Aetna PPO

[AnnaB6 1]

I Just Got My Approval! I Also Have Atena Pos.

[MileHighGreen 0]

Congrats! I am still waiting to see if the advocate will take my case for appeal. When did you submit your paper work? Do you have a date already? Best wishes! Hopefully I will posting the same thing soon.

[vallin 0]

Way to go Anna Woohoo!!! did you do the 3 month approval thing...?

[MileHighGreen 0]

I just got word from my surgeon's office that the LapBand company has agreed to pay for my appeal. They sound pretty confident I will win on appeal, it will just be a wait. ISo, I have decided to use the time prepare and keep losing. Nobody said we couldn't go into this already losing weight. If I win, I am hoping the tool will just help me to develop the habits to keep it off for change! :clap2:

[vallin 0]

Milehighgreen I hope you get approved, I am keeping my fingers crossed for you!!!! I meet with the Dr. today My surgery will be this Friday or the next.:ranger:

[MileHighGreen 0]

I will say a little prayer that your surgery goes very smoothly and that you have little discomfort. Let me know how you are doing!

Lisa:kiss

[Kayemarie 0]

I was appealing Aetna:help:....they denied me first time because of the 3 month multidisciplinary presurgical program or the 6 month presurgical program. I completed the 3 month on May 29th. They submitted my appeal on June 8th.........I just receieved my APPROVAL:clap2:...yes your read right....my APPROVAL :whoo:for the surgery on Monday. They took the entire 60 days before they gave me an answer. But I am APPROVED:biggrin1:...I love the sound of that. Tomorrow I will call the surgeons office to see what I do next. Hopefully a quick surgery date.......don't give up.......

Kerri

[vallin 0]

My surgery is this friday at 11:00:think:). I am excited and scared at the same time weird. Last night I had a dream when they went in they found a baby in my tummy and I said "How are you going to take it out laproscopy"? I know it's just my nerves getting to me.

[MileHighGreen 0]

Thank you for the story of hope. Last night I had to go in for my CPAP fitting. Whoever thought I'd be happy about a co-morbidity? This should stop Aetna from being able to deny the surgery because I didn't have any. I completed my three months before I submitted the first time so it will be interesting to see if they can come up with another reason. Based on what my doctors office said I think we will be sucessful on getting approval.

I will be thinking happy thoughts and having good wishes for both of you on your surgeries. Keep me posted on how you are doing. You can send me a private message if you don't want to do it here. I am very excited for you.

It is amazing what our dreams can conjure up when we are stressed or worried. A baby... well maybe later on you will. :notagree

My suggestion is to picture everything going perfectly and having very easy recovery.

Take Care, Lisa

[MileHighGreen 0]

Hey I am just thinking good thoughts for you tonight! Good luck tomorrow... I am very happy for you!

Take Care, Lisa

[MileHighGreen 0]

Hey Mariposa, Hope you are doing well. Let us know how things are going when you feel up to it.

Take Care, Lisa

[vallin 0]

Hello everyone, I am doing great! My surgery went smooth and my Dr. Marsden hands worked art. I thought I was going to be more difficult having has three previous c- sections I was prepared for the worse. It is best described as discomfort but not pain. Milehigh how is your appeal going have you checked the status. News is MEDICARE is now covering the operation and fills no questions asked as long as your BMI is high,,,this means commercial insurance needs to follow Medicare guidelines I hope you are approved and soon. Losing this weight so fast has been amazing and I know it will not be coming off like this for long once I go to stage 2 and 3. THIS is funny I went to Boston Market at lunch and said I need 1 cup of Soup broth only, when I got to work and took the top off it had fat floating on top, now keep in mind 1 month ago I would have said "oh well bottums up" Today I actually stopped and thought about what i was putting in my body:whoo:. I hope this last a long, long time.

[roxy 0]

i too have Aetna and i my dr. had approval within 48 hours. I had to go through all that 3 month stuff as well! well good luck on getting approved!

[MileHighGreen 0]

Well... I got the diagnosis of sleep Apnea now and my current BMI is over 40 so even though I haven't been over 40 for the last five years I think they will have to allow the surgery! The LapBand company is picking up the fees for my appeal so I think it is good sign that they think I will win on appeal.

Good to know you are up and about. I hope mine goes as well as yours if and when I get approval. I haven't done any form of child birth so I might not have your tolerence for pain. Did you even have all the discomfort I read about from gas during surgery? Congrats on the good food choice as the nutritionist likes to say! Keep up the good work!:clap2:

I guess Aetna just likes picking on me. Although my BMI not being over 40 for last five was an easy pick for them to say no. :cry

I will keep you posted. Lisa

[Conniee 0]

:help:

I am totally discouraged!!! I am not new to the suggestion of having the lapband, but after 4+ yrs of "mulling it over" I finally decided to go for it. I went to TX Gastric Banding in the Conroe area. They told me that the AETNA PPO Plan requires that I do the 3 month disciplinary program...not a problem...BUT they say that I have to see the dr the first month to "discuss weight issues and start a diet/exercise plan"....then, they say I have to go to the primary care doctor for 3 consecutive months AFTER that first visit!!! Is this the case??? Has anyone else ever heard that? Anyway...they first told me that I could go to dr Aug/Sept/Oct and submit first of November, then when I started doing that AFTER I have already paid $75 in cash for a nutritionist - now they tell me that I have to go Aug/Sept/Oct/Nov then submit, which everyone knows will go past Dec 31st to get an approval, and even if it doesn't, Dec is a bad month because dr's take off a lot. So, even though I have met all of my deductibles for the year AND my out of pocket expenses...they are going to jerk me around where it will not be approved until after Dec 31st and I will have to pay for the surgery co-payment. That will be $2300.00 IF I am approved...GEEZ! Can anyone shed some light? Aetna refuses to tell me specifically if this is how it goes. Sorry to rant, I am just disgusted.

Thanks for listening.

Connie

:faint: hates Aetna!!!