Lexigurl82

First Aetna told me they have up to 15 days for a decision. Then they told me 30 days when I called them again. I was approved after a week.

same here...according to my calendar my period will start a day or two before my surgery, which is on 12/2. I was told the nurses and surgeon will be very understandable, plus they've seen everything. I hope I can manage to clean myself and change my pad myself after surgery

I think your heart was in the right place. But as others mentioned above me, you know when you're obese. I am set to have my surgery on 12/2. The reason I am going thru this surgery is because I came to realization that I am a fatty and my health problems would increase if I didn't do anything about it. I have a friend of mine who is 5'4 and 314 pounds. She was recently diagnosed with diabetes and is extremely self conscious about herself and her body. Earlier in the year we both agreed to do weight loss surgery together but she changed her mind before we could even get started in the process. I have asked to go thru with it only because I want her to be healthier and happier. She comes up with multiple reasons on why she doesn't want to do it like not having money to go thru the process (she has insurance) or fear not waking up from surgery, etc....she decided that she wants to lose the weight on her own and all I can do is be supportive of that. The person who made a Facebook rant about you is probably sensitive about their weight and has not come to the full realization that they are obese.

@@lolitajm I had my sleep apnea test done in May and had my 1st appt with the surgeon in July. I did the 3 month process with Aetna. The surgeon's office submitted everything to my insurance on 10/14 and I got a call on 10/23 saying the surgery was approved. Good luck!!!

congrats on your approval I made the decision to have my surgery on 12/2. I could have had the surgery weeks ago but I wanted to get past the Thanksgiving holiday and prepare myself financially. Do what you think is best. If you want to have the surgery now, I say go for it. Just like others have mentioned, everyone's recovery process will be different. Surround yourself with positive thinking and you'll be fine.

My surgery date is December 2, 2015! I have to be on a 2 week high Protein, low carb diet for 2 weeks which begins on next week Tuesday...I'm excited!

same here...I keep calling my insurance every 2-3 days asking for status on whether I have been approved or not. The surgeon's office said they will call me with an update but I just can't wait lol. Be optimistic and hope for the best

I meet my surgeon exactly 3 weeks from today. I also meet the nutritionist while there. November is also my last month of the supervised weight loss program. So all I foresee myself needing to complete is the EGD, upper abdomen ultrasound and psych eval. I'm ready to get my papers submitted already!!

Let us know what they say about yours! When did they submit your information? And what insurance do you have, @"Lexigurl82" ?

@@sassyfrass23 I was approved! I have Aetna and my surgeon's office submitted paperwork to Aetna around October 14th. A week later I was approved. My surgery date is set for 12/2/2015. Have you heard anything? If not, continue to be proactive and hope for the best. Good luck and let us know how everything goes!

sometimes it's like that...my surgeon's office took a week to submit my paperwork to my insurance. it took the insurance company a week to review and approve my surgery. good luck!

I should hear tomorrow about my appeal with Aetna. I was denied over a technicality and a "deadline" for my clinicals to be turned in...they nev er even reviewed my info. So now I find out our insurance policy is changing with Aetna the first of the year. Of the four policies offered NONE cover bariatric surgery.

I am trying not to freak out right now. The "what ifs" are getting to me. Please someone say it will be !! Lol

How did the appeal go?

so sorry to hear this. Peer to Peer can be very useful and some people are approved after a peer to peer. Good luck!!!

congrats!

Thanks everyone... I'm going to keep the surgery date for 12/2/2015 but I still feel a little weird about it. I appreciate all the kind words it did help me out a lot.

**TMI Disclaimer**

My VSG surgery is 4 weeks away. According to my calendar and what my body is going through now, my expected menstrual cycle should happen on or before the day of surgery---and I JUST realized this today. It's been messing with my head all day because I want to have this surgery done so bad but I feel like I need to reschedule... my flow is pretty heavy and I just think it would be so messy to deal with on top of having surgery. I shed a tear or two talking to my husband about it because it's embarrassing to even think about...my surgeon is a male and I would hate for him or anyone to know that I'm having my period. My husband told me I was silly for thinking such a thing and told me to go through with having the surgery. He really hurt my feelings. I don't know, maybe I am thinking too much or a little emotional right now about it. I am so embarrassed and don't know what to do ....help...

"I would rather lose the weight than to have someone cut on my body"

"All you have to do is eat vegetables and fruit"

"What kind of surgery is that and what are the side effects?" (Instead of asking me positive questions)

Even though I have been asked/told these things I still decided to tell my husband, daughter, immediate family and friends. At this point in my life I do not care what someone thinks I should or should not do. I have struggled too long with obesity and I'm ready to be healthy and fit. I have a supportive husband and daughter, that's all that matters. One minute people will tell you not to do it and the next minute they're going to ask how you did it. Remember that...

congrats!!!

so sorry to hear this...use this time to take all that anger and sadness into eating right and going to the gym...like the person above me said, revenge is one day running into him or someone he knows and you look so good he would wish he never left...dude was no good for you and he didn't sound very supportive. you don't need that negativity in your life so it's probably for the best. just continue to love yourself and one day you'll find your ace, someone who will love and support you.

It wound up being a pretty major ordeal for me. With less than 2 weeks before my surgery, I was still getting prices that were all over the map, some of which were unbelievable because I knew that i had both a $5000 bariatric co-pay and then a $2000 additional out of pocket max. This meant that I knew that I would owe at least $7000, plus any amount above the $13000 maximum that my insurance would pay. Finally, I just went to the hospital and asked to speak directly to the patient account director. Once I had there information, I knew that my out of pocket would actually be $18,000. As a result, I had to switch surgeons and hospitals and do some shopping around. I'm now scheduled for November 10th.

OMG...you could have the surgery in Mexico for way less...no way should your out of pocket be $18,000, especially when you have insurance. Please keep us posted!

Definitely talk to your doctor. My surgery is 12/2 and my surgeon told me to take chewables, not gummies post op. He did tell me once the stomach heals I can take Vitamins in pill form.

My surgeon who is board certified said to me no sodas or any carbonated drinks unless you're willing to drink them flat. I hate flat drinks so he said just leave them alone for good. Like someone mentioned above, think of the reason you're having this surgery. Sodas are sugary and have no nutrients. This surgery is for us to change the old habits and develop new and healthy habits. As a soda drinker myself (I'm pre-surgery) I realize that I won't be able to have another carbonated drink and I'm ok with that. I hate being overweight and I'm looking forward to doing right this time.

be careful about not eating right...weight gain could delay your surgery

oh yeah I am learning that too...I looked at the checklist and the surgeon made it clear not to have food funerals because if you gain weight prior to surgery then they can postpone the surgery. I'm working on losing more weight before my pre-op on 11/30 ..I cannot afford to have my surgery rescheduled because it is holiday time and I need to use my insurance this year before the $800 deductible starts over on 1/1/2016

goodness no...that's pretty steep for an information session...was it required by your insurance? I wonder why they billed your insurance if it were free...I would call the hospital and ask them why they billed your insurance...

@@rking my approval took a week. I was really surprised that it was so quick because Aetna told me it could take 15-30 days for a decision. Good luck and keep us posted!

I would say switch surgeons. As soon as my surgeon's office received my approval they called me to schedule my surgery. The only thing I haven't gotten yet was pre-op instructions but I won't bug them since my surgery is 6 weeks from now. Before you switch, call your insurance carrier and make sure that the switch will not interfere with the approval you already received and explain to them as to why you are making the switch. Make sure you get the first name and last name initial of the reps/supervisors you speak to and a reference number if they have one. I work in insurance and authorizations... this is to protect you in case someone says later down the road says that they never told you that you could switch, etc. Good luck and keep us posted on what happens!

I have Aetna but I never knew of a deadline...are you sure that was the real reason for denial?