Your Aetna experience?

dogluvr · 02-27-2008, 02:17 AM

^ I'll keep my fingers crossed for you. They submitted my precert today to Aetna but not sure if the review nurse got in touch with my wl center and requested my files. My best friend d got approved in one day through them. I can only pray for a swift approval like hers. Keep up the faith!!

lonestar5212 · 02-27-2008, 07:28 AM

Dogluvr - Good luck to you. I pray you don't have to wait this long. I wish I could figure out why some people get approved so fast and others have to wait so long. Hopefully, you will have a short wait.

NeNe967 · 02-27-2008, 07:59 AM

Last Thursday, February 21, 2008 my paperwork was resubmitted to Aetna after doing their 3-month pre-op diet. Per the doctor's office it should take about a week to get a response. Wish me luck!!!

I just think I might be devastated if they coming back saying I have to do something else to get approved. I'm thinking positive though and praying that I finally get APPROVED.

SKoenig · 02-27-2008, 08:35 AM

I found Aetna to be a little more strict than my previous insurance. I had everyhting sunmitted to my old insurance in Dec. but they wouldn't even look at because i was switching to Aetna in Jan. Other had a really easy time with my previous insurance NGS. After everything was submitted to Aetna In Jan 3 weeks later they said they didn't have enough documentation which was not true. My GP 15 pages of weight history and a letter begging for me . After he sent another letter I was approved very quickly(FEB. 4) Got scheduled for 2/20 and voila I'm done.(Except losing the weight that is) Good luck and be patiently persistent

dogluvr · 02-27-2008, 02:17 PM

Got the word that they faxed all my files over to Aetna this morning.

So I wait.

JDUB0414 · 02-27-2008, 07:50 PM

Dont worry it will come soon everyone. Please dont listen to people with regards to the amount of time it will take because everyone is different when it comes to that. I'm praying for everyone.

polly522 · 02-28-2008, 03:01 PM

^Great for you

I called the coordinator, and she said that in our neck of the woods, Aetna is not likely to approve the 3 month, it is better with the 6 month. So I go on, and get all my ducks in a row, but she did let me kow about the 2 year history, so that is great, they already have that. She scheduled me for my Steps to Success class for next month! So I am on my way! Congrats to everyone who has been approved!

Hope4Jen · 02-29-2008, 05:23 PM

Wow,

Just found out that my Aetna EPO plan will remove and replace my band for a slip. WOOHOO!! Surgery this THURSDAY. I am very very happy because I have been unfilled for a week and I am having that hunger like the old days.

hopeinapril · 02-29-2008, 05:30 PM

Aetna BITES! I hope their company goes bankrupt!!!

I'm obviously upset as they are not paying for the surgery. Oh, well.....
now I am going self-pay.

I still hope that company bites the dust........what comes around WILL go around!

polly522 · 02-29-2008, 06:16 PM

Why are they not paying for your surgery?:confused2:

hopeinapril · 03-01-2008, 05:42 AM

Hi Polly:

Aetna is not paying because they say the policy doesn't cover any type of bariatric surgery. It really sucks because I have gone through almost 2 months of their doctor supervised diet. My BMI is high enough that I qualify.

Of course, there was no indication on my copy of the policy that this surgery wasn't covered. I've been given misleading information when I called. I am now positive that I am not covered, but seriously pissed at all the hoops I had to jump through to find that out.

I am still ticked at Aetna, but will not waste my precious time on that low life company. I am going self pay and will just have a great big refund check next year. That works for me!

MicheleK · 03-01-2008, 09:06 AM

My 3 month supervised diet plan starts on March 7th. I'm glad I don't have to do the 6 month plan but I still feel kinda sad that I'm having to jump through hoops for Aetna.

The plan I'm on (through my husband's job) covers most of the surgery but it's still pretty depressing that a person with 52 BMI has to go through all this to get some help.

miss meliss · 03-01-2008, 03:44 PM

NeNe & Dogluvr I'm watching y'all with my fingers crossed!! Hope you hear soon! I submit on April 7th.

bigunc · 03-01-2008, 04:40 PM

MicheleK if you polled everyone on this board you probably would find that 95% would agree that no one liked the idea of a 3/6 month diet.
But... As my Surgeon told me when I asked; Why am I required to lose weight to have the Lap Band for weight loss? His answer: Look at this as trial period. Getting the band is a lifelong change, If a person can't stick too a diet for 3-6 months how will they change their eating habits for the rest of their lives. I wasn't thinking like that at the time. But what he said made a great deal of sense.
Trust me, once you start the diet you will look forward to your next weigh in. I can only talk to the pre-op diet as I was only banded 2-25-08. But I do know I am better prepared to make this band work because of the strict pre-op diet.
Don't get discouraged, you can do the pre-op diet if you tell yourself you have to. I don't know about your medical circumstancses but mine was to loose weight or not be around for much longer. I already have 5 of the co-morbities listed in the Aetna clinical policy bulletin for obesity surgery. So a diet was the only way for me to ensure no more health issues in the future.

NeNe967 · 03-03-2008, 09:43 AM

Quote:

Originally Posted by miss meliss

NeNe & Dogluvr I'm watching y'all with my fingers crossed!! Hope you hear soon! I submit on April 7th.

Thanks miss meliss, I need your thoughts and prayers. I haven't heard anything yet, but I am prayerful that I will hear something this week.

Sincerely,
NeNe