New York

2cute! · May 10, 2008

Hello everyone! I am glad to have found this website. Me and my close friend are preparing ourselves for the lap band. We have done our research and just patiently waiting for my approval from the insurance company. I have Aetna PPO. I have heard so many things about Aetna and their waiting procedures. It would be helpful if anyone can give me insight on how long do you usually wait for the precertification. My surgeon is going to be Dr. Bessler. I am just counting down the seconds, minutes, hour etc:smile2:. Your help will be greatly appreciated!

p.s. Does Optifast spoil if not use? My nutritionist encouraged me to buy it in the beginning because i have alot of weight to loose. I am kind of mad at myself because i should of researched into it more and waited until i was close to pre-op. I have three unused boxes and was curious to know, will they still be good by the time i do my pre-op? Thanks again.

kathystrick · May 10, 2008

Hi and welcome to LBT!

You might want to check the Insurance and financing thread for info on Aetna. I have BCBS PPO and it took about 3 weeks for pre-authorization. Have you seen a copy of Aetna's policy on WLS?

Is your Optifast pre-mixed or powder? I know the powder would last longer, but the pre-mixed usually have a pretty long shelf life too. Did you check the packages for a "Use By" date?

lizbuff · May 10, 2008

I have Aetna PPO in Georgia and was banded Monday 5/5/08. My surgeon's office was great in getting all the info to Aetna. Once Aetna got all the info, it took less than 24 hours to have approval. That said, I did have to have 3 years weight history, do 3 month supervised diet with my PC and nutritionist and have psych evaluation. The good thing is my surgeon didn't require liquid diet pre-op except Clear liquids the day before surgery. I had to do Atkins-type, high Protein, low carb diet for 2 weeks before surgery. I actually lost 13 pounds on it.

As long as your docs are thorough and get everything to Aetna, it shouldn't be a long wait. Good Luck!!

2cute! · May 12, 2008

Congrats on your surgery! Well I have Aetna PPO in New York. I cant believe that you got your approval in one day! WOW! Yeah i had to have at least five years of history and a 6month supervision, as well have a pysch eval. What i dont understand is why is the procedure different with the insurance. I sent my pre-cert on the 5th of May and I it will probably be another 2-3 weeks before I hear anything. I am just impatient right now. I am ready!

lizbuff · May 12, 2008

Call, call, call Aetna. I called and got the answer right away. No waiting for mailing, faxing, etc. I didn't pester, just called the day that I knew my surgeon faxed the info and the next day. When I called the 1st day, Aetna cust service told me it should take no more than 24 hours. They were right. I don't know if different companies' plans are different or not. My insurance is through my husband's previous company, Dow Chemical. Good luck!

mediummike · June 4, 2008

Hey 2cute - I just replied to your other thread but will provide more detail here. I have Aetna PPO as well. Once I had all of my pre-surgery tests done, aetna actually replied pretty quickly. Great thing about Bessler is that his staff handled everything - I never had any contact at all whatsoever with Aetna. Once they submitted everything (including all pre-op results) I seem to remember it only took a couple ofweeks for Aetna to respond (yes, thankfully!).

2cute! · June 13, 2008

Hey again! I read the other one first. WOW! Congrats to the weight loss. Dr. Bessler seems like he know what he is doing. Very confident! Did u have any complications?

cantwait2bfree · June 13, 2008

Hi there!!

I'm from Queens and I also have Aetna PPO. I had to do the 6 month doctor supervised diet. Once I did that and saw all of the specialists I got approved within 3 days!! I get banded on Monday. Good luck to you. :rolleyes2: