Question:
WHO HAS AETNA INSURANCE ? DID IT TAKE A LONG TIME TO GET APPROVED FOR WLS ?

   — JENNIFER W. (posted on May 7, 2007)

May 7, 2007
hi jennifer i submitted my paper work to Aetna and i called for an answer within 14 days, i was denied and i still don't know why but my doctor id appealing the denial as of 4-15-07 he is doing called peer to peer don't know what that is but it might be a term i will have to find out later.....i have Aetna pos and i live in Illinois just so you know hopes this helps
   — Pam S.

May 7, 2007
Yes, It took about 2 weeks to get approval, good luck
   — flutterby52

May 7, 2007
I had Aetna at the time of my WLS and everything went smoothly for me. After everything was submitted, I would say a decision was made within 2 weeks or less. My suggestion is to be very organized, make sure you have all your paperwork done and everything they require (labs, doc appts) done. Make sure your surgeon is willing to go to bat for you - make them fight for you and help you appeal, if necessary. My surgeon always has his patients write a "to whom it may concern" letter, so you can explain, in your own words, just how obesity affects your life and how losing the weight would improve it. Brightest blessings to you! ~Sarah in VA
   — platypus

May 7, 2007
I have been trying to get approved through Aetna since September or October of 2006...it is 5/8/07 now! I did the 3 mos. classes, etc. and they denied me since I wasn't "fat enough long enough" for them...unfortunately, I had entered the wrong weights in the computer program my surgeon uses!!! I thought they wanted the LOWEST I weighed when I filled it out since all they talked about was diet diet diet dieting throughout your life! Crikey! Had I been with someone who could have explained it to me I would not have done that at all! But the idiot submitted it...KNOWING that I did not have a BMI of 40 or more for over 5 yrs in a row. I submitted doctor's proof that I did weigh more over that time and they refused to correct my paperwork! So I am in appeal right now...showing adema so severe it is ripping my skin, sleep apnea, heart issues and more...the paperwork was sent out over 3 weeks ago and they claimed "they just got it!" I hate AETNA and believe that they should be forced to address their requirements that were set over 10 YEARS AGO!!! Where is the ins. comm. when you need them? This is plain crap!
   — LouAB

May 7, 2007
I have been trying to get approved through Aetna since September or October of 2006...it is 5/8/07 now! I did the 3 mos. classes, etc. and they denied me since I wasn't "fat enough long enough" for them...unfortunately, I had entered the wrong weights in the computer program my surgeon uses!!! I thought they wanted the LOWEST I weighed when I filled it out since all they talked about was diet diet diet dieting throughout your life! Crikey! Had I been with someone who could have explained it to me I would not have done that at all! But the idiot submitted it...KNOWING that I did not have a BMI of 40 or more for over 5 yrs in a row. I submitted doctor's proof that I did weigh more over that time and they refused to correct my paperwork! So I am in appeal right now...showing adema so severe it is ripping my skin, sleep apnea, heart issues and more...the paperwork was sent out over 3 weeks ago and they claimed "they just got it!" I hate AETNA and believe that they should be forced to address their requirements that were set over 10 YEARS AGO!!! Where is the ins. comm. when you need them? This is plain crap! Also found out that others that were better off medically and weight wise were approved!!!! So, there really are NO STANDARDS, it's the luck of the draw!
   — LouAB

May 8, 2007
Artna will approve you if you jump through all their hoops! Go to their website and look up their clinical guidelines for bariatric surgery. That will tell you what needs to happen for them to approvbe you. I had to have a doctor-documented diet for six months, although I had been dieting for years! I had to go to the doc once a month and get wieghed in. I also had to get a psych evaluation, and an exercise consult. I also had a sleep study and was diagnosed with sleep apnea, and a heart doctor consult for high blood pressure. At the time, Aetna required a high BMI as wwell as several co-morbididties, and that you try to correct them without the surgery. document everything! Good luck!
   — Novashannon

May 9, 2007
I waited from August 2006 until April 2007. I did all the appeals available and finally on the last appeal they agreed because I am severe diabetic as well. It was a long hard struggle. I researched on web a lot and did a lot of Exhibit A, Ex B etc and they must have thought I knew some legal stuff because they jumped on it once I did that.
   — DONN1

May 13, 2007
i have Aetna -- i did everything they asked of me -- i did the 6 month dr supervised diet -- i had a BMI of 40 at the time my paperwork went in -- i got my approval in 2 weeks -- i was shocked -- i heard that aetna was the hardest to work with -- but i found the process to be easy -- i never called them once -- my surgeon's office handled everything -- in fact i still haven't talked to aetna and i had surgery almost 6 months ago :) good luck to you and do what they say and you shouldn't have any problems
   — RCassety