DENIED!!! Aetna Insurance

I just found out that my insurance company has denied coverage for wls. Has anyone had any experience with Aetna insurance? Do they approve anyone?

I don't have Aetna but was wondering what they used as a reason for denial? If there is an exclusion in the policy against WLS then there is not much you can do, but if it was for needing a psych eval. or nutrition eval. or past diet info. then you can appeal that and send in the other needed info. Let us know why you were denied. Greg

The criterion that I didn't meet was physician-supervised nutrition and exercise progam ie: (dietician consult, low calorie diet, increased physical activity, and behavioral modification) I have followed a low calorie diet and increased physical activity but I have not been to a dietician or behavior modification. So now I have to start the process over again. I can follow what Aetna calls a Multidisciplinary surgical preparatory regimen for 3 months and then they should approve it.

I just found out today that I have been denied for the same reason! They (BCBS) want me to have records of a physician assisted weight loss program within the past two years. I don't have this. It really sucks. I tried to get approval for the surgery a couple of years ago and was denied because I couldn't document my obesity through medical records for the past five years (not a big fan of doctor visits!). At that time they did not mention the assisted program. Insurance is so frustrating. I think they figure that it is more likely that I will change to another insurance company before my comorbid problems get really bad and they won't have to pay for my care either way. Ok, rambling now. Good luck with the 3 month regimen! Make sure you get that in writing because at the end of those three months there is likely to be some new hurdle to jump that they haven't informed you about. Sorry to be so negative but I am really bummed about my denial. I hate insurance companies!