kossde

I'm going to be compeltely honest. For me, Gastric Bypass was never really an option. I'm terrified of surgeries and really wouldn't be ok having a sugery that seems quite a bit more complex than Lap Band. If I were diabetic, however, I might have to do some more research. I know a gentleman who used to work with me who had lap band and developed diabetes after the surgery. On the flip side, however, I also know a person who had lap band a year ago and has since stopped having to take meds for her diabetes. If I were you, I'd get a second opinion. Your doctor might be completely accurate in his suggestion, but it's important to realize that gastric bypass is much more expensive than lap band, more perminent, and non-adjustable. But I hear it also produces faster results.

Hi Everyone! I'm brand new as a registered member but have been reading this forum for ages. I don't want to take away from this thread (hope this isn't against the rules or anything) but I've documented my whole ordeal at: http://www.lapbandtalk.com/f8/approved-aetna-without-complete-medical-history-55056/ It's very long, so you probably shouldn't read it unless you have a lot of time. Ultimately, I was approved just yesterday! - never had to appeal. Also, didn't have a proper medical history (didnt even have 2 years). I am very VERY excited :smile:

My psych eval took 2 visits. The first visit was when he did all the tests, the second visit was for the results. During the second visit, we did talk a lot about what to expect - turns out the person who did the eval also had lap band a few years ago so he really knew what he was talking about. Ultimately, he said I'd be an excellent candidate for the surgery.

Hello everyone! I just registered here today, but I have been reading the forum for months – since I started working with my doctor to go through Lap Band surgery. Anyhow, I have Aetna Choice POS II and thought that I’d share some of my experience. I think this will be a long post, but I hope it’s helpful to those of you who are trying to get approved. I began working with my doctor four months ago to prepare for the surgery. We did the three month pre-op routine. Over all, I went to both my primary care doctor (who also managed my diet) and the nutritionist four times – The initial visit plus one each month of the diet. I also was advised to have a psychiatric evaluation – though according to Aetna’s website, that isn’t actually required unless you have a history of mental illness. The counselor who completed the evaluation made a note on the evaluation that he felt I would be an excellent candidate for the surgery. I don’t know if this impacted Aetna’s decision or not. The whole process cost me less than $400 (though I think I may have to fork out another $1000 for out-of-network deduct able for the actual surgery). I paid a $20 co-pay for all of the primary care visits and the two visits for psychiatric evaluations. The nutritionist charged me $50 a visit. During this time, I lost approximately 21 lbs (gained 3 lbs the first month and lost 24 the additional two months after my doctor threatened me with the phrase, “Aetna won’t approve this surgery if you don’t lose weight). I followed Aetna’s requirements to a tee – excluding the aspect of having a 5 year (now 2 year) medical history. While I have had a BMI of at least 40 for at least 5 years, I went to a doctor maybe twice during that time. I was upfront with my doctor about this dilemma but she assured me that we’d figure a way to work around it. And, to make matters even MORE complicated, the two doctors I did visit LOST my records!! Both of them! So, about 3 weeks ago, I had completely given up hope of ever getting approved when I read on this site that Aetna had lowered their requirements for medical history. Immediately I scanned in a whole bunch of pictures of me from between 2005 and now. Four of these pictures were official headshots – Passport, Drivers License, Work ID, and College ID – I did this because I knew that an official picture which had my name on it would be a lot harder to deny as ‘proof.’ Then, because I don’t generally look nearly as obese as I really am, I included about 6 full-body pictures. None of these pictures were flattering, but then again, none were inaccurate in any way either. I put the pictures in a nice little word document, placed a caption below each one stating the approximate date of the photo as well as what was going on (such as during my trip to Las Vegas or when my niece was born.) Then, I wrote Aetna a letter. This letter was about five pages long (notice how I write too much?) and detailed my weight struggle from practically day one (I was about 8 when it became a problem). This is where it got interesting. I emailed the entire ‘letter and pictures’ over to my doctor and asked her to go ahead and send it to Aetna as is. The doctor faxed Aetna the request, but it took Aetna over a week to actually receive it and document it. I called Aetna every day for an update. On about day 4 after they actually received the fax, I was told that the request was ‘pending additional information’ – You guessed it, the nurse who reviewed my documents needed a medical history. Unfortunately, I didn’t have that! So, after going around with my doctor for several days on how to proceed- my doctor was notified by the Aetna nurse that she would have to send the information up to the people who deny or approve the requests as is since she couldn’t wait any longer. I was a little relieved; I hadn’t realized that she wasn’t the one who approved it. Well, after my Doctor called and woke me up with the ‘bad’ news, I told her to tell the nurse to go ahead and PLEASE send the request up so that someone could make a decision. The request was approved the very same day she sent it up. I just found out yesterday. I had to call Aetna twice because I had convinced myself that the first person I had spoken to was giving me inaccurate information – that was entirely too easy, I thought. Now, I am just waiting for the letter so I can fork over the cash and get the surgery done with. One last thing: My BMI is over 40 but I have absolutely no co-morbidities. I do have an under-active thyroid, but that only began to occur about two years ago – didn’t cause my obesity. Sorry for the long post, but I thought it was important to let people know – YOU CAN GET APPROVED WITHOUT THE RECORDED MEDICAL HISTORY! Good Luck everyone! :smile: