A quick Aetna Question! weight-loss prior?

[ichatter 0]

Hi Guys!

Okay so i am in the process of jumping through hoops and i am still early in the process. I just got more blood work done then i would like, but i just had a couple quick questions....

1. I am 5'4 and 250lb, i have been overweight by entire life, but i was 200lb from about 17-19, then have varied between 215-245 until now (i am 22) does this seem to be enough of documented obesity? Obviously my BMI has fluctuated, but its not like i was ever thin..???? I have high cholesterol and, i have high levels of cortisol we are re-testing right now. I am also getting my thyroid tested but i doubt that will come back bad. I have to set the appointment for the sleep test and we will see. But i also have PCOS. I know this isnt caused by being obese, but could this still count as a co-morbidity since it is a DEFINITE contributing factor to my weight?

2. (more important!) So once i start this 6mo. supervised diet... i am a litle confused. I am not sure exactly what they want out of it. Do they want me to lose weight to show that i can? Or, do they want me to not lose weight and prove that me doing it on my own doesnt work? I mean truthfully i have lost 20-25lb in the past, but around the 30lb mark something happens and just start gaining again... i dont want this 6mo. to look like ive just been lazy my whole life yknow?????? ack! help!

[bigunc 0]

There are a couple of ways to get approved for the surgery by Aetna. You need to go to the Atena web site and look for the alpha list of clinical policy bulletins. Find the one listed for Obesity Surgery. You need to see how your personal health history fits the requirments.

As for the diet requirements, they want to see a commitment from you to lose weight. You need to prove your commited to a life long change in eating habits.

I was lucky, my Nurse Coordinator was very well versed in the Aetna requirements.

Good luck. Hope this helps.

[miss meliss 0]

I am jumping thru the Aetna hoops myself at this time. I have learned that your BMI can not be lower than 35 for the past 2 years (per new rules 02-08-08). If you have been lower than that and it was because of a goofy diet then you can write a detail desciption of what you did and if you gained it all back immediately. Also if you use a regular doctor you have to do a 6 month diet. If you use a baractiric center and work with thier dietitian then you only have to do a 12 week diet. Good Luck!! ... Meliss :cheers2: