Question:
Getting Approved with Aetna even though not met 5 year criteria.

Has anyone ever gotton approved with Aetna even though they did not meet the five year criteria? I have all co-morbities and all weight loss journals. The only thing I do not have is the 5-years. I am two months short. What can I do?    — Tammy P. (posted on March 14, 2004)

March 14, 2004
I do not have an answer for you, but instead a question. I am new to all of this and I am just researching all the info I can. I have my first informational appt for May 10, 04. That is the soonest I can get in. Many talk of the "5 year" thing. Since I don't know what you are talking about and I also have Aetna insurance, could you please clue me in?? I hope I don't run into the same situation that you are in, but if I have the proper info before hand I can avoid some of these problems. Please email me direct if you will. Thanks so much, Tanna, [email protected]
   — crjt

March 14, 2004
Hi Tammy, I also have Aetna and for the 5 year thing they accepted my clinic(s) documenting what my weight was for any kind of visit for the last 5 years. I had to go through 3 different clinics since my insurance had changed, but I sent the clinics a letter and asked them to note what my weight was near the start of each year, going back the 5 years. Aetna accepted that. If you are two months short I am not exactly what you mean, so feel free to email me privately if you want. I had a long, long battle with Aetna and would be happy to share my war stories. After almost 2 years, I got approved and had my surgery 4 weeks ago. Pat F. [email protected]
   — Patricia F.

March 14, 2004
Tanna -- Te 5-year thing being discussed is that some insurance companies require proof that you've been obese for 5-years previous to the request for surgery.
   — Shayna T.