Question:
Hello! I was wondering if anyone has had recent experience with Aetna QPOS?

I am being told different things now than when I made my surgical appointment. Before - according to Aetna Clinical Policy Bulletin I could go to a Dietician and follow that plan for 3 months - then I would be approved. When I called DR office today to check on status of reports needed, I was told that I have to go for 6 months total???? OR I could go to their doctors, Internist, Psych & Dietician for 3 months - and self pay. Doesnt make sense. Anyone have ANY input? Thank you!    — cathy1966anne (posted on May 11, 2005)

May 11, 2005
Cathy Ann: I got approved (after 1 denial) by Aetna last year. I was told (by Aetna) that I could reapply for approval at 3 months (of 6 months diet/exercise program), but I could not have the surgery till the FULL 6 months was complete. I reapplied at the 4 month mark and got approved then waited a few months to have surgery. Good luck.
   — leslee4567

May 12, 2005
Aetna is changing their policy on WLS, as of October 1 or your renewal date they will not cover the surgery UNLESS you pay a 1.5% premium increase. Their reasoning behind that is that WLS is now to them a "cosmetic" surgery. My advice to you is to get on the 6 month supervised diet and get all the other req's done so that your surgeons office can try to get you approved ASAP. I was approved only 12 days after all my paperwork was submitted. Oh and having a date scheduled when you apply for approval is a HUGE help! Feel free to email me if you have any other questions! [email protected]
   — dreamy6501

May 12, 2005
I went with liv-lite and did 3 months,sent papers in and was approved the next day. I think you need the psych & dietician it realy helps. It cost me 100$ a month for 3 months and they did all the paper work and delt with the insurance co.
   — mark A.