,the fill Docs want addtional $$ and Aetna is saying no we already paid you... Well boohoo and we are in the middle just needing fills. While I was on the phone they said my case is still under medical review and I should know by the end of the week!!!!!

[MileHighGreen 0]

I am so sorry how frustrating! I hope in the end it works out for your best interest. That might be a first.

How long after your paper work was turned in until you got approval for the band?

[vallin 0]

I called Aetna and my case is still under medical review they did receive the paperwork on 7/23/07, I should know somthing by this Friday. I am worried they will say no, this insurance gal says not to worry that she thinks it will be approved.

[vallin 0]

milehigh when are you going to complete your 3 months?

[MileHighGreen 0]

I finished in July and submitted paper work. GOT DENIED. I am going to send it to an advocate to see if they think I can win an appeal. The reason given over the phone was that I don't meet the criteria. I have been over 40 BMI for the last two years but only over 35 for the three before. I have borderline co-morbidities. It will be a fight but lots of people are cheering me on.

Have you heard anything yet?

[vallin 0]

:(I am sorry to hear you got denied,, that is a bummer don't give up. Aetna denied my sister last week because of a low BMI in 2003 when she was being treated for obesity,, but all other years her BMI was 40 +. She was told that a letter from her PCP would help and that is what she appealed with. Don't give up Milehigh that is what Aetna wants you to do.

I myself was approved yesturday and I am so excited, today I have started my liquid diet!!!!! :clap2::clap2::clap2::clap2::clap2:

[MileHighGreen 0]

I am so glad you got a quick approval. I should know better I can never do anything the easy way. I am just trying to keep up the spirits until I get the letter and can take the next step. Keep me posted on how you are doing.

Lisa:clap2: