Your Aetna experience?

jennlynn26

I am currently going through the process to have Lap Band. Starting my 6 month supervised diet this week. Done my sleep apnea, stress test, pulminary function test, and a few more. Waiting for results. I have aetna NAP choice POS II. I want to make sure since i am spending all of this money for these test and supervised diets (around $ 800) that i have every thing that aetna needs to approve me for the surgery. The only thing that i worry about is the proof of being 40+ bmi for 5 years, even though i have. There were a few years in between that i didn't go to the doctor (not even the female doctor ) so i not for sure if i can come up with these records. So i would just like to here anyones experience with aetna good or bad. I really want this surgery so information would be very appreciated and helpful.

Flowerpurr

I am going through the same thing. For me to do the supervised diet and all the non-sense is around $1200.00 so I don't want to spend the money if I don't have to. I am only missing one year in between but can prove over six years just not all in a row. Good luck!

__________________
Approved June 9th 8:22am!!!!

Surgery Scheduled July 15th!!!!

dogluvr

I have Aenta PPO and I am "covered" - but it remains to be seen whether they approve me or not. I am getting all my ducks in a row and getting a sleep study done since I do not have a consistant 5 year history.

Gladtobefree

I have Aetna PPO and was just approved yesterday. I didn't have the 5 years bmi history consecutively but sent them 2002,2004 2005,2006,2007.

swstacey1977

I have Aetna PPO and it took them 2 days to approve me. i had the psy eval, 6 month diet with notes about nutrition and being on a low calorie diet and that i was advised by my PCP about behavior modification. THIS IS IMPORTANT TO INCLUDE IN YOUR 6 MONTH DIET WITH AETNA!.
i did have 5 years medical history of obesity and sleep apnea test. and a letter from my pcp saying that i needed the surgery and that he felt it would benefit me. Aetna was very nice and i had no issues. just remember to ask your doctor to include all that stuff in the diet because that is the main reason they will deny you. Good luck and God bless.
i have my surgery Nov 30th. 2007. my BMI is 48. 30 years old.

swstacey1977

one more thing, make sure your diet says that you have tried diet pills. Aetna ask for that documentation to be in the 6 month diet also. even if you don't get them filled, ask your doctor to put you on some and make sure he documents it!

JDUB0414

My husband and I just completed the six month dr. supervised diet plan this month. I have all the requirements they asked for. My husband on the other hand doesn't have a continuous 5 year history proof because he hasn't been going to the doctor. They submitted our paperwork to the insurance company Friday 11/16, I am anxious and nervous about getting approved. I'll let you know how it comes out..

BTW: I have Aetna PPO

Gladtobefree

jdubo414 good luck. It took about 8 days for them to approve me.

circa

I too have Aetna - I don't have 5 years of history, I have 99, 2000, I think 2001, 2003, 2006 and 2007 but nothing inbetween. I mean, if I was fat in those years, what makes them think I was sneakily skinny the other years just to go back to being fat the other years just to trick them? :P Anyway - my advocate is working on it.

lonestar5212

Jennlynn26, flowerpurr, & charmaine - I am in exactly the same situation as all of you with Aetna. I am missing one year also. I have every year back to 2000 except 2004. My BMI is 41.5 and I have diabetes. I haven't submitted yet because I am still doing the supervised diet. Time will tell what Aetna does with me. Keep us posted. Congrats on your approval Charmaine.

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Dr. John Marsden-DFW
Surgery 3-14-08
1st fill - 4-14-08
2nd fill - 5-23-08

Gladtobefree

Thanks Lonestar 5212 I'm very excited. It sounds like you will soon follow. My bmi is 37 and I have high blood pressure and currently take two medications. When will your diet end? Keep me posted.

lonestar5212

Charmaine - My last appt. for supervised diet is Jan. around the 20th. They told me they will submit my file that day to Aetna. It seems so far away, but thank goodness the holidays are keeping me very busy.

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Dr. John Marsden-DFW
Surgery 3-14-08
1st fill - 4-14-08
2nd fill - 5-23-08

Gladtobefree

I understand how you feel my surgery isn't until Jan 4th. Don't worry the time will fly by especially with the holidays. Good luck

JDUB0414

I talk to the insurance company on 11/29/07. They said they have all of our paper work and the file is still being reviewed. I am hopeful that we will have an answer soon. Please pray for both my husband and I to get approved:help:

kmefaith

HI, I saw your message and am curious. You said your approval was within 2 days. That is awesome. Dec 12th will be my last weight loss and nutricienist appointment, then they submit my approval. Since all this started my doctor put me on blood pressure meds as well as it was consistantly high. Aetna told me that I need a 4 month plan, plus I have been fitghting this for many years now, and my doctor help support that. So I am hopeful I will get my approval finally. How long after your approval came through did you go in for your surgery, and how are you doing now?