Does anyone out there have Aetna?

Hello it's Brittany. I just visited my primary care doctor today and talked to her about needing a letter of medical necessity. She started typing it before I even left! I'm so excited because this was the last step I had to take before they submitted it to my insurance company. I know my plan with Aetna covers the surgery, but I am still scared that for some reason they will deny it. Please write back if you have Aetna! Thanks and Merry Christmas!

Brittany, Aetna is easy as long as you do their 3 or 6 month supervised diet deal first. The only negative is that they don't cover the band, only bypass. Dr. C

Thank you so much for responding so quickly! I have been obese all of my life and have tried every diet known to man! Do you know if that will count or do they want you to try it again?

Brittany, They are very specific - you have to either do a 6 month supervised diet with your PCP, or a multidisciplinary approach for 3 months with a dietitian and your PCP and exercise. Good luck, Dr. C

As always, Dr. C is right on the money. I had my surgery 10/10/05 and I have Aetna. I did the multidisplinary (sp?) 3 month program and they approved it on the first try. Good Luck! Denise

I have Aetna and it took 4 months to get approved. Just make sure you keep on them, and get the name of someone within, don't just speak with the customer service reps. I had proof that my physician told me to go to Weigh****chers and then another document stating that my 1 month follow up I had lost 13 lbs using Weigh****chers online. I then provided my 6 months of receipts and weigh ins via Weigh****chers Online. I also provided my cancellation receipt which was 6 months on the dot. When I did Weigh****chers, WLS was not even a consideration. It's important to keep or find all of your receipts. I had to submit this info 4 times before it got to the right person. I also have most of the comorbidities they list on their website at: www.aetna.com see bulletin 157. I was also denied once but the appeal process was more simple than the whole submitting for approval. Much success as you begin your process of approval.

Hi. I have Aetna and am currently in the process of giving them what they want, so i can get what i want. I have done many diets (just like everybody here). At one point in 2001-2002, I lost over 100 lbs, but couldn't keep it off. I contacted Barix and they sent all the paperwork I had dating back to 1995, including the 100 lb. loss. they denied it because it had to be within the the past 2 years (and mine was 3 years old). but they told me to complete the 3 month multi-diciplinary program. I took the letter to my PCP. he wrote me scripts for the dietician at my local hospital and to see an exercise therapist there also. I document everything i eat and go weigh in with the dietician once a week, and I go to the health center and exercise for 26 minutes three times a week (usually its only two days a week due to my schedule, and their only open M-F). I am less than 30 days away from completing Aetna's requirements. Check out my profile. Best of luck to you on your first time requesting approval. Angie

Brittany, I have aetna and I had to have 3 monthly visits with a nutritionist and my PCP. My PCP wrote a letter of medical neccesity and Tracy from Dr. C's office took it from there. The one thing I learned thru the process is that the monthly visits with the nutritionist and the PCP have to be in the same months. I had visited my PCP at the end of August and didn't see the nutritionist until the first of Sept. That didn't work. So I had to see my PCP again. So, I went Sept, Oct. and Nov. and then turned everything over to Tracy. I was approved on my first attempt. If you have any questions, just let me know. Good luck!

Hi Nancy, I am so excited for you. If you ever have questions call me anytime. Are you so excited with a million emotions? The week before you will ask yourself if you made the right decision. We all think, Did we???? We did, believe me. I went to my nieces(Betsy F) shower yesterday and I hadn't seen alot of the people since I had surgery. They were shocked and I was embarrassed because everyone was making a huge fuss about me. It was so much fun. Are we not the luckest people to have met Dr.Curry? He just made the biggest decision of our lifes ,the easiest decsion. Thanks again Dr.C and have a wonderful Christmas with your wife and all the BOYS. Love, Cindy

Hi Cindy, Thanks for your kind words. I'm sure I'll end up calling you as the date gets closer! I am so excited but do have mixed emotions from time to time, but the excitement is winning over the fear! How exciting that you went to Betsy's shower and everyone was making a fuss. I can't wait for that day. I do feel very blessed to have met Dr. Curry and people like you! Take care and have a wonderful holiday!