I have been lurking here all lat week, so I wanted to share with you guys, too! Thanks for all of your transparency!

Here is short synopsis of my WLS journey:

July 2000 RNY with Steven Olchowski in NC

2005 Olchowski lost his license in NC for performing variations on the RNY, even mini gastric bypasses

2006 I start having internal bleeding issues---26mths, 3 colonoscopies, 3 endoscopies, 1 camera endoscopy, and a CT scan later---it was found that I had 2 hernias and one had ripped a tear in my intestine (surgery 2008)

April 2014 my sister shared that she is seeking wls, I started scouring OH website for info for her and I learned revisions were possible

June 2014, saw my PCP and she was agreeable to helping in any way she could

August 2014 I picked up CIGNA  as my primary insurance thru work

(as Tricare was our family insurance and has a once a lifetime policy for wls)

Oct 2014 Met with Dr. Folahan  in TX (8 hours from my home)

November 24th packet sent in for pre authorization to CIGNA

December 4th denied by CIGNA because of no proof of compliance with post op (argued that all of that was lost when he lost his practice in NC) and because my BMI is 46 and not 50 or greater

Jan 5th sent my packet of information to my surgeon to begin the appeal process

Jan 16th peer to peer done; APPROVED!!!!!

There is no expiration date on my approval letter, according to surgeon’s office, and they did not submit a date with it. I am praying for June 10th, summer break, so that I can have time to heal and take care of myself, learn my new body and new insides before going back as a high school teacher.

Office mgr is going to set it up for that, and hope that it all goes through well!

YAYAYAYAYAYAAYAYAYAYAAAAAAAA!

Thanks for all of your suggestions and support!

Shelia

I have AETNA as well and for the gastric bypass I have to do a 3 month weight loss program. And I still have a $1500 out of pocket fee 

hello all, this is my first post. i just paid my first premium for a NJ plan i bought off the exchange. I do have coverage through my employer but bariatric surgery is excluded.  has anybody else bought a plan off the exchange and had surgery? i'm just waiting for my coverage to go into effect 2/1/15 to schedule my consult with a surgeon.

Is there anyway you can help me with the appeal letter also. I never thought I would have so much trouble with Aetna. Thanks!

I have the same ins company and when I called them they told me it's not covered under my plan now I don't know what to do