Aetna and BMI at 40

[BGMOM12 3]

I definitely will. My doctors office just told me they submitted me this am and it could take up to 4 weeks. That is insane. My surgery is scheduled for 3/28.

[GassyGurl 428]

My insurance required all my weights for the past two years, plus all my nutrition visits to be above 40. Any one below would disqualify me.

I ended up paying cash, and traveling to Florida. It's a huge risk if you drop below. Don't trust us, nor your Dr, get it from your insurance company yourself to be safest.

Best wishes!

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[Dee_Rose 6]

My insurance required all my weights for the past two years, plus all my nutrition visits to be above 40. Any one below would disqualify me.

I ended up paying cash, and traveling to Florida. It's a huge risk if you drop below. Don't trust us, nor your Dr, get it from your insurance company yourself to be safest.

Best wishes!

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That whole 2 year thing frightens me... do you have aetna?

[GassyGurl 428]

No, I have blue cross blue shield Federal. Its spelled out very clear in my policy, so I knew it up front. It would have really shucked had I gone through the process, then found out.

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[BGMOM12 3]

Dee_Rose this is the link to the Aetna Obesity Policy

http://www.aetna.com/cpb/medical/data/100_199/0157.html

[Dee_Rose 6]

Dee_Rose this is the link to the Aetna Obesity Policy

http://www.aetna.com/cpb/medical/data/100_199/0157.html

I have read through this and I only half way understand it ( I also have a college degree am I nuts?) My dr says Aetna only needs 4 consecutive months of dietitian and this says 6?? Nothing about 2 years... for my situation I don’t think... I’ll call them again... they are not so great on the phone.

[BGMOM12 3]

1 hour ago, Dee_Rose said:

I have read through this and I only half way understand it ( I also have a college degree am I nuts?) My dr says Aetna only needs 4 consecutive months of dietitian and this says 6?? Nothing about 2 years... for my situation I don’t think... I’ll call them again... they are not so great on the phone.

I just got approved!!!!!!!!!!!!! That was so fast. I sent you a private message with info.

[Dee_Rose 6]

I just got approved!!!!!!!!!!!!! That was so fast. I sent you a private message with info.

Oh wow awesome!!! That was so fast too!!!

[kakatlady612 1,053]

BGMOM12 aetna- thank God they didn't forget ya! Congratulations on your date, when is it so we can pray for a smooth surgery.?? Oh I'm so happy, always happy when somebody gets scheduled. Takes my mind off my own bumpy road to RnY.

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[slsmith7704 3]

I have read through this and I only half way understand it ( I also have a college degree am I nuts?) My dr says Aetna only needs 4 consecutive months of dietitian and this says 6?? Nothing about 2 years... for my situation I don’t think... I’ll call them again... they are not so great on the phone.

I am in health care and it makes about as much sense as mud.

1st. Not all Aetna plans cover weight loss surgery. It is specific to your policy.

2nd. You must have a BMI if greater than 40. If your BMI is between 35-40 you have to have one of the following. A. High Blood Pressure not controlled by a minimum of 3 medications. B Heart disease like coronary artery disease. C Type 2 Diabetes.

3rd. You have to have been part of a doctor supervised weight loss program for at least 6 months during the last 2 years and been in one for at least 90 continuous days.

So basically if your policy covers it and your BMI is greater than 40 and you have been under a doctor supervised weight loss plan for 6 months at any time during the past 2 years they should approve it.

[AtlantaRed 651]

I have Aetna and just started for conversion. I was told not to gain even half an ounce from my initial weight at the first appt.

[SleeveinIL 386]

I also have Aetna and I only had to do 3 consecutive months of Nutrition counseling before scheduling a surgery date. My BMI is 45 so I didn't have to worry about the pre-surgical weight loss. I hope all goes well for you. Aetna has actually been pretty good about answering my questions so far.

[BGMOM12 3]

On 2/27/2018 at 8:11 PM, kakatlady612 said:

BGMOM12 aetna- thank God they didn't forget ya! Congratulations on your date, when is it so we can pray for a smooth surgery.?? Oh I'm so happy, always happy when somebody gets scheduled. Takes my mind off my own bumpy road to RnY.

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Thank you for the will wishes!!!!!!!!!!!! I go 3/28. I am so excited.

[kakatlady612 1,053]

And well you should be, I'm sure we will all be praying for you on that day. Hey I just started a March Success stories thread this AM, hopefully my surgical act will get together and I can be one of you guys. At any rate congratulations again on your date.

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