Question:
Several questions re: Aetna (LONG be patient with me please)

I will have Aetna in January (if my current appeal doesn't come thru before then). They will cover surgery with NO problems, but they state you must have BMI of 40 or 35 with severe co-morbs. Not sure what severe co-morbs are? My BMI is 40.2 and I have asthma, PCOS, high cholesterol, high triglycerides, migraines, chronic back and knee pain, infertility and a VERY strong family hx of diabetes, cancer, hypertension and heart disease. I have a diet hx for the past 15+ yrs. I have been overweight since I was 10 yrs old. How soon can I apply for the surgery after I am covered? What diet history do they want? Only medical supervised was Phen-Fen (my endocrinologist) and other RX weight loss meds. I have been to WW, TOPS, Nutri System, Atkins, Figure World, Mayo Clinic diet, Richard Simmons and like all of you everything else out there. Also if I can find a WLS PCP and/or surgeon I can get the surgery for $10!! Any help on WLS friendly PCP in the Dallas area?    — Laura S. (posted on December 5, 2000)

December 6, 2000
Hello, I have aetna, you should be fine just make sure you have a medical supervised diet and yes phen phen fits, also co-morbs are like sleep apnea, high blood and those kind of things it sounds as though you have everthing covered! they gave me approval right over the phone! good luck kim
   — kimberly G.

December 6, 2000
You have your bases covered girl!! Having your information in order and ready to get to an insurance company will speed up your process. I don't think you have to wait to begin the approval process. Even though your BMI is kind of low, you have a lot of co-morbs so you shouldn't have a problem. Just make sure you have documentation diagnosing your problems. Good luck!
   — christine L.

December 6, 2000
For once I think your failing health and scary history are in favor for you. If you go to Aetna, you will have no problems. I have Aetna HMO, I had a BMI of 47 no co-morbs and only one supervised diet. I don't even think they asked for my diet history. I was the healthiest fat person on earth. Got my approval in three days. You should be fine. Good Luck.
   — Alison B.

December 6, 2000
I think you can submit for approval anytime after you receive your insurance. I have Aetna HMO and was only on with them for a few months when I applied and was approved. Even if they deny you and say you have to be covered w/ them for at least 6 months then you really haven't lost anything...just don't give up. Your list of co-morbids should also help in the process, I didn't have any co-morbids but my family history was horrendous. PS: I got a call from the hospital today stating Aetna was paying 100% of the costs for surgery, my part is the hospital co-pay. Woohooooo. Good luck !
   — Stephanie D.

December 10, 2000
Hi Laura, I have Aetna and was given a verbal approval in 1 day and a written notification in 3. I have a BMI of 41 and just recently diagnosed with Type II Diabetes. As far as a diet history, I didn't have any documentation, medically that is, just my list. I think Aetna is very good in approving WLS. Good luck to you! Kim
   — Kim F.