Aetna's 3 mth diet - a diet?!?!?!

Gina Olson-Ferraro
on 5/24/05 8:14 am - Stuart, FL
Okay - I need to knwo if this 3 mth pre surgical weight loss diet - is somethign Im supposed to really follow and lose weight - or something I just have to document with the doctor for paperwork - If I lose wieght with diet and excersize - isnt that grounds to deny me again b/c Im losing weight on a low cal diet/exercise? We know its temporary - but on paper - they dont?!?!?!
Shayna T.
on 5/24/05 8:49 am - Miami, FL
Losing or gaining weight didn't affect my approval. I think the diet is an attempt by the insurance to see if you are really serious about WLS, and as a way to prove to them that you have tried everything, including other medical intervention, exercise and eating modification. You are lucky you only have to do 3 months, some patients (like me) had to provide 6-months and some are even having to provide 12-month medically supervised diets. Good luck! ~ Trish
Gina Olson-Ferraro
on 5/24/05 8:52 am - Stuart, FL
well ya see - heres the thing. I was denied b/c I didnt have the 6 mths...and for an appeal - Im doing the 3 mth PRE SURGICAL regimn.....I just dont know how much to lose if any - to be the most beneficial to get approved with this appeal
roser13
on 5/24/05 9:11 am - Glendale, CA
Dito. I too had to have documentation of a 6 month diet. They just want to make sure that You've tried everything. It took me 3 years to get approved because I never wanted to do the 6 month diet thing. I kept on putting it off. Now it has been 3 weeks since I had my surgery!! Rosie
Jennifer G.
on 5/24/05 10:07 am - Jacksonville, FL
I have aetna and I did a 3 month diet for them. What they really want to see is if you will be able to stick the the diet you have to do after surgery, they dont want to pay for your surgery and then right afterwards you eat something you shouldn't and end up hurting yourself and costing them a bunch of money. Also with my Dr if I was to go and weigh in and had gained he would give a warning and if you come in and have gained weight again he will drop you as a patient because aetna WILL NOT approve you if you have screwed up twice.(a aetna member service person told me the same thing when I called to ask if that was true). But I did my 3 months and on my 90th day I had lost 36lbs and when I was leaving my dr's office they faxed eveything to aetna and in 2 hours I got a call and was approved that was on 5/16 and I got scheduled for my surgery to be on June 9th. So I would suggest you stick to the diet and exercise and you will do fine. Jennifer
REYES34
on 5/25/05 4:29 am - tallahassee, FL
Be happy its only 3 months.. I have to lose 10% of my weight before i can even think about being approved. (its 35lbs) And then on top of that i have to take these really boring classes every week for a year, and they also make you exercise which im glad they do because if you think about it, you will be a little healthier and it should help with heal time and your over all well being... So do what they ask.. who knows it might be the best thing for you. try to lose something .. go walk for ten mins or as long as you can.. you will be surprised about what you can do... be positive, TRUST ME I KNOW ITS HARD. But things could be worse... you could have no insurance or one that does not even cover the surgery... in the long run they are trying to get you into healthy habits now... because once you have the surgery you will carry them with you .. BECAUSE OF COURSE WE ALL KNOW THIS SURGERY IS A TOOL NOT A CURE.
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