approval-aetna

[celticgirl 0]

Hi,

I would like any feedback regarding getting pre-approved by aetna for lapband surgery. My bmi is 39, I have extremely high cholesterol/triglycerides, mild sleep apnea that may be causing heart papitations. Do you think I have a chance to get qualified? I have Aetna POS. I've been in the range of bmi 35-39 within the past 4 years. I'm currently on a 6 month diet/exercise program that is being monitored by my doctor.

PLEASE send me some feedback and hope! Does anyone out there have a similar situation?

[OnMyWay2Thin 45]

...laughing... We had the same bmi and I also had sleep apenea and diabetes. Aetna looks for the 39 BMI with at least 2 co-existing factors. Honestly, I sailed right through. They approved me on the first subit. I was very happy with Aetna. Now I'm 1 month and 1 week out and have lost 30 pounds since surgery day! My diabetes is completely gone and I'm feeling great. Good luck, Aetna should be good to you!

[goosefraba 0]

as long your policy doesn't have WLS exclusions there shouldn't be a problem. i was denied because i needed the 6month diet supervision so Dec is my new date. i hear good things regarding Aetna.. Good luck!

[Jesangel76 0]

I have Aetna and in the process of getting approved. They are strict as they require 6 months of seeing a nutritionist, a psychotherapy analysis, a health factor, a mandatory info session on the surgery and a BMI of late 30's and higher. I completed the 6 months of nutrition and have Type II Diabetes - just recently found out that I my bad cholesterol is a little on the high side. So, there shouldn't be any reason for them to deny me.

But, yes Aetna and Cigna are two of the most difficult insurance companies out there when it comes to Bariatric surgery. Although, sometimes it really depends on how the contract was negotiated with Aetna and your company and sometimes it doesn't. Good luck to the both of us!

[koswalt4 0]

I had my band surgery in May and at the time I had Aetna. They finally approved me after being turned downthe first time. I had to do a 6 month waiting period of dr visits every month to be weighed and had to have all of the test and other dr visits met. Once I finished all of that it was clear sailing. Good luck and hope everything goes well. My surgery was May 15, 2008 and as of today I have lost 54 lbs.

[suziq53 0]

i was just approved iam so excited my surgery is the 27th i have aetna pos ins myself and i finished a 90day supervised diet with my family doc and turned in my paper work on friday the 3ed oct just 10 days ago...i kept a running of my meals and such and seen the doc once a mo. and they approved me and right now i have met my deductable so the doc office is saying they may pay 100% or close to it now ...i can't wait i start my 10 day diet this friday and my last seminar nx tue..i have the rest done except the tests from the hos before surg time..so aetna has been good for me i can say that much .good luck to you :smile2:

[aubrie 6]

You are so lucky. Aetna denied me twice. I had to appeal. It was horrible. It took me 11 long months to finally get approval, but it was worth all the aggrivation and headaches!

[celticgirl 0]

Congrats on your weight loss! You have diabetes..major co-morbidity. I don't have anything except extremely high cholesterol/triglycerides and mild sleep apnea. Aetna says 1 co-morbidity now, but mild sleep apnea isn't a co-morbitiy, only severe sleep apnea. Heck, I'll say a prayer and hope for the best. My doctor said it all depends on "who" is reading the request at the time it gets recieved at Aetna.