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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