Help with insurance.

I have Aetna and I am getting very discourged with getting insurance approval. Anyone else have trouble with them? Anyone have Aetna and have been successful getting approval? I really need to hear from you. I am about to give up. But I really need this surgery as my helath has been going down hill fast. Thank you.

Hi Anne how are you? I am sorry to hear you are having a tuff time with Aetna. I have aetna and I am stuggling a bit too. I am also having Dr. Shram do my surgery. Have you ever been to the support group meetings in Holland? My expereince with aetna has been one where the people at Barix say one thing and Aetna says another. So I document every phone call and always take down names and numbers so that I can refer back to whoever I spoke to in the past. I met all of my requirements and Aetna still asked for more documentation. Even Barix was shocked. My apeal was sent in 2 weeks ago and I am now waiting to hear an anwer. I am suppossed to hear something possibly on Monday 17th. We will see. What kind of problems have you experienced? Melissa

Mellisa... I posted this responce to ANN but I want to make sure you get it too.... At one time on this board I was known as the AETNA WARRIOR. If you get time read my profile and you'll see why.. ugh. Aetna LOVES to deny people and then over turn their denail on appeal. DO NOT GET DISCURAGED THAT THEY DENIED YOU! I along with others on this board where denied and are now 7 and 9 months post-op. Yes Aenta is a PAIN but they will cover WLS, you just have to put out the effort to fight. If I can help you in ANY way please let me know... Best WISHES! and PLEASE keep up the fight! Erin 9/12/05 282/174/155 (I think)

Hi Ann... At one time on this board I was known as the AETNA WARRIOR. If you get time read my profile and you'll see why.. ugh. Aetna LOVES to deny people and then over turn their denail on appeal. DO NOT GET DISCURAGED IF THEY DENY YOU! I along with others on this board where denied and are now 7 and 9 months post-op. Yes Aenta is a PAIN but they will cover WLS, you just have to put out the effort to fight. Let me know where you are in your battle... I'm more then willign to share my experiences, knowlage and letters.... Best WISHES! and PLEASE keep up the fight! Erin 9/12/05 282/174/155 (I think)

I have been approved by Aetna qualifying for the WLS and by having 6 months doctor supervised diet and that my BMI was over 40. There are different Aetna insurance. I had the health Maintenance Aetna. I did have to pay close to $7000.00 with all of the copay and deductables also. Take care, Janice

Hi Ann: I am the one of the first people to get Aetna to approve me (hubby works for UPS) you have to follow their rules exactly on the Clinical Policy Bulletin 0157. They mean business with this, and in the end if you follow their rules you will succeed not only with getting approval, but also with long term success with weight loss after surgery. I learned a lot from the surgeon's medical weight loss program that I had to be on for 3 months prior to approval. I know everyone wants to try to skip this because it makes surgery seem so far away, but today I am actually lower than my goal and am succeeding pretty easily because of all I learned during the 3 months diet, exercise, and behavior modification I went through. I am from Paw Paw and went through MMPC in Grand Rapids. I had Dr. Baker and did really well after surgery, very little pain, and no complications, thank the Lord. There is no reason for you to give up, just get hold of Aetna (www.aetnanavigator.com or by their 800#) and find out just exactly their requirements. Who is your insurance through, by the way? Are you any relation to the Sonnenbergs in St. Joseph, MI? Wes is a friend of ours! Let me know if I can help you, my e-mail is: [email protected] Pam

Soory to *hijack* but... Ms. PAM you have a new FACE! And look at the BEAUTIFUL smile! Looking SMOKING BABE! Erin

Erin: Thanks for letting me know the new picture was up, I didn't see it until you sent the message! Thanks for the compliment. Sure feels nice to be thin! Love, Pam