Aetna has denied me AGAIN!!!!!

I am so upset right now. First they said I didn't have a high enough BMI (38.7) even though I had high blood pressure. My surgeon talked with them until he was blue in the face today explaining that my BMI is 40 and that I have a co morbidity. This time AETNA said that I have not had my comorbidity long enough (less than 5 years) for them to approve it and I haven't had a BMI of 40 for 5 years either. It sounds like this guy at AETNA is making up the rules as he goes to me. Lola at Dr. W's office says she has never had this much trouble with AETNA. The AETNA doc told my surgeon that I have to appeal to AETNA again. This time I will get a different director that will review my case. I am in tears as I type this. I just feel so hopeless right now. I have never felt like this before in my life. I know my surgeon is going to fight for me, but I never dreamed I would have this much trouble. Is some one trying to tell me that I shouldn't have the surgery - that it isn't right for me? I am questioning everything right now. I am sorry to be such a whiner, but I just don't understand why this guy at AETNA is being like this. Thanks for listening, Robin

You will not give up . Robin listen to me please . So many go through this and the insurance company wants you to give up . I want you look inside yourself and really ask and see how important this is . I know you want this ... For me I would have dug ditches , clawed my way through rubble to get this surgery . And I know you will too . I tell you this as I know .. I would like for you to do this . Call Aetna Back .. ask for a supervisor . Get them on the phone and see if they can explain it better than butt head . Even if you hear those words again ... you get right back up and get your doctor involved in your appeal . Have him write down everything . If you have to appeal it 10 times it is so worth it . We will help you here and encourage you . But you have to want this .. and I know you do sweety . Do not let them steal this from you .. you and your health is worth it ... I am here for you .. Love you... and praying for you ! Nat

Oh Natalie, Thank you so much! I am not giving up. I have never given up on anything in my life - no sense in starting now ! And I am with you - I will do whatever it takes to get this surgery - not just because I want it - but because I truly believe I need it in order to live my life! I am going to call Aetna as soon as I finish typing up this note. Fortunately my doctor is very involved in my fight and is being a huge advocate for me. I do feel good about that! Thank you for your prayers and support! And please know that you have my prayers and support as you go through your surgery. I can't wait for them to get that nasty tumor out of you so that you can get back to your life. Hang in there! Love and Hugs, Robin

Nat is exactly right. I'm so sorry to read this, Robin. I really wanted this to work out easier for you, but sometimes it isn't that easy. If you really want this, you can make it happen. I've seen it before and I know I'll see it again. I would call and talk to a supervisor and get the exact reasons and then take all those reasons and discredit or prove them wrong. You deserve this. Just hang in there, never fear about complaining to us, that is what we are here for. We're all praying for you!!!! Amber

Hi Amber, Thanks so much for your support and prayers. I feel confident that if I persevere, I will reap the rewards of having done so. Thanks Again! Hugs, Robin PS- Sorry I'm gonna miss you guys again tonight. My 7 year old daughter has her school play tonight. So I'm crossing my fingers that the next time ya'll get together, I'll be able to join you!

Hey girly!!!!!!!! I fought for a YEAR to get approval. They flat out said NO WAY, NO HOW, NOT EVER!!!!!!!!!!! I said.....................UMMMMMMMMMMM, yeah right!!!!!!!! So I did their 6 month diet study, not even knowing if it would help. Then they denied me again!!! So I sent back the very same info AGAIN!!!!!!! Guess what...........they said YES!!!!!!! Totally amazed everybody at the drs office.............they'd NEVER had anybody get approved from my insurance b4!!! SO, there is HOPE!!!!!!!!! Just keep on fighting, never give up!!! They will get tired WAY b4 you will, I promise!!!! Keep your head up, and keep positive............YOU WILL WIN!!!!!!!!!!! XOXOXOXOOXOXOOX Sharon

And look at you now!!! lookin' so great with your family in your photos in your profile. I'm gonna jump through each and every hoop they put out there until I get what I want. Thanks for your words of encouragement! I know I can do this. Maybe they just do this to see if we've got what it takes to make it after surgery. Hugs, Robin

Robin, Never give up, never surrender! I had to fight too! You're more than welcome to read over my profile. I have a couple of letters in it....if I can be of any help let me know! Best wishes! Kirsten

Hey Kirsten, I read your profile just the other day, and man, you did have a fight. Thanks for permission to use your great letters if I need to. Right now my surgeon's office is handling everything, but I will ask them if they think an appeal from me would help. Knowing that I have the support of all of your guys means so much! Thank you! Hugs, Robin

Robin like Nat said do not give up like I did. I have Aneta and they turned me down 3 times and I said oh well I will try on my own. Well that has not worked out so good. Keep after them and they will see the light soon. Just hang in there and we will stand behind you all the way.