Excited and trying to be patient!

Hello all,

I was on a week or 2 ago venting because nothing had been sent in to my insurance. So, today, I called Aetna to just see if maybe.....and it was submitted on June 11th!! I am so excited and trying so hard not to get my hopes up in the event Aetna doesn't approve me. It's still pending and I was sure hoping I would be one of the lucky people who only took a day to get an approval.

I guess I'm worried now because I don't have any comorbidities other than a BMI over 40 and sleep apnea. I am just so nervous and excited and just can't wait to have an answer! I'm so, so close now. Please keep your fingers crossed I am approved. I want to be able to share in the excitement of seeing myself shrink and be able to completely understand you all go through with the excitement and the frustrations of this whole weight loss endeavor.

I hope to be able to post an approval post soon! As always, I'm hoping you are all happy and healthy.

Hugs,

Aethnea is the hardest insurance to get approval with. My friend had to a six month supervised diet even before they would consider approving her. I have heard how others have waited over an year for approval. Please expect delays and dont get upset if they have you do a supervised diet  or if you get denied..APPEAL.
GOOD luck to ya

Hi Pat!

The funny thing about Aetna-- because I have heard good and bad on them. My doctor says he sees about 99% approval rate on them and the bariatric coordinator said in her experience they seem to be one of the "better" ones. I guess we will wait and see. My last visit with Dr. G, he told me on one of the patient's, there was a 1-day turn-around decision in the patient's favor. Unfortunately, though, anything dealing with me either takes forever or doesn't work out. I was aware of the 6-month supervised thing, but there is also a 3-month supervised requirement if done with a multidisciplinary team, so I opted for that one.

I have heard stories from people, who, because their BMI was over 40, they were approved without other comorbidities. So, I don't know. I hope I am one of the fortunate ones they approve. But, like I said, anything dealing with me is bound to take some kind of weird turn--good or bad. lol

At least the waiting for submission is over. I told my hubby that if I am not approved, I will definitely appeal. I haven't gone through the testing and all the money I have put into it just to sit down and give up.

Thank you for giving me the heads up!

Paulette

Paulette,
I just hate for people to get their hopes up thinking that all is going to be well. Especially when it comes to stuff like your surgery. Unless Dr. G has some kind of trick that others dont have they are slow to approve wls. But fast at other things for example the same woman that had to fight for wls submiited preapproval after she reached goal to have her tailbone repaired...lol she lost weight lost her padding and found sitting to hurt like crazy. Her claim was submitted on Monday and approval came back the next day.
Like you said dont give up fight cause somethimes thats what it takes.
For me I was instantly approved..but Dr. Keith said I was hard headed and needed to lose 40 pounds...did that and then found out he wanted to make sure that I could stick to the program.
So I wil suggest this to ya..while you wait start working on giving up the bad stuff...pop, caffine sugar, bread  etc...beleive me it helped me greatly...Now I only ant french fries and I have maybe 4 to 5 and thats it before I could eat all I could get..what a difference RNY makes.

Hi Pat,

Thank you so much for your post! I love getting everyone's input and ideas! Since being on the 3-month supervised diet, which I started back in February and finished in May, I have been watching my diet like a hawk. I have managed to lose 25 pounds. As for pop and caffeine luckily I did stop that as well when I started the 3-month diet. Good thing I did, as Dr. G found an ulcer when he did my EGD on the 3rd. He said, no caffeine and no alcohol. I've never had a problem with alcohol anyway.

Being on a low carb diet has definitely helped in the "cravings" department, as well as being able to lose fairly quickly. Although, the first 2 months of my diet I did with the dietician recommended, which was eat basically what I wanted but making sure it about portion control. Then I noticed after about a month, I wasn't really losing very quickly and almost stalled, so that's when I decided to do the South Beach way and I lost 10 pounds the first week. I figured with having the band, weight loss is slower anyway, so why slow it down more by eating too many carbs.

Since about January, I have also started journaling everything in regards to my feelings, when I get the urge to overindulge, etc. and trying to work through those issues. I have found, though, I am more prone to overeat if it is something that I truly LOVE the taste...such as, sweets. So, I cut those out.

At this point, all I can do is just wait and see how long until I get an answer. I have been on pins and needles waiting for the doc to send my info. So, now I just have to wait some more. I do hope and pray they approve me, but if they don't. I will appeal. If I lose the appeal, then I will just have to figure out some other way to get it. Nothing is beyond my reach. I'm stubborn and hard-headed when it comes to something I truly want, especially when it benefits more than just me. My family and I have so much to gain from the experience. Anyway, I went off on a tangent I guess LOL Sorry for the long post.

And again, Pat, thank you so much for your insight and suggestions I truly do appreciate them.

hihi,

i have aetna and no big problems, except it felt like forever to hear the "YOUR APPROVED!!"

i had sleep apnea, a bmi over 45 and high blood pressure. now basically all those are gone w./ surgery.

good luck! and btw im sure if you feel you dont have enough comorbiditnes but your dr feels like youd still benefit from wls he may fanagale something for ya! (but maybe thats the jersey girl in me talking here! haha)

xoxo
am

Saying prayers you don't have to wiat long for approval.
Emily

Thank goodness, I got my approval today So less than a week after being sent!