Question:
Does AETNA approval without prior 5 yr weight history?

The doctor's office that I have selected to have my LAP-RNY surgery done with told me that the AETNA requires prior 5 yr weight history and I don't have that. What can I do? Please advise on options that might be available to me. Robert    — Roberto S. (posted on July 22, 2002)


July 22, 2002
Hi Roberto, I am in the waiting process with AETNA. I was told there was certain criteria. I have not heard the 5 year plan but, I would tell them that you have been on many different diets in the last years. I would name them and give dates. You can just tell them you don't believe in diet pills so you did not go to a conventional doctor in regards to this topic. Does your PCP have a record of your weight? If you are like my hubby, he has not been to a doctor in MANY years. Good luck on your journey. Deb
   — Deb K.

July 22, 2002
Hi. I am 22, and on my dad's insurance, AETNA PPO. I never had a medically supervised diet, only did Weight watchers, gym memberships, and tons of other things like that. I did, however, get my PCP to write a letter to the insurance company saying he supported this surgery and that it the "last resort" type thing. Hope this helps! From what i hear, AETNA approves almost everyone the first time around and is great, just make sure to write down all your diets, even the ones you have made up yourself!
   — Lezlie Y.

July 22, 2002
I have Aetna US Healthcare QPOS and I am wondering the same thing. I haven't been the 100 lbs overweight for 5 years but have had weight problems and now have co-morbidities. I am a nervous wreck! I just keep hoping it will work out. <p>Right now I am concerned because they say they have no record of my LOMN etc having been received and it was faxed on the 12th! Crossing my fingers.<p>Best wishes for all of you waiting too!
   — Helenjean P.

July 22, 2002
I have Aetna US Healthcare QPOS and I am wondering the same thing. I haven't been the 100 lbs overweight for 5 years but have had weight problems and now have co-morbidities. I am a nervous wreck! I just keep hoping it will work out. <p>Right now I am concerned because they say they have no record of my LOMN etc having been received and it was faxed on the 12th! Crossing my fingers.<p>Best wishes for all of you waiting too!
   — Helenjean P.

July 22, 2002
Aetna DOES want to see the diet history, I would give them as much information as you have.. even if it isn't 5 years! I was originally DENIED coverage from Aetna due to lack of adequate Dr. Supervised diet history. I had to do some footwork to get my paperwork together, but when I sent it in for appeal the overturned their decision and approved me. I hope this helps! Good luck!
   — sunsect

July 22, 2002
I would say dont sweat it!!! I was approved with Aetna in less than 24 hours and I DID NOT have a 5 yr diet history. The only documented weight loss attempts I had were... #1 My OB/GYN prescribed me diet pills after my 3rd baby was born. I was only on these for 1 month. #2 I was on Jenny Craig, again..only for 1 month. In fact it was sooooo long ago that Jenny Craig no longer had my records. They just gave me a note on Letter Head saying that they had my name in their computer. Thats it. No problems at all!!! Aetna was GREAT!!! Good luck. You have a great insurance!!!
   — skymaxjr

July 22, 2002
I was approved with Aetna the first time around - I really didn't have much in the "Physician Supervised" area of diets - most of the diets I tried were on my own. I typed up a very detailed history of every diet I had tried - if you would like a copy of that I would be happy to share it with you. Just send me an e-mail [email protected]
   — Kim A.

July 23, 2002
I have Aetna Us Healthcare and I wrote all my diet attempts down, made up dates because when you are dieting for 20 years who keeps track. anyway, this was sent in on Feb 25, 2002 and I got a request for my pcp to send a note that showed I was on a supervised diet from him. Which I took Phenermine for 6 months. He wrote that on a note and I was approved by Feb. 28, 2002. So don't sweat it just write down as many fad diets that you have tried lost and gained weight with and then send it in. Best of luck to you RK
   — Robin B.

July 23, 2002
Here's the link to Aetna's website. http://www.aetna.com/cpb/data/CPBA0157.html
   — Margaret G.




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