Aetna question-2yr BMI requirement

[sdpatt39 0]

Aetna's requirement is that you have a bmi of 40 for at least 2yrs. Does anyone know what Aetna consider 2yrs? Do they consider the current year as a part of the 2yrs? Or are they looking at the past 2yrs such as 2006 and 2007? I just want to know if I consider having the approval/surgery in 2009 are they going to look for my bmi requirement in the years 2008 and 2009 or 2007/2008.

[IM_LORI 0]

I wouldn't guess. I would call them and ASK! If they want 24 months up to today, give them it. Manipulate the data to give them exactly whatever they request. :smile:

[tmbowe 1]

I was just denied by Aetna because my Dr . Did not Submit my weights for 2006.. They submited 2003,2004,2005, 2007 and 2008 but 2006 was missing.But because there requirments are for 2 yrs the denial letter told me I needed 2006 to prove i was overweight. When I called the rep I asked her if they thought i got skinny for 1 yr. Anyways 2006 through 2008 would be what they require, If you plan on getting the surgery next Yr I would probably send them 2006-2009 then you know you are not missing anything

[sdpatt39 0]

Thanks for the info. Will you be able to get the records for 2006?

[tmbowe 1]

Yeah I already got them and resubmitted. Now it is just a waiting game