a_new_me_finally

Same thing happened to me and because of it, they deemed it wasn't medically necessary and I'm going through the appeal process now. I'm sick to my stomach I don't know what to do!

Aetna PA, 25 yo, bmi 45 with pcos, fatty liver and gerd -- denied because I gained 2 lbs during the nutrition period and the deemed it wasn't "medically necessary"(go figure). Secondary insurance won't cover. Able to submit three appeals (reconsideration, level 1 appeal and level 2 appeal). We will see how that goes.

I agree mommabird. I am trying to remain the same or alteast lose some weight; however, my dietician is moreso going over things with me for after the surgery. It was never mentioned that gaining weight could have me denied from from getting the procedure done. I'm glad I read some posts on here, otherwise I never would have known because my doctors office never mentioned it to me. Overall so frustrating and stressful

Currently, I am participating in the 3 month diet program required by Aetna. I have read on here, and various other forums, that they are very strict with their Pre-Op program and the weigh-ins. I have read that people have been denied because they have gained 2lbs or less! I am so worried I will be denied if my weigh fluctuates any higher than what it is. Has this happened to anyone who had Aetna and/or has been approved and/or denied. I definitely need some help because I am SO worried and stressing about my next weigh in and it is taking a toll on my body and mental health. Any help or advice would be greatly appreciated.

Thank you MrsB I'm just so nervous!!! I know this will help me long term and I really need this tool, I am just so scared of getting denied its destroying me

Serra, I am experiencing almost the same exact thing with my immediate family (I just recently posted a thread on here similar to yours). In some strange way I am thankful that you're going through the same thing because I know that others feel the same way that I do and are experiencing the same things. My battle is with my immediate family and immediate friends and it has been tiresome as well. I too want to be healthier and happier and I am also afraid it will break friendships and relationships that I have as well. I understand where you are coming from because the people I am experiment the same backlash from don't realize what they are saying either. I think you need to do what is best for you, and that is what I keep saying to myself, this isn't about significant others, friends, family etc, it is for you, your health and your selfesteem. I know it's hard, trust me, I COMPLETELY get it, but for what it is worth, you're not going through this alone. I wish you the best of luck and I am sure you will do great once you do get your surgery! Remember this is for you, not anyone else!

I'm recently beginning my journey with WLS (in the beginning stages, I just had my psych eval and my first appointment with the dietician) and I am very excited to start my journey; HOWEVER, my immediate family and some of my close friends are unsupportive. One day they are on board with what I want to do, then the next they're trying to talk me out of it. I have a close friend that is about to under-go her surgery, and another that is post-op I confide in, but it still makes me feel a little unsure and actually hurt that my immediate family and other close friends do not support my decision. I've been told "you've lost weight before, why can't you do it again", "you stopped working out, you know you need to work out once you have surgery right?", "you're not going to be the same person", "I will work out with you and eat healthy with you, you don't need this surgery", "I won't see you anymore because you're not going to be able to drink" and other variations and comments. I know deep down this is what I want to do, and I've even taken my mother to my first appointment when I met with my surgeon. Has anyone had the experience of family members and close friends trying to talk them out of their decision to have wls? How did you cope with that? I need some advice considering I still have 6 more months (at least) before I can actually undergo surgery since I have Aetna. Any advice would be greatly appreciated!

I am in the beginning stages as well and when they were asking me if I had any "weight-related illnesses" I mentioned PCOS, and they attributed that to my weight (which my GYN did as well) and they said I qualified for the surgery. I hope that helps! I have Aetna and BCBS is my secondary. Hope that helps & good luck on your journey !!

I don't blame you, sometimes I think I would've been better off keeping it to myself and only telling my two friends (the one who's pre-op and the one who is post-op). It's just heartbreaking when your loved ones aren't supportive of you trying to better yourself and make yourself healthier.

Yes, exactly! They will go on and on and on, so much as to corner me about it at social events, telling me why I shouldn't do it and how they're going to help me, and then in the next breath say "but if you really want to do it, I support you." Clearly you do not if you're shoving alternatives, which I've already tried, down my throat. It's just so frustrating because most of these people have that are projecting their opinions on me have never been overweight all of their life (like I have), haven't given up things they love due to weight-related physical and emotional issues and haven't been restricted to certain stores, they don't understand what I've been through all my life, but continually research alternatives instead of researching wls and trying to understand where I am coming from. Just very frustrating and emotionally draining!