Beckysue

The letter from Aetna says I was denied because I don't have 2 yr history of 35 BMI and one of the listed medical issues. I just don't Understand we sent them records from 2010 of weight of 220 2011 and 2012 and between then and now the lowest I've been is 202. Currently 214 and 5'3". So BMI has not been under 35. Also sent them two years of bloodwork records showing pre diabetic glucose levels, high cholesterol. Now we need a peer to peer review and surgeon wants PCP to do it and PCP wants surgeon to do it. The nurse at the surgeons office doesnt understand why i was denied. She said the surgeon almost never does peer to peer review. PCP doesnt want to do it because he has never had a patient with lapband and has never donethis before. I just don't know it's driving me crazy!

Jenndkopp good luck to you too. I'm hoping the peer to peer will work but don't know at this point. I went to the seminar in March of 2012 and have been work ( jumping threw hoops) for almost 9 months. It's just so upsetting. Keep me posted on your progress.

We are waiting for the official letter from Aetna. Dr. Trahan's office called that's how we know I was denied. Nurse Lillian said as soon as we get the letter we will appeal with a peer to peer review. I'm trying not to loose hope.

Thanks mzyunique1 I am going to appeal its just so frustrating. But I'm not giving up.

Hi Bonnie Just wanted to drop you a note. The insurance denied me doctor's office heard from Aetna. I can't understand why I am 5'3" 215 pounds, pre diabetic, elevated blood pressure and high cholesterol . I did the six months and only lost a few pounds ( but didn't gain) and was denied. We are waiting for the letter to find out why so we can appeal it. I am heart broken and have been so upset since I heard. Dr. Trahans nurse told me not to give up hope so I'm trying not to. Hope things are going well on your journey. I'll let you know if we get the appeal. Becky

Well the doctor's office heard from Aetna. I can't believe it but I was denied I am 5'3" 215 pounds, pre diabetic, elevated blood pressure and high cholesterol . I did the six ;month supervised and only lost a few pounds ( but didn't gain) and was denied. We are waiting for the letter to find out why so we can appeal it. I am heart broken and have been so upset since I heard.

Well the doctor's office heard from Aetna. I can't believe it but I was denied I am 5'3" 215 pounds, pre diabetic, elevated blood pressure and high cholesterol . I did the six month supervised and only lost a few pounds ( but didn't gain) and was denied. We are waiting for the letter to find out why so we can appeal it. I am heart broken and have been so upset since I heard.

A friend who lost 100 pounds wears her wedding rings on her middle finger. I asked her why not resize? She said it reminds her of her accomplishments every morning when she puts her rings on.

Still waiting to hear from Aetna. Monday November 19th will be 14 business days since they got all my paper work so I expect to hear something then. IT'S STILL DRIVING ME CRAZY

Still waiting to hear from Aetna they have had all my paperwork since Oct. 31st. It's driving me CRAZY ! Everytime I call they tell me it's still in review.

I have not heard from Aetna yet I'm going to call in a little while to check the status.

I called Aetna today ( paper sent to them on the 31st) its still in review. They said a nurse still has to look at it. They told me they have 14 days. So I guess I'll know by Tuesday.

Thanks I'll call back Friday. I would be so upset if I got approved and had to wait till February.

I have Aetna and I have just finished the six month supervised weight loss. I am 5'3" and weigh 210 pounds I have pre diabetes, high cholesterol and slightly high blood pressure. I am waiting for Aetnas yeah or neah. Papers were submitted November 1st and insurance said it can take 7-14 days for answer.

Congrats I am still waiting my paper work is at the insurance company.

Still waiting. The paper work was actually sent to Aetna on the 1st of November. I called today and was told it is in review and it usually takes a week to 14 days. I was fine all through the six month supervised diet and now I'm so stressing. I hope I hear soon!

Thoughts and prayers for your sister. So sorry she is going through this. (((hugs))) for you.

I just finished my six months and I had to track everything I ate and keep under 1400 calories a day. I printed it and took it to my dr. At each months visit. My surgeons office recommended I keep track of it on my fitness pal. I also needed to note on it that I exercised at least 3 days a week. Good luck my six months flew by now I'm waiting to hear from insurance. Just submitted last week. Fingers crossed

I just finished my six months (i only lost a couple of pounds) and my surgeons office submitted my paper work to Aetna Friday (11-2-12) so I am waiting to see if I'm approved. I am 5' 3" 210 pounds and am pre diabetic, my blood pressure is slightly high, and my cholesterol is high so I don't think there will be a problem but I am so stressed about it. Wish me luck

Hello it's been a while I finished my six months and all the required tests. All has been turned over to Dr. Trahans office. And Lillian(the nurse at Trahans. Office) has contacted the insurance and I'm just waiting to hear if I am approved.. I hope things are going well for you I'm sure your anxious for your year to be over. I know six months almost drove me crazy.

Sending positive thoughts your way. I am finally at the end of my six month supervised time for Aetna. My thyroid was one point to high and I've had to take thyroid meds for the last month before we can submit because dr.'s office said insurance will turn it down unless thyroid is in normal levels. Getting checked in the morning hope levels are good

I started my six month diet (for Aetna insurance) May 16th so I am right there with you. It is frustrating and makes me wonder if they think we will change our minds in the six months?? I have also met others on here that have a year wait- it makes me glad I only have six months. Good luck to you and hopefully the time will fly by

I had my appt. with PCP on Friday Dr. Trahan's office sent him a letter with all the required test he needed to do on me, and detailed information on what he needs to include in his notes for the insurance to cover the surgery. I. Go Tuesday for a blood test testing everything He also needs to do a EKG and I needed to have a mammogram. I have appt. with Rita Smith the nutritionist for the first viisit and Christy for metal health evaluation on June 14th. Also Dr. Trahan's nurse said I need to keep detailed records of what I eat on myfitnesspal.com and try not to go over 1400 calories a day and exercise at least 30 min. 3 to 5 times a week. I have to print that off from myfitnesspal every time I go to PCP and give it to him to put in his records. Do you have specific requirements you have to do in this year you had to wait for surgery?

Dr. Trahan sent my primary dr. a letter requesting blood work, EKG and over all health check. I would be so frustrated if I had to wait a year. I have already done almost a year of weight watchers and that won't count as my supervised weight loss

I am working now to make mental health appt. with Christy Riebeling and am waiting for a call back from the nutritionist. I go Friday to primary dr. For my first visit for six month supervised weight loss and to start doing required blood work, EKG and whatever else they ask for it's like a second job