I WON .. I BEAT AETNA

Hello, I just got my letter. After 3 denials, I was on my external review & they over turned Aetn'a decision. So I"M APPROVED!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! I saw the letter in my mailbox this afternoon & got a sick feling in my stomach, like I was about to see another DENIED, so it was needless to say TEARS OF JOY are running down my face!!!! I called Patrice at Overcash's office & she's not in till Tuesday, so hopefully I will find out then when I can have surgery. I never thought this would happen in a million years, I am floating on air right now :0)

Congradulations!!!!  I'm in the middle of a huge fight - where my insurance covers WLS but dealing with issues surrounding a 6 month program I already did.  Make sure you keep us posted.

Congrats that is wonderfull !  Aetna can be very difficult so glad you are now approved!  I'm on my first denial with Cigna.  They keep me jumping thru hoops .  I have done everything they need  for approval  but still  no decision.   Good luck and lot's  of healthy  wishes for you!  Glad you did not give up.  Health  should not be a corporate decision  but  a decision of caring  for people, not the bottom line. All the best, franni

What were you denied by Cigna for.  I just got denied, but have not seen the letter yet. 

Congratulations!  Can you provide details of why you were denied, how you countered, etc.  You mentioned 3 denials before external review.  How did that work exactly?  I bet I have to face the same problems with Aetna.

I was denied 3 times because my BMI went to 37 in the past 5 years. I don't have the Co Morbs. "They wanted" like diabeties, cornary heart dis. high Bp. On my 3rd denial they sent me a paper with directions for a external review, which I filled out & sent in & about 20 days later I got approved. The external review is sent to a Dr outside of Aetna. Which Gary on the ins boards says is much more lienient on things like that. I really thought I would NEVER get approved & was just abvout to give up, I'm glad I stuck with it.. Keep on Aetna.

Congrats!!!!! I have been through the same thing with Aetna, I hired Gary Visco to help me with my external review. It worked. I was approved Sep 28th and my surgery is scheduled for November 1. I know how your feel. realived, happy, and sick to your stomach all at the same time. congrats Lynnette