Aetna POS II

bostonbabe · January 16, 2008

I am currently going through the 3-mo. requirements (doctor and dietician) for AETNA. I also have five years (even longer) documented obesity weights. However, I don't have a lot "wrong" with me--I've been on high cholesterol meds for the last ten years and Nexium for probably the last 5 for GERD. Has anyone out there been accepted for surgergy by AETNA with a POS II. I have also been on thyroids meds for over ten years. I'm afraid to get my hopes up about the surgery b/c I'm afraid they will reject me. Also, what does surgergy cost when out of pocket? I live in West Houston and working with Dr. Ferrari. Has anyone out there had a similar situation or have been approved by AETNA?:smile:

coolcrystal · January 16, 2008

I'm not sure how to post links here, but if you go to the Insurance section/forum, there is a great thread about Your Aetna Experience (or something to that affect). I'm going through Aetna too, but sadly, I think it depends on who reviews your file, what mood they are in.. etc. LOL.

NYGMEN · January 16, 2008

I had Aetna POS II and have been turned down 2x by them. I have a BMI around 54 and have had it for over 5 year. I also have 3 slip disk in my neck and two in my back as well as sleep app. They wanted the 6/mo requirement so i did that(got done this Dec) and they said it would still take up to 6-8weeks for them to review it.

So i dropped them and took my wifes plan (United) as of the first of the year. Everything has been sent to them and I have a date of 1/24 for the band. I have been on the pre-op diet for 6days now and i hope it's a go. Unlike the first two times my doctors office said they don't think i will have any problem. Sorry if I put a dim lite on Aetna, But they gave me a hard time from the start. Just hang in there

JDUB0414 · January 19, 2008

Even though it took a while for them to approve me I think....I got approved after 6 weeks or so. I've had a BMI of over 40 for the past five years but have absolutely no co-morbids. The previous poster is right, I think it depends on the person reviewing your file and what mood their in. Good Luck. :lol:

Flowerpurr · January 28, 2008

What if you have one year where your BMI is only 36 but you have other years over 40 with a total of 7years? Will they kick it out?

NYGMEN · January 28, 2008

They need more then just BMI. I had a BMI over 50 and over 45 for more then 5 years. Still no good. You have to do the 6/mo Doctor diet. If you didn't start it yet you should soon. I had a number of things other then BMI (Sleep Ap, Bad disk in my neck & Back) but they wouldn't move until i got done with the 6/mo and it had to be 6 in a row.

I changed at the last minute and went with United but i tried with Aetna POS II for almost a year.