Aetna and Denial

I need the help and advice of you all here in Washington. I am trying to get approved through Aetna to have a revision done. I have gained back over 1/2 my weight back and now even with a BMI of 38.9 they are saying its not medically necessary, even though all my co morbidites are back and I seem to be gaining by the hour.
If anyone has any experience or just advice for me about Aetna or insurance appeals in general please let me know.
Tired of being fat and tired and not getting the help I so despretly need.
Thanks
Michaelle H.
Puyallup

I feel for you.  All insurances are really tough on ppl who gain weight back.  For it to be medically necessary you would have to something pouch related that made you ill I think. 

You can call the Governer's Office and ask to speak with someone regarding a denial on your medical insurance.  Christine Gregiore started her political career as Big Insurance Kahuna (sorry I don't remember the department.)  Anyway, she was fairly famous for taking on the major insurance companies about denial of care.  They can advise you of where to go to get some advocacy help.

On a more personal note, if you were to begin a six month program of weekly nutritionist, exercise (physical therapy for example) and counseling, (which Aetna would pay for I believe, at least for ten sessions?) you would be on the track of getting accepted again as demonstrated by your actions.

I am sorry to say this so bluntly, but insurance companies will use your weight gain and the return of your comorbidities to argue how WLS for you was proven unsuccessful and therefore not a medical necessity despite any comorbidity or their severity.

You will be in my thoughts.  Be kind to yourself.