To say I'm frustrated is an understatement! I've spent the last 7 months doing EVERYTHING that was asked of me by the medical center/Aetna and I found out today that I was denied because I haven't been morbidly obese for at least 2 years (I've been 100 lbs or more overweight for MANY years) and I have no comorbidities. I am 5'5'" 232 lbs. I have GERD, a hiatal hernia, high cholesterol and rediculous hypothyroidism since my thyroidectomy 10 years ago. My previous case manager at the bariatric surgery clinic led me to believe these would be sufficient for Aetna, hence why I went through the long, tedious process to be approved. The case manager in charge of my case now apologized but what good does that do me?!
What ticks me off is that my husband and I work hard in this life, and we pay $$$ for our insurance coverage. But when I go to actually use it I'm told I'm not qualified. WTH! Apparently being 100+ lbs overweight isn't fat enough?! They would rather wait until I'm sick from hear disease, hypertension, etc then help me get healthy NOW. It just doesn't make sense to me.
Self pay isn't an option for me. I'm waiting to hear if I can just pay for the band when I get my hernia repaired. Hopefully I'll know tomorrow. The case manager said we can appeal and that could take 30-60 days. I have a feeling that will be denied too.