I received approval from Aetna! (Aetna POS II). I did the 90 day Multi-disciplinary approach. Technically I started in December, but I had a little hiccup and missed one of my appointments with my Primary Care Doctor in January. All I did was tack on an extra appointment with him in April, and all was good. When I first started I was so confused about Aetna's requirements, so I wanted to share for those that are taking the same route. Here is what I did to get approved.
December:
I met with the Surgeon and bariatric coordinator. I was intimidated about the process because of the insurance requirements. I started a journal to help keep track of my appointments and for a place to relay my thoughts as I went through everything.
I met with my Primary Care doc for appointment 1 of 3.
I met with a physical Therapist office, the week before Christmas, inside of our local YMCA to meet the exercise requirement. I wasn't sure how often I was supposed to meet with them. I scheduled an appointment twice a week. I later found out that once a month would have sufficed.
January:
I met with nutritionist for appointment 1 of 3
I met with psychologist for appointment 1 of 3
I met with Primary Care doc for a reason not related to weight loss, so it did not count as appointment #2, and I had to start over in February with my PCP visits.
I met with physical therapist twice per week.
February:
I met with nutritionist for appointment 2 of 3 (I lost10 pounds at this weigh in)
I met with psychologist for appointment 2 of 3 .
I met with Primary Care doc for appointment 1 of 3 (again...sigh)
I learned that I only needed to meet with the exercise therapist once per month, so I only had one visit this month.
March:
I met with nutritionist for appointment 3 of 3 (I lost 9 more pounds at this weigh in)
I met with psychologist for appointment 3 of 3, and took the evaluation test.
I met with Primary Care doc for appointment 2 of 3.
Since I had already had 3 months straight with the exercise therapist, I did not go anymore after my February appointment. But I did keep an exercise log and gave it to my bariatric coordinator to submit as well, just to help my case.
April:
1 visit with Primary Care doc
For some reason it took my PCP a while to get everything sent over to the bariatric coordinator so that she could submit it for approval, but it was finally submitted on 4/25, and approval was granted on 5/5.
I am 5'9 and started out in December at 290 pounds. As of today I am 259 pounds and I'm proud that I did that on my own. I feel confident and have proven to myself that I can make the lifestyle and habit changes that are required in order to make this tool successful. I was diagnosed with Type 2 Diabetes in December, which lit the fire under me to get serious about my health. I am waiting for a call back from the Bariatric coordinator so that I can get my pre-op appointment and surgery scheduled.
This has been quite a journey so far. I'm excited to watch it all unfold.