Aetna Insurance & getting sleeved in St Louis Mo

Kimi Siar · February 12, 2016

My surgeons office insurance specialist said that AETNA insurance would not allow me to go through the "normal" DesPeres (Excellence center) Hospita or DePaul Hospital WLS doctors (dietician / behavior therapist etc) like most of their patients due to their restrictions they wanted much higher qualified docs (such as an eating disorders psychologist) etc etc / I was hoping to find a very recently approved sleever in St. Louis who has AETNA to get their list of all doctors used that got them approved . I know it's a long shot but I'm not sure where to go - my a Surgeon is Dr Minkin - one of the best in Missouri . Thanks.

Brown Suga · February 12, 2016

I have UHC and Dr. Eagon is my surgeon. He is with BJH and sleeves at Barnes and Barnes West County. He is arguably the best in the entire St. Louis metropolitan area. Mind you:

1. He is my surgeon so I'm probably biased but have to believe this.

2: I am not scheduled until 3/21 so I have not placed my life in his hands.

3. He is the only WU/BJH surgeon and does some of the most complicated surgeries...his office is very busy!

Have you tried searching posts for "Missouri" or "St. Louis"? There are quite a few of us on this board. Good-Luck!!!

Kimi Siar · February 13, 2016

I appreciate your reply and info. Thank you i will search missouri and st louis.

Mary2016 · February 13, 2016

I have Aetna also. I see where there are 2 options to qualify. 1- 6 month physician supervised diet. 2- 3 month pre op interdisciplinary process. But it talks about nutrition, excercise and behavioral therapist. I am seeing the dietician and have a psych clearance scheduled. They report back to the surgeon. So I think I am on option 2, but I wasn't told to seek out an excercise person nor follow up with the psych person. Anyone with Aetna have insight into this?

Kimi Siar · February 14, 2016

Yes - i am on Cobra for this reason and was hoping to go the 3 month route but there are no clear answers from my contacts with any pros so far.

1excited · February 17, 2016

I have aetna and I was required to participate in an exercise program. They submitted the exercise records with my packet. In fact my doctor's refused to submit without it because they said it explicitly says exercise program

Edited February 17, 2016 by 1excited

Mary2016 · February 18, 2016

For the excercise program....can I do something besides having to join a gym? I have my own equipment with treadmill, recumbent bike and elliptical. I don't want to do a gym. Can you have a consult without gym membership?

1excited · February 18, 2016

For the excercise program....can I do something besides having to join a gym? I have my own equipment with treadmill, recumbent bike and elliptical. I don't want to do a gym. Can you have a consult without gym membership?

My doctor said no because it is about accountability. My gym had to give me logs that prove I was there and I did the free training sessions. I could have used the program that works with the hospital, but their hours of operation really did not work with my schedule. Talk to your surgeon and insurance company. Good luck.

Edited February 18, 2016 by 1excited

pvechiola · December 29, 2016

I have Aetna also. I see where there are 2 options to qualify. 1- 6 month physician supervised diet. 2- 3 month pre op interdisciplinary process. But it talks about nutrition, excercise and behavioral therapist. I am seeing the dietician and have a psych clearance scheduled. They report back to the surgeon. So I think I am on option 2, but I wasn't told to seek out an excercise person nor follow up with the psych person. Anyone with Aetna have insight into this?

I have Aetna and they are very strict, I started my nutrition classes in August and I will finish classes in March. I also have to chart my Protein intake daily. I have to see a psychologist twice I have another appointment tomorrow so that will be done. I have had a sleep apnea test so I didn't need another one, I also just finished my EGD and everything is fine with that. Now just to finish my nutrition classes. It seems like these insurance companies want to make all of this sooooo overwhelming that I'm pretty sure they think you'll give up. I just have a list and everytime I get to cross something off it gives me the edge to just have patience and continue along, and I pray alot for the patience.

I have UHC and Dr. Eagon is my surgeon. He is with BJH and sleeves at Barnes and Barnes West County. He is arguably the best in the entire St. Louis metropolitan area. Mind you:

1. He is my surgeon so I'm probably biased but have to believe this.

2: I am not scheduled until 3/21 so I have not placed my life in his hands.

3. He is the only WU/BJH surgeon and does some of the most complicated surgeries...his office is very busy!

Have you tried searching posts for "Missouri" or "St. Louis"? There are quite a few of us on this board. Good-Luck!!!

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