kaclimer

I went to Dr. Hamn's seminar last week and saw him today for my consult. They gave me a sheet that told me what my insurance (Aetna HMO) required. It had all the usual (BMI of 35-40 or more, 6 month supervised diet, nutritional eval, psyc eval) but the part that is confusing is they said I needed to show the 'presence of severe obesity that has persisted for at least 5 years.' And that they need a copy of at least one office visit for each of the last 5 years that has my weight on it. Not a letter from the doctor saying I have been over weight, they need to see the actual medical records. My problem--I have seen the doctor every year EXCEPT 2005! I saw them in 2001, 2002, 2003, 2004, 2006, and 2007. My question--The official criteria on Aetna's website does not say I have to do that. It says 'Presence of severe obesity that has persisted for at least 5 years defined as any of the follow': BMI exceeding 40, or BMI greater than 35 with co-morbidities. I am wondering if I am going to be out of luck since I might not have consecutive years, or is that a rule the doctor requires to gather the information? For goodness sakes, I was obese in 2001, 2002, 2003, 2004 and 2006, one would reason that I would have been obese in 2005. :biggrin1: Anyway...I was wondering if anyone else had to provide that kind of information. Especially with Aetna.

Hi! My name is Kim and I live in The Colony. I am very interested in getting the lap band and was excited to see my new insurance was going to cover it! I am going to the seminar with Dr. Hamm on Friday morning. This site looks like it is going to be a very good source of support.