Aetna insurance

[D'Sleeved 62]

Is anyone insurance is through Aetna? If, so were the approval process difficult to get approved, for gastric sleeve surgery??? I have only one more appointment with the nutritionist and I am very nervous....

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[Red_lips_and_confidence 148]

Girl, I had the WORST time with atena insurance. Not to worry you but this was my experience. About three years ago I tried and was denied, I then appealed and was denied again.....fast forward to last September 2015 I started the process AGAIN...10 months later and I was approved! Do NOT gain any weight during your weigh ins ( I weighed in on weeks where I was on my period and they gave me a hard time ) I had to jump through so many hoops with atena, make sure you have everything and more that they want, if you can be tested positive for sleep apnea that helps a lot. I just had surgery Monday June 27th and they took a month to get back to me and they have to have a medical review board review my case cause I gainen5 lbs, that almost got me denied. I am 4 days post op now and 5 lbs down. Just do what I did and keep fighting! It's emotionally/ mentally exhausting but if you want it bad enough you'll fight for it. Make sure your bariatric office who is submitting your paperwork has everything, if I wasn't all over them they would have submitted the wrong things etc. don't get discouraged! Keep your head up and proactive !!

[D'Sleeved 62]

Thanks for, the reply... For the next four days leading up to my last nutritionists appointment, I will continue to walk as much as I could so that my weight will remains the same... I was informed that I need to lose a told of 20 lb; I hope they are expecting my to lose that amount of weight before surgery!

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[Sugary Sweetheart 97]

No problems with Aetna.

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[D'Sleeved 62]

@ Sugary Sweetheart

How long did it take for Aetna to approve your surgery?

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[NewLA 31]

I had no problems....only had a 90 process, no weight loss requirement no net gain. They have 15 business days to make a decision once submitted. My paperwork was submitted on June 2, approved June 14th. Sleeved on June 30th... I did call every 2 business days to check in on the status

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[Shrinkinqtpi 202]

@@NewLA

Thank you for clarifying. I have AETNA and have now waited 2 weeks since my paperwork was finished at the doctor's office. It is so hard to wait and doing everything I can to stay patient. They told me it would be finished by the 13th which is 4 more business days. It's time for the AETNA chant. AETNA! AETNA! AETNA!

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[D'Sleeved 62]

@ NewLA

Thanks, for the information; I have more clarity now... I will contact the administration office; every "two days" to stay make sure they are staying on top things... That was also great advice.

Thanks!

Lol to @@Shrinkinqtpi

Let go Aetna lets go!!!

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Edited July 8, 2016 by D'Sleeved

[D'Sleeved 62]

@Shrininatpi

With Aetna; the protocol Is first 3 weeks liquids diet (protein) (broth) and the 4th week is only Clear Liquids only?

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[Shrinkinqtpi 202]

@D'Sleeved

My plan through Dr. Primomo

Preop is 2 weeks 100 grams of Protein per day with Clear Liquids the day before

No food

64-128 ozs of liquid

3 multi- Vitamins per day

Post op

1 week liquids

1-2 weeks puréed foods

1-3 weeks semi-solid

3 multi's/day

Vitamin D 2x/week

Calcium citrate 2x/day

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[D'Sleeved 62]

Okay thanks

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[wwboy 141]

I have Aetna and had no problems getting approved on round one.

[D'Sleeved 62]

@@wwboy

What do you mean; we you say on round one? How many rounds do we have to go through?

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[AmberMc03 59]

My best friend and I are going through this journey together. We have the exact same insurance (except her out of pocket max is lower than mine due to it being based off annual salary and my insurance is under my husbands salary and hers is under her salary).

When the surgeons office submitted her paperwork 3 days after her last weight in appointment it took a full 14 business days.

My paperwork didn't get submitted correctly by the surgeons office and I called Aetna and then the surgeons insurance coordinator and threw a fit over their mistake and she submitted on a Thursday and I followed up with Aetna on Monday to ensure everything was submitted correctly and they had approved it on Friday! But I was already 2 weeks behind my BFF of approval.

So now she is starting week 3 post op and back to work the last 2 weeks and I am only 5 days post op.

But both the surgeons insurance coordinator and Aetna will tell you that it does take up to 14 business days for approval. Plus this surgery is considered elective so priority is is lower in the pre-cert department.

[D'Sleeved 62]

@@AmberMc03

I no it sucks! that you two ladies; when through all the appointments and etc together.

And due to the fact of miss documentation your surgery date has been delayed..

At least they was able to address your issues ASAP.

With that said and done; I will also be staying on top of things with my coordinator; I will be placing another call on Tuesday to see where I am at with the approval process.

14 days isn't that long to find out if, I am approved or not, so I will no where to started next; on my journey...

I am keeping my finger crossed to have everything taking care of before my children goes back to school.

I enjoyed reading your story... Thanks! for all the information.

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