Question:
Has anyone been denied by Aetna US Healthcare Managed Choice

I was denied for surgery by Aetna US Healthcare Managed Choice because I did not send them any medical records for doctor supervised diets. I have been on two supervised diets and will send them the information they requested. I was wondering if this has happened to anyone else and they were approved after submitting the medical records for the supervised diets.    — blank first name B. (posted on July 23, 2001)

July 23, 2001
I did have to submit history on medically supervised diets. But I think Aetna is one of the companies that approves this surgery pretty easily. They just want proof of medical necessity. I gave them my diet history, weight history, what medically supervised diets I had been on. Then I had to get a psych exam and then i was approved within in a week. Just get all your ducks in a row and you should be fine. Good luck!
   — [Deactivated Member]

July 25, 2001
It's too bad your surgeon didn't take the responsibilty to make sure his office squared away your paperwork BEFORE it was submitted. I was approved in 3 days by the same insurance. Good luck in getting the decision reversed.
   — Julie M.

July 25, 2001
Janet, I read your question with interest when it posted because, like you, I'm insured by Aetna. I didn't have any "documented" history of weight loss efforts except for a lifetime membership to Jenny Craig (major waste of money), but I did supply the names and phone numbers of all of my previous health professionals, going back to 1984. I can only assume that they did a little checking and found that the charts even in 1984 indicated a weight of 225 lbs then, and a steady increase each year. By the way, I got verbal approval yesterday, with a letter to follow after Aetna coordinates surgery date with my doc. I'll bet that when you submit the information to Aetna, they'll approve in no time flat.
   — linmazz

July 12, 2002
I received word from my surgeon's office that the letter that I faxed to Aetna detailing all the diets that I've been on, supervised and otherwise, was not good enough and that I was going to be denied. I have a BMI of 56, along with co-morbidities of diabetes and hypertension and a family history of heart disease and colon cancer. This is pretty disgusting. I've been trying to get my primary physician to call me back so I can request them to send something to the insurance and that is frustrating also. But, I'm going to keep up. I hope it is going to pay off before I die first, which is how I feel right now.
   — Brenda O.

July 12, 2002
Hi Janet, I also have Aetna Managed Choice. I only had 2 "documented" weight loss attempts. The first was Jenny Craig. I was only there for 1 month. The second time, my OB/GYN prescribed me diet pills after my 3rd child was born. Again, only for 1 month. Thats it!! My starting BMI was only 36. Sleep apnea was my only comorbid. I was approved in less than 24 hours with Aetna. I am now working on a tummy tuck. Aetna is GREAT!! They are known for their speedy and fairly easy approvals. Good luck!!
   — skymaxjr

October 17, 2002
I am having the same problem. For years I've avoided the doctor, but now, they want medically supervised diet attempts. I did them all on my own. My BMI is 56, my comorbids are arthritis, sleep apnea, high blood pressure, depression and more. I worked for another company and had bcbs and did all of the requirements for them. I lost my job due to cutbacks and my new employer is only affiliated with AEtna. The requirements are different and I'm scared to death I won't get approval. What I want to know is, if my BMI qualified me for surgery with BCBS, why won't AEtna? I'm still doing the grunt work for AEtna, and am praying to God I will be approved. Any words of encouragement or advice are greatly appreciated.
   — kathleenv515