aetna approval

I am just beginning my journey towards bariatric surgery.  My insurance is Aetna. It covers this type of surgery but requires preauthorization,.  I am so afraid that they are going to deny my surgery.  I am 60 years old 5 foot tall and currently weigh 230 lbs.  I have been between 195 to the 230 over the past few years and have had to fight weight issues as long as I can remember.  There have been times when I would loose 60 or so lbs but it would all creep back along with some extra pounds.  Does Aetna consider Weigh****chers as a form of diet for approval?  Can anyone please give me so insight, advice or any help as to how to make sure Aetna approves this much needed surgery.  Both of my grandmothers were very obese and died fairly young as did my mother and I would like to live and be able to see my grandchildren marry and have their own children.  Any insight and advice would be so much appreciated. 

I cannot answer your questions but I can wish you luck! Crossing my fingers for ya!

Thank you.

I had another insurance for surgery but my company switched us to Aetna shortly after and I've had no issues with labs being covered and such. When I was prepping for surgery I wrote a history of my WL attempts and used my time in Weigh****chers. I followed the format of the history shown in Weight Loss Surgery for Dummies...I kid you not. It's a really good book. I bought it through Amazon. It helps walk you through the entire process.

--gina

I also purchased that book through Amazon and downloaded it to my kindle.  Glad to hear that it will be of benefit.  I have started to read it from the beginning and plan to go through it completely.  Did Aetna allow you to use Weigh****chers as time required for the 3 or 6 month requirement of a supervised diet program?

I don't know if it was used in my case or not, I had several years of doctor monitored WL programs too. I've read in others' cases that Weigh****chers was accepted.

--gina

You really need to approach this as if you were going to court over a law suit.  You need to gather information from your insurance company, in writing, and make sure you understand all of their rules from the beginning.  Then start fulfilling the requirements so that you can force them into paying for your WLS.  Because they don't want to pay for it, and will do what ever they can to get you to drop the idea.

So call Aetna, and ask them for the criteria for WLS, and make sure you get a copy of those rules in writing.  Then you know exactly what you need to do to get the surgery approved.

Don't follow what other people tell you to do - if they make a mistake, you could waste months of doing the wrong thing instead of being on track and documenting that you are following the insurance company's criteria.

Thanks for your suggestions.  I am trying to get a head start on getting my ducks in a row as they say.  My Aetna insurance won't go into affect until Jan. 1st.  I have read on their website and I know that I have to do a 3mo supervised weight loss program.  Wish I knew for sure if Weigh****chers would be considered that or not.  I did email my PCP and asked him if he would help me with this the supervised weight loss program.  I should received a response from him tomorrow, so I am keeping my fingers crossed.  I meet with the people at the bariatric surgery clinic on Jan. 2 to begin getting things moving there.  I really hope I can have my surgery by spring.  Thanks again.  Have you had surgery and if so what type did you have?   I would like to hear from people that have been through weight loss surgery and hear about their experiences and how difficult or easy  their journey has been.