I finally got approved through Aetna Hmo!!!

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After a second level appeal to Aetna HMO, I finally got approved last week and my LAP-BAND^® surgery is scheduled for 12/21/06!!! I am freaking out!

Advice to anyone trying to get approved- don't give up! Keep appealing and getting letters from all of your Dr's untill your insurance co approves you! The insurance companies deny you thinking you will just give up- don't do it!

I am so excited - and a little scared. Has anyone ever died from LAP-BAND^® surgery? I don't wanna be the first! I can't wait to start my new life! I have been overweight for 18 yrs.

Any advice anyone has about the surgery would be totally appreciated!

Happy Holidays !!

Kim:clap2:

That's great, Kim. Hope it goes well for you.

Kim,

How was your surgery? I noticed you were scheduled for 12/21. How are you feeling?

I, too, have Aetna HMO. I fall below their BMI rate (I am 37) and don't have a comorbidity. My Doc and I are praying that once I do the 3 month test period that they approve the surgery. How many appeals did you go through?

Looking forward to hearing how you are doing,

Cate

I'm Aetna HMO too! Were you 40+ BMI??

I have Aetne Select, which is an HMO and want to do the LAP-BAND^® Surgery as I hear it's alot safer. I weight 525 lbs and 34 years old. I stand at 5 feet 9 inches. What do you think my chances are of getting approved through Aetna HMO. My doc appointment is for this Wednesday. Thanks Sam

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Hey Guys!
Wow! Thanks for all the well wishes and replies!

My surgery was a total breeze! I was back to work in 4 days! Haven't had any complications, and I have lost about 52 lbs so far! I think the wt just falls off no matter what you do the first 4 months, then you really need to follow the rules and exercise. I had been lazy in the exercise dept! Getting fills is major important too! If you can eat more than 1/2 cup of food within 20 minutes and not be totally full, it's time for a fill.

I just found out that I am 8 wks pregnant! I am sure it's thanks to losing all that wt! I still have at least 100 lbs to lose, but I know I will get there!

Good luck to everyone! It's the best thing I ever did!
kim:whoo:

__________________
Banded 12/21/06 by Dr . Daniel Scott- UTSW
Lost 60 lbs the first year then got pregnant! 28 weeks pregnant as of 2/16/2007

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Hi Sam!

Sounds like you should qualify based on your BMI. The main thing you need to verify with Aetna (or any insurance co) is that wt loss surgery is a covered benefit through your employer, also check the certificate of coverage to see what the qualifying steps are for the surgery if it is covered. Aetna made me have 6 months of supervised diet and exercise visits with my PCP (make sure you dr. notes that he discussed "behavior modification, diet plan, and exercise" on every visit! Mine didn't put behavior modification and I had to do a whole new 3 months in addition to the 6 I already did! Also- YOu can do only 3 months of dr supervised visits if it is pre surgery! I also had to have the usual- nutrition evaluation and Psych visit. Make sure your nutrition visit is about your diet before the surgery , not a LAP-BAND^® consult. ... Aetna got me on that too! Oy!

Good luck at your visit! Let me know if you need anything at all!
Kim

__________________
Banded 12/21/06 by Dr . Daniel Scott- UTSW
Lost 60 lbs the first year then got pregnant! 28 weeks pregnant as of 2/16/2007

Congradulations, this is all just great news. I wish you the very best.