Miss Piggy

Start my preop diet tomorrow...4 shakes a day. They told me I could add some sugar free syrup to give the vanilla some flavor. I know I can order it online but I'm hoping I can pick some up in the store. Does anyone know of any stores that carry them? Target, Walmart, GNC? Thx!!

Will be the first day of my new life!!!! Go on Monday for my preop consult and start my liquid diet. I'm so grateful to everyone here for their knowledge and support

Initially denied....approved this morning after peer to peer!!!!!!!!! 37 BMI Tons of comorbids but nothing that Aetna usually considers. So grateful!! Tentative surgery date of June 5th

Still shaking...still crying....so relieved!!!!

Waiting for the official letter and then the doctor will try a peer to peer. If not, I have another level appeal through our benefits administrator. Fingers crossed!!!

My BMI is under 40 and although I have a ton of co-conditions, I don't have the exact ones Aetna would approve. Going to appeal and hope for the best!!

Expected it but still devastated

Just got off the phone AGAIN and now it's apparently with the medical director...not sure if that's good or bad, lol!

Today is day 15 and its still pending...blah!!!!!!!!!

Blah... everything submitted on April 11th. Keep calling to check for updates and was told today that they are requesting an "interpretation of my weight history". WTF? My PCP submitted my weights for the last several years in a graph form, which clearly shows the weight and date it was taken. What else do they want?? The surgeon's office said they will take care of it but I'm so irritated, lol.

Sorry to be a post hog today Was just wondering for anyone who went through the Aetna approval process if there is anyplace online to check? I have a reference number and the representative told me I could check for any updates online but I can't find where. Do anyone have any experience with that? I looked in my portal but all I see where I can check completed claims, not pending preapprovals.

P.S. I'll start... denied/April 17th

37 year old female, 255 pounds, 5' 10", 37ish BMI over 35 BMI for at least the last 8 years 3 letters written for medical necessity - surgeon, PCP, back specialist 1 personal letter from myself Documented Conditions (comorbids but not "technically according to Aetna) - depression, chronic migraine syndrome, metabolic syndrome, high triglycerides, prediabetes, herniated discs, spinal stenosis, joint pain Just trying to take the lightheartered approach since its now out of my hands, lol. Submitted April 11th and I confirmed Aetna has the file. They have up to 15 days. Any bets or Approval/Denial and when... kind of like the baby due date/sex game

Just curious if anyone has submitted multiple doctor letters to insurance with their package? Is there such a thing as too many? I wrote one and also have one from my PCP, back doctor & surgeon. I don't quite fit the guidelines with "official comorbids" so I'm hoping this helps although I don't want to irritate them either, lol.

Started with surgeon A and have completed 2 of my 3 insurance required visits. If I were to switch bariatric programs/surgeons, would the process start all over again? Would it pick up where I left off? Thx!

Bumping back up I have my psychologist, nutritionist & PT appointments tomorrow with my final appointment on April 11th and then it's off to Aetna. SOOOOOOOOOOOO beyond nervous. Any other Aetna updates

Working myself into a frenzy that I will get denied. I have 37ish BMI consistently for 8 years. No "official" comorbidities but a lot of other conditions that are related. I will have 3 letters from 3 doctors (PCP, surgeon & ortho) stating medical necessity. I have also written a heartfelt letter (although I doubt that will make a difference, lol). My final appointment will be on April 11th and the coordinator will send everything over after that for approval. My question is... the Aetna bariatric surgery bulletin sets guidelines that I technically don't meet but I have seen other posters with a lower BMI get approved. I have heard some other posters say "it depends on your employer's plan". What exactly does that mean? Can the guidelines vary according to employer? Our plan is a PPO and we have amazing coverage. I have always been directed to the bulletin whenever I contact Aetna but I'm wondering if I should inquire with my husband's employer directly? I'm just grasping at straws... the waiting and not knowing is torture

I have Aetna and they are requiring 3 months for me... I have my 2nd this week

I'm in the same boat... my BMI is 36-37 and I passed my sleep study . My last appointment is April 11th and that is when they will submit everything. I drafted a letter outlining my situation. My PCP, back doctor and surgeon are also submitting letters so I'm hoping that helps. I have a lot of issues but none that officially count as a cormorbidity - depression, chronic migraines, fatty liver disease, high triglycerides, spinal stenosis, herniated discs, high blood sugar. Keeping my fingers crossed!!!

Good to know... thanks!!!

Thanks everyone I just finished my letter and talked to my coordinator. She said we will make the best case we possibly can and hope for the best although there are no guarantees. So... I just have to wait... and wait... and wait. It won't even be submitted until mid-April. I have totally thought about the weights (and I would do it in a heartbeat) but I don't think that would help my case since I have never been above 40 BMI. My BMI hasn't been below 35 in over 8 years. I have records showing it between 36 - 37 for the last several years, never going below 35 and never going above 40. If your BMI is below 35, I don't think there is a chance to get approved with Aetna. They will approve at above 35 with a comorbidity though or above 40 withough a comorbid.

Thank you... the pre-diabetes is a recent find so I'm hoping that will do it. It's so hard but I'm trying not to get my hopes up.

I know it's a long shot but just wondering if anyone has been able to get a medical withdrawl from their retirement plan... we have a 457 and cannot borrow but we can withdrawl for uncovered necessary medical expenses. Not sure if this would technically qualify. I'm still hoping insurance will cover it but I need a plan B (and C, D, E, etc, lol). I know I should ask our provider but I really don't want to unless it becomes necessary, KWIM? We would have to talk to my husband's employer and I am not ready to do that, lol. I'm hoping to hear other's experiences.

Long story short... I have (and consistently have had) a BMI of 36-37. I have Aetna insurance and was hoping that I would be diagnosed with sleep apnea to use as my comorbidity. Got the resuts of my sleep study and it was clear . I know I am continuing on with my 3 month multi disciplinary and hoping it somehow gets approved. I have started to formulate a letter listing my other conditions and hoping it will push it through. I have a history of depression (documented that it stems from my weight), spinal stenosis and herniated discs. It also appears from my most recent blood work that the I have pre-diabetes and very high triglycerides. Just hoping for some words of wisdom or suggestions I guess. Feeling pretty defeated.