Aetna Denied me :(
Congrats to those of you who were able to have your insurance pay for your surgery. It seems as though I wont be that lucky. I was denied a second time today and told that theres not really a way I can appeal it. They have all of my PCP records and said they dont have 6 mths of a consecutive weight regimn. So now its off to the world of payment plan or loan options...
Wait Gina...
Have you thought about doing the 3 month diet plan that Aetna requires? Go to the Aetna website and you will see all that it entails.
Aetna just denied me and I did the 6 month plan! They deny almost everyone once or twice hoping that you will give up and self pay or quit.
Good Luck
Sallykate
I wouldn't give up. I wrangled with Aetna for 6 months before finally getting approved. I did the three month program, and all of my paperwork was done exactly as Aetna requires. Most of the people that I have talked to that did the three month program have not been denied. But you do have to keep on Aetna day after day after day. Finally, after getting fed up with being told a) they never got my info; b) they needed more info; c) they lost my info, etc. etc. etc., I finally got my HR person involved. It went from they had never gotten my info on a Thursday to being approved the following Tuesday. Keep on them and good luck. The best advice I can give you is find an Aetna doctor that is familiar with the three month multidisciplinary discipline and go for it. US Bariatrics in FT. Lauderdale does that. I am not sure if my doc, Dr. Jawad does, but would highly recommend him, regardless.
Between two docs, I was denied FIVE times in all. Aetna is notorious for stalling and finding fault in (to me) trivial semantics. Of course, having a WLS-specific attorney helped me a lot, too. Although my husband was willing to use the 401k on the surgery, I wasn't willing to give up easily.
Hang in there and BE the sqeaky wheel! Repeat after me: "Embrace your inner b*tch!"
Kristen
Kristen Most Active
Recent Topics
