Quick response from Aetna, but not good!

Robin C.
on 10/26/06 2:21 am - Norfolk, VA
Keeping my fingers crossed! I am pretty upset right now! Lola called from Dr. W's office. She is wonderful! I knew immediately though from the way she asked me if I had a minute to talk that there was no good news. AETNA DENIED, yep - DENIED me! They said that my BMI was 38.9 (over the rquired 35 with a comorbidity) but since my BP is controlled by my meds, they were denying me. Lola said, basically they are telling me to gain weight, then I can have the surgery, which makes no sense. I pointed out to Lola that my body scan calculated my height to be 5'4.5" rather than 5'6" that I was claiming before. So that in combination with a weight of 242 gives me a BMI of 41.1 - over the required 40. She agreed that the body scan would definitely be the most accurate measure of my height and said she would make sure that Dr. Wohlgemuth was armed with this info on Tuesday when he makes a face-to-face appeal to the insurance doc. He doesn't understand why I would be denied in the first place because the national standard is BMI >35 with High BP. Hopefully they'll get it straightened out on Tuesday, I'll get my approval, and have surgery very soon. I'm definitely saying some prayers tonight! Please say some for me too! Thanks, Robin
(deactivated member)
on 10/26/06 2:51 am - Virginia Beach, VA
I am sorry to hear that you were denied. Good things come to those who wait. I am proof of that. I have been trying for 2 years to get this done. I haven't been approved but my new insurance only requires that I get a referral from the Dr. Enough about me. I hope that all goes well with the appeal. Best of luck to you. Corinn
Robin C.
on 10/26/06 3:04 am - Norfolk, VA
Thanks, Corinn. I am being patient, I've got my chin up, and I'm not cryin' yet. I feel confident that my surgeon will get this taken care of soon. If not, I guess I'll just go on a food frenzy, gain the few pounds that I need to, and then get approved. I hope all goes well for you with your new insurance! Robin
Chyanne2u
on 10/26/06 6:32 am - Kings Mountain, NC
Hey Robin, I know first hand exactly how you're feeling. It's very frustrating and I've been there too. Over and over I was denied but I wouldn't give up. Just hang in there and it will happen for you. If there is anything I can do, don't hesistate to call. I too will say an extra prayer for you tonight. Not only that your approve will come but that God will give you grace until then. Lots of Love Kathy
Robin C.
on 10/26/06 7:55 am - Norfolk, VA
Thanks so much for your support, Kathy. I'm so glad you didn't give up 'cause look at you now. You are doing so well. Thank you too for your prayers. I am not going to give up - I have faith in my surgeon fighting the good fight for me, and if that doesn't work, then I'll appeal until I get it. It means so much to know that I have the support of all of my OH family. Thanks Again, Robin
Betsy Anitahug
on 10/26/06 7:21 am - Danville, VA
Robin, Please do not give up...alot on here were turned down and now look at them...some have to just fight longer but it will all work out....you are in my thoughts and prayers..' Hugs, betsy
Robin C.
on 10/26/06 7:56 am - Norfolk, VA
Thank you very much for your support and kind words, Betsy. This is just one little obstacle in my path. I know that I will get there, but it helps to know that you guys are out there cheering me on! Thanks so much! Robin
Sporty Jill
on 10/26/06 11:04 am - Norfolk, VA
Robin- Keeping my fingers (and toes) crossed for you. I'm sure that everything will work out for you. Good luck! Jill 263/147 (and still holding onto those last stupid pounds)/145 (my goal) 135 (docs goal)
Robin C.
on 10/26/06 9:27 pm - Norfolk, VA
Thank you so much , Jill. I need all the fingers and toes crossed that I can get right now! Have a terrific weekend! Hugs, Robin
Ernurse323
on 10/26/06 10:17 pm - Virginia Beach, VA
I had to gain weight to have the surgery. Put some sand wrist weights in your panties or load your bra up with weights !!...LOL A girl has gotta do what a girl has gotta do !! Hugs...I am sorry..but a few boxes of Twinkies can solve the problem. It did for me. I was right under. Dana
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