co-morbidities - pending insurance approval

Hope all is well!

I am currently awaiting to get an answer from my insurance company (Aetna) regarding weight loss surgery for the gastric bypass. So I decided to contact my surgeons office yesterday to see if they had heard back or to see if they could give me any new updates. They explained to me that it is still pending and would contact me as soon as they knew. So I asked about my file and what they thought about getting approved and they respnded that they were concerned that maybe I didnt have enough co-morbid conditions i.e. sleep apnea, hypertension etc...however I do have herniated discs in my lower back due to the weight as well as insulin resistance. And this has been documented that due to the weight this condition would worsen. And of course I meet the BMI requirment by far. I also had the history of weight and weight loss attempts as well as the nutrionist and PCP appointments required. Heck, I even passed the Psych eval. with flying colors lol... So I guess what I am asking is to see if anyone has ran into this problem or has heard of not enough co-morbid conditions to get the approval needed from insurance to cover??? Needless to say I am a little bummed and feel like my only shot to a healthy / happier me will be shot down....

Thanks for any thoughts,
~ Waiting Patiently ~ 

Well, I was only denied because of they type of surgery I requested. Pacificare basically told me if I would have asked for RNY or Lap Band or any other covered surgery they would approve it. So now I am requesting RNY. My co morbid conditions are super morbidly obese, Hypertension, and a family history of all the other stuff and my doctor said I would be a great candidate for surgery as well as all the other life threatening stuff that comes with being overweight. Oh I was trying to get VSG but I am good with RNY. I kind of wished that I would have gone with RNY in the beginning like I started to because I would have had the surgery by now.

Most valuable lesson I learned.... be your own advocate.

Call the insurance company yourself and ask what the status is on your case. This way, if they're missing documentation or anything, you can make sure it gets in... etc.

I was denied the first time because the insurance was "missing" some information (funny, they had all the other info I faxed in at the same time, in the same packet).

Keep pushing. Don't rely on the surgeon to do it all for you.

Good luck!