Aetna Insurance - 2 year history of BMI

Hi All,

I have Aetna insurance and am planning on attempting to get approval for VSG. My only issue is that I do not have the 2 year MEDICAL record of my BMI. After I had my son in 2009, I did not have a medical record of my weight until February of this year. I was a slacker and didn't see my PCP and I didn't get sick at all and need to see a Dr. Since February of this year, I have seen the Dr a LOT, as well as a cardiologist, etc. I was just wondering if anyone has had experience with getting around this requirement or if there is anything I can provide in lieu of a medical record. For example, in 2012, I started a weight loss blog online and I actually posted photos of the scale while I was standing on it which clearly shows my weight during the year 2012. And of course I could provide photographs, although that too seems like it may be a stretch. I plan on asking my PCP for a letter of medical necessity to explain that I have been morbidly obese for the entire time I have been her patient (over 10 yrs), but I don't know if that is enough.

I don't have any records from urgent care, WW, a gym or anything like that. My personal blog and photos are really all I have to document my weight during the year 2012 (which is the year I need to meet the 2 yr requirement). I know I can just put off having the surgery for another year but I probably won't be with the same employer in a year and my husbands insurance doesn't cover WLS so I feel like this is my only chance.

What do you guys think? Is it worth submitting this information and seeing what they say? Has anyone ever heard of a success story using other means of documentation? Am I just out of luck? Any advice??

Thanks!

I would try anything. Just send it in to see what they say. I know I had to send the last 2 years of weight as a requirement but

what do you have to loose.  I am still waiting on approval myself. Hopefully sometime this week. Good Luck!

Aetna is very picky. I tried submitting two years ago and they wouldn't approve until I had an additional 5 months doctor documented weight. I put my surgery off and I'm once again in the middle of the process. The dr's office called yesterday because Aetna was looking for my 2012 weight. I'm worried because my BMI was 39.7 as I was in the middle of a diet. I have documented weight for many years but they want 24 consecutive months. My fingers are crossed that they will approve.

I would submit and see what they say. If they say no, you can at least get them to tell you why so you will know for sure what you need going forward. Good luck! I hope it all works out for you.

I have almost the exact same story as you!  I have been obese for years but did not have recent medical documentation.  I wrote a letter explaining the lack of current medical weight documentation (basically that I had not been sick since my son was born in 2009, my husband lost his job so insurance changes  and a move had me just putting off regular preventative exams, etc)  My plan states that I need documentation of "at least 2 years of persistent obesity"  so we provided medical records from my pregnancy in 2009 showing that I was, indeed, obese back then.  I stated several times in the letter I wrote that I had "at least" two years of obesity...I had more like 15 years!  I was approved.  I'm having surgery in January.  I hope this helps your spirits.  Good luck!

Oh, and I should also add that Aetna is my insurance company.