I have aetna and have just started the process to get approved...

[Lenamarie301 43]

So... I just went to the surgeon's office today for my first visit. I have had recorded high blood pressure for over 2 years and have been dieting with exercise with steady fluctuating weight. The surgeon put me on a rx for HB today. WIth aetna I was told I need 4 months of documented, consecutive, supervised diet. I am so nervous about getting approved. I am 5'7- 1/2 and weight 242 with a BMI of 37. My husband says I snore like a dragon but I am not sure if I have sleep apnea. I am 33 will be 34 in July...... So I guess I want to know if anyone with similar circumstances and aetna insurance was able to get approved... what did they make you go through and how long did it take..

[dlv54609 4]

I just went through the approval process with Aetna and was finally approved today for surgery June 7th.. I was originally scheduled for surgery on May 24th and on May 23rd at 4:45, they denied my approval. I was livid as the entire day of the 23rd I was jumping through hoops to get them the documents that they required. They blamed it on my doctor's office when it was their incompetency that caused the issues. They said that my doctor did not send them the needed lab results as well as other documents when in fact, they were sitting in my file at Aetna's office. Be very careful with them. They required that I go through the pre-op program as well and I did everything they asked. I am the same height and weight as you are and I have severe sleep apnea that has been documented through a sleep study and am currently using a CPAP to correct it. That was what they denied me for. My doctor had to have a peer-to-peer conversation with their doctors to get me approved but finally, they did approve me.

My advice to you is to stay on top of what documents Aetna needs from your medical doctors and keep checking with them so you don't have to go through the stress I have just gone through.

[Lenamarie301 43]

Wow thank you for the info. I think I may need to get checked for sleep apnea... Good luck with everything!

[leliwhoaoh 27]

I am also just starting out, but I have insurance directly with the hospital I work for. My insurance required a 6 month medically supervised weight management program, sleep study, labs, various radiology tests, 2 visits with a cardiac/ exercise physiologist, one visit with a nutritionist, and a mental eval...and although my doctors office did tell me that I needed to have all these things done before they would even consider approving me, I took it upon myself to call my insurance and have them email me the requirements (so that I can have it in writing). My point in all this, I would still make a call to Aetna just to make sure the your doctors office hasn't missed anything :]

[Lenamarie301 43]

You're so right I better call them myself! I called before but the lady was so vague... I will get more answers this time! Thank you and good luck with everything!

[dede0314 356]

Make sure you don't gain any weight during your 4 month supervised diet.

[Lenamarie301 43]

OK I will watch that. I am trying to practice better eating habits now!

[leliwhoaoh 27]

Make sure you don't gain any weight during your 4 month supervised diet.

I gained 2 pounds on my 3rd (out of 6) weigh in, they kind of scolded me but didn't make it a terribly big deal, do you know if you gain weight during the supervised visits if it will impact the prior auth?

[dede0314 356]

I was denied due to weight gain. I really think it depends on who reviews your paperwork. I've seen some people talk about how they gained weight and Aetna still approved them the first time. I would suggest trying your best not to have any more gains and make sure at your last weigh in that you weigh less or the same as your first weigh in.