Your Aetna experience?

circa · 12-03-2007, 11:49 AM

Thus far, my experiences with Aetna for everything have been rather pleasant. I have another condition that, I'm allergic to the treatment for - they approved an alternative treatment just based on the fact that I have a known allergy. Now, I'm attempting to get an alternative to the alternative - since the first alternative isn't working as well as expected. They denied my first 2 requests but my third has been tentatively approved pending an independant specialist review. I have not submitted my Lap Band paperwork yet, but I"m working on that.

kRiStI wItH a I · 12-04-2007, 03:46 PM

:help:Hi, I have Aetna POS, and was wondering if it is better to go to an in-network Dr. or out-of-network. I went to a seminar the other night and they said they are out-of-network for all insurances, but will only charge what the insurance will pay. They wouldn't charge for the addt 30% or so. Anybody have any idea which is better??? Thanks!!!!

Kristi

sgaul07 · 12-07-2007, 03:56 PM

I read the post here all the time but this is my first time posting. I have jumped through all the hoops that I was told to and I have 1 last visit with the nutritionist on Dec 20, 2007. Then my paperwork is submitted. I am so nervous and excited... I have Aetna. I have heard good things about them and not so good. I have giving the weight loss history, did all the test and it's been pretty smooth. I say a prayer everyday. Good luck to everone who has had the procedure and to all of us still waiting.

Stacy
Garland, TX
37 years old
255lbs

skculpepper · 12-07-2007, 04:39 PM

I am waiting for insurance approval. I had my last appt. with the nutritionist and the Dr.'s office. They will submit my paperwork to Aetna, hopefully everything will be fine. Everything has gone rather smoothly. Please keep your fingers crossed.:)

lonestar5212 · 12-07-2007, 05:44 PM

sgaul07 - I am exactly one month behind you. My last appt. is Jan. 20 and then they will submit to Aetna. I have my fingers crossed for all of us. Good luck and let us know. I am also a Texan (Flower Mound).

skcwpepper - As you just read, I am waiting in Texas too!! Hang in there and good luck!!!

swstacey1977 · 12-07-2007, 05:52 PM

I really do feel as though you guys will get approved. just call them a couple of days after you know your paperwork was submitted. I also want to add that my company is switching health insurance companines as of Jan 1st 2008 and Aetna knew this and they still approved me. and they were very nice to me. I know the waiting game is awful but hang in there and keep up the faith. it will all work out. I was banded 11-30-07 and have lost 12 pds so far. Good luck and let us know how it goes.

miss meliss · 12-07-2007, 09:34 PM

I have just started my 6 month supervised diet for Aetna. Your comments have been very helpful. How much did y'all lose during your supervised diet? I hate to over think this....but it is very important. Can you lose to much or to little? I would love to here the amount you lost and still got approved.

skculpepper · 12-07-2007, 10:09 PM

I lost 9 months first month, gained 2.6 the next month. Nutrionist advised that was okay, shouldn't have any problems getting approved.

miss meliss · 12-07-2007, 10:25 PM

Thanks skculpepper!

bbarnett51 · 12-09-2007, 04:28 PM

I am just looking into the lap band and i have Aetna. Could you please explain what the process is to be approved. Obviously there is a 6 month diet? What else is needed? I haven't been to a doctor in 8 years so i have no proof of weight. What do i do in this situation.

swstacey1977 · 12-09-2007, 04:49 PM

no doctor visit's at all? like Pri-med, ER room, Gynocologist, no place that you have been weighed? what about your weight loss attempts? has your past weight been documented at all? I have never heard of anyone that has insurance and was not asked to at least submit 3 years worth of weight documentation. also, the surgeon's office is going to ask you about earlier weight loss attempts.

bbarnett51 · 12-09-2007, 05:04 PM

Quote:

Originally Posted by swstacey1977

no doctor visit's at all? like Pri-med, ER room, Gynocologist, no place that you have been weighed? what about your weight loss attempts? has your past weight been documented at all? I have never heard of anyone that has insurance and was not asked to at least submit 3 years worth of weight documentation. also, the surgeon's office is going to ask you about earlier weight loss attempts.

My father was a doctor and passed away in '99. I have only been sick 2 times in those years and his partner treated me. I am about 80-90 pounds overweight and I have tried Diet Center, Weight Watchers, and protein power. I lost a good amount of weight but it all comes back on. I have tried everything and I am really tired of it. But the only records will be from diet center and that was only for a year. The other 2 were on my own and I have no official records.

I have trouble sleeping, some shortness of breath, and my knee is giving me a LOT of trouble from an old injury.

I haven't been to the gynocologist b/c i am a guy:biggrin1:

I am just looking into this procedure b/c of numerious failed diet attempts. I used to be very active and now can't do much of anything. I am VERY interested in the lap band.

Thanks for your help! This is a very informative site. Any info would be appreciated.

circa · 12-10-2007, 11:10 AM

Quote:

Originally Posted by bbarnett51

My father was a doctor and passed away in '99. I have only been sick 2 times in those years and his partner treated me. I am about 80-90 pounds overweight and I have tried Diet Center, Weight Watchers, and protein power. I lost a good amount of weight but it all comes back on. I have tried everything and I am really tired of it. But the only records will be from diet center and that was only for a year. The other 2 were on my own and I have no official records.

I have trouble sleeping, some shortness of breath, and my knee is giving me a LOT of trouble from an old injury.

I haven't been to the gynocologist b/c i am a guy:biggrin1:

I am just looking into this procedure b/c of numerious failed diet attempts. I used to be very active and now can't do much of anything. I am VERY interested in the lap band.

Thanks for your help! This is a very informative site. Any info would be appreciated.

I would speak to your father's friend - the doctor that treated you. He would be able to summarize your medical history for the insurance company. This may really be helpful for you.
I found that since I had a lot of pertinent information missing from my medical records, having the doctor write a history of what my weight was like during the times he treated me, it really did help.
Anything is worth a shot.

coolcrystal · 12-10-2007, 04:26 PM

I have Aetna POS and will be sumbitting my stuff in January. I have my last 6 month dr. visit this week on the 13th, then I have to get a psych eval and have one visit with a dietician.. I'm like 49 BMI, so, hopefully I will get approved. i don't have diabetes or anything like that, but according to their requirements, you just have to have over 40 BMI or 35 with the co-morbidities.

I did that stupid sleep apnea test, and didn't get a wink of sleep. So, they just put on there that I had nothing, but, when I lay on my back my fat chokes me, so I have to sleep on my side. But, she said it probably doesn't matter anyway since I'm over 40 BMI.

I'm curious, I haven't lost any weight on my 6 months visits. I wonder if they will deny me for not losing any weight.

MELISSAV2943 · 12-11-2007, 11:28 AM

I was approved by Aetna on 12/6/07 !!

Good Luck to you all

Melissa

Your Aetna experience?

In or Out of Network Dr.

1 visit left (aetna)

Waiting in Texas

Weight Loss