I'm a newbie

I'm working on a 3 mth pre-surgery regimen that Aetna requires. It was either 3 mths or 6 mths dieting and I am one who lacks patience. The quicker the process, the better. My first month into it and I'm meeting with my doctor, dietician, psychologist and personal trainer. I am dedicating myself to this without hesitation or question. I am concerned though. I was wondering if anyone had any issues with or thoughts on Aetna? My biggest concern is the 5 yr medical history. I can come up with 4 yrs of doctors visits, but for the last 10 yrs or so haven't been able to be weighed on the regular doctors office scales so I'm uncertain if my weight issue has been documented. In addition, I don't believe I can produce a full 5 yr history, I only recently (in the past 4 yrs) have obtained health insurance. Any insight or opinions would help. I've been doing a lot of internet research, but it's kind of one sided without a discussion. My family is probably tired of hearing me going back and forth with it and my nerves have now become an unwelcomed addition to my normally restful sleep :-O

Hello Farrah, I have Aetna, I had to fight to get approved. I was denied 3 times & I was approved only after the external review (4 months later). I too was only able to come up with 4 years of medical history. I was denied because my BMI went down to 38 Four years ago right back up to a 44.5 (day of surgery). The reason also was I did not have high blood pressure, diabeties, or sleep apnea. Do you have any of these, not to sound mean, but it would help if you did. I did they 3 month plan also, just because I don't like to wait either & have NO patience. I only went to my dr & a dietician once a month for 3 months. MY advice to you is fight, fight, fight.. It also would help if your DR was all for this surgery, my primary was NOT & therfore would not do a thing to help me get approved, so needless to say I don't see him anymore. Do you have a surgeon yet? Please email me if you want to talk, [email protected] Good Luck to you!!! Julie

Hi, thanks for the encouragement. I need all I can get :) I do have high blood pressure and i'm what my doctor calls "borderline diabetic". I love that there is a place to discuss this openly and honestly, my family and friends don't quite understand what going through this feels like, so it helps to hear it from other pre and post opties :) Thanks again! Farrah ps. my email is [email protected]

Farrah, I have Tricare Prime so I don't know if this will work for you but I also was unable to be weighed on my physician's scale for many years (not anymore thoughYAYYY). So they told me to have the doctors office write a letter stating that their records indicate that as of 5 years ago(include the date) my weight was 350+. That was all it took for me. I actually wrote the letter short and sweet and my PCP signed it. Ir's an idea! Hope it works for you! Kat

Thanks Kat! Great suggestion :) I'm contacting my surgeons office to follow up tomorrow. I want all of my ducks in a row before submitting to the ins company. I want the first time to be the only time! Thanks again. Very encouraging... ~Farrah

Hi Farrah, I am probably the wrong one to respond since I had to sue Aetna for approval - I hope that all goes well for you. I would try to find any medical records with your weight recorded from 5 years ago. How about pictures from 5 years ago? Pictures are considered "documentation." HTH, Kristen

I looked through stashes of pictures and none of them were taken with a camera that has the date printed on it. Does that matter? Thanks! Farrah :)

Farrah, try to make it to the OH Conference in Orlando the weekend of May 5th, Gary Viscio, esq the Obesity Lawyer, will be speaking on how to deal with Insurances not only for WLS but also for Pastic Surgeries after losing the excess weight we carry. Good Luck & Prayers for your WLS Journey, Mike

Thanks for the suggestion! I will surely be there. I need all of the support and knowledge I can get. Thanks for leading me in the right direction :) ~Farrah