dede0314

I think you should tell your PCP. Even if you only go to them for your annual physical. I believe its important they know what test should be done when they do your bloodwork.

Sorry you're going through this. Don't give up appeal until you can't anymore. My insurance denied me three times and I finally got approved through an external review. It's frustrating because it takes time but it's worth fighting for.

Congrats!!

Congrats! I also have been working through this process for a year. I finally got my approval last week and I am meeting with the surgeon on the 23rd and I should be getting my date then. I wish you the best luck on your journey!!

Congratulations!!

They did take a few days to get back to me when I first filled out the form. I also called them and left a voicemail.

Congrats! I have my pre-op visit with my surgeon on the 23rd and will be getting my surgery date then. I am beyond excited. Good luck with your journey.

Thanks everyone!

I finally got my approval today. I have been going through this process for almost a year now and have been fighting with my insurance company for about 7 months. I was denied by Aetna 3 times and my case went through the external review which I found out today that I won. I hired Lindstrom Obesity Advocacy and they were great. I can't wait to get a date and finally be apart of the losers bench. I feel like I'm getting a second chance at life. For all those having a hard time getting approved DO NOT GIVE UP.

I actually just got my approval today... I've been fighting with Aetna since February trying to get approved. I gained 9 pounds during my supervised nut visits so I got denIed. I just won the external review. I think as long as you don't gain weight during the process and do everything they require you should be okay.

Congrats.... I'm trying to get everything ready for a second level appeal... Hoping that goes well

@@momma_missie Thank you!!

When I spoke to the representative she said the notes said that I gained weight even though I lost all the weight I gained. I still haven't gotten the official denial letter in the mail.

@@bvenegas Good luck and keep me posted on your progress.

I have Aetna and called today and my level one appeal has been denied. I did the 3 month program and gained 9 pounds during the process and was initially denied because of that. I did and extra 3 months and lost 16 pounds and was down 3 pounds from my initial weight and I called them today and they have decided to uphold their initial denial. I am going to hire Lindstrom to do the second level appeal if I get denied again I will do the external review. If the external review is denied I'm planning on going to Mexico. I'm so upset I just want to cry but I won't give up.

@@JamieLogical Thank You!

For those who have had surgery with Doctor Ortiz how do you do your follow ups. I'm in the process of trying to get insurance approval but have been denied I'm doing a second level appeal but if that fails I'm seriously thinking about going to Doctor Ortiz but my main concern is post op care.

They just submitted my paperwork I'm so nervous. My doctor noted on my paperwork that I'm on medication that makes me gain weight so hopefully they take that into consideration. How long did you all have to wait for a decision?

Has anyone gained weight during their program and still got approved by Aetna? I've gained weight and my last weigh in is this Friday I'm nervous I will get denied.

I don't think you need two years of history anymore. Their requirements were revised on 8/12. Must meet either 1 (adults) or 2 (adolescents): For adults aged 18 years or older, presence of persistent severe obesity, documented in contemporaneous clinical records, defined as any of the following: Body mass index (BMI) (see appendix) exceeding 40; or BMI greater than 35 in conjunction with any of the following severe co-morbidities: Clinically significant obstructive sleep apnea (i.e., person meets the criteria for treatment of obstructive sleep apnea set forth in CPB 0004 - Obstructive Sleep Apnea in Adults); or Coronary heart disease, with objective documentation (by exercise stress test, radionuclide stress test, pharmacologic stress test, stress echocardiography, CT angiography, coronary angiography, heart failure or prior myocardial infarction); or Medically refractory hypertension (blood pressure greater than 140 mmHg systolic and/or 90 mmHg diastolic despite concurrent use of 3 anti-hypertensive agents of different classes); or Type 2 diabetes mellitus

@@nbw1220 I hope everything works out for you. Keep us updated.

Thanks for the info

@@jessiquoi Did you get approved already? So all you did was meet with a nutritionist for three months?

Congrats on your approval. I am just starting the process with Aetna so all you did was visit the nutritionist for 3 months. DId you do anything with an exercise therapists?

Hello, I am in the process of starting my journey. I have my first meeting with the surgeon on Sept. 26. I have Aetna POS I am really nervous that they are going to deny me. Can anyone who has gotten approved by aetna tell me in detail what they did?