tashanicole1271

Michele, Are you sure you don't have any cormobidities that will help in your cause? Although I don't have the same insurance as you, when I started my journey, I deemed myself to just be "fat and healthy." Upon my initial visit to my PCP, I found out I had slightly elavated BP and cholesterol. My BMI was right at 40, but these issues helped in getting my approval. I have Aetna of TN and I know the 6 month diet did not count against me, eventhough I lost no weight! Hang in there and don't be discouraged.....

I know many, including myself, who did not lose weight on the 6 month diet. My PCP, who followed me while on the diet, said that the insurance companies that require it are moreso looking to see if you can be consistent with following through with your appointments over that time span. I didn't try that hard because my BMI was right on the line of where it needed to be for approval. All of that being said, the 6 month diet is a go tool to see just how seriuos you are about having WLS.

I wonder if the BMI had anything to do with it? These insurance companies are such sticklers about it being at least 40. I have been on the forum so much that I feel like a denial for one of us is a denial for us all! Keep fighting and hang in there.....God bless!

My doctor's template also gave calorie recommendations and what type of diet was being followed, such as low fat, low, cal, etc.

Congrats to both you and your wife. You both have made what I consider life changing and life saving decisions. I will be getting banded within the next month. I wish my husband could also, but he had some health issues in the past, so I don't think they will let him get it. Both of you be blessed.....

My PCP had so many people coming to her for their 6 month supervised diet that she made a template that she used every month to record your weigh and dietary recommendations. I finished my 6 month diet Nov. 7th and did not lose a pound. In fact, I think I gained a few in that period od time. My PCP said the diet wasn't so much to lose weight, as it was to see that you would stick to appointments on a monthly basis. That somehow proves you are really serious about what you are doing. Anyway, All of my paperwork was submitted to my insurance on Nov. 9th and I received my approval letter on Nov. 19th. Good luck to you and God bless.....

I have a lot of ceil blue scrub tops that are XL, if you'd like!

It seems that different doctors and different insurances have a wide variety of tests you have to have before the surgery. I am having "bloos tests and other testing" done tomorrow, then I am scheduled for an EGD on Wednesday. After that, I am supposedly ready to see the surgeon to start the pre=op diet and schedule surgery.

When I started the journey, my BMI was 40.7. I purposely tries not to lose weight on the 6 month supervised diet that my insurance required, in fact, I may have gained a pound or two. If they are denying you, I would say that is is probably because of your BMI. I would go to my PCP and have my new weight recorded for the appeal records.

Before I started the process at all, I called Aetna myself to see what exactly they covered or did not cover as far as WLS was concerned. That is what your surgeon"s office should have instructed you to do. These surgeons deal with so many people, with so many different insurances that they don't really know who covers what! I work with insurance on a daily basis and it is your company who chooses the plans. Before it's time for you to sign up, I think you should try to find out which covers what. This might aid in your decision.

I think you should send anything that will show your need for the surgery. I have Aetna insurance and just got my approval letter in the mail on Friday. My insurance required a BMI of 40 if there were no comorbidities. I was right at 40 with none, or so I thought. I ended up with slightly elavated blood pressure, which my PCP considered weight related. I think you are on the right track, just send everything you can to the insurance company.

What insurance do you have? I have never heard of having to get a letter before hand. My insurance required a letter to be sent in with all of my records prior to possible approval, which I received by letter today.

I wish I would have found the TN forum earlier, but I am having surgery through Dr. Woodman. I first went to Dr. Woodman on 5/16/08 and I got my approval letter today, 11/28/08. My PCP supervised my 6 month diet, but I didn't lose a pound! She told me the diet was more of a way for the insurance to see if you would consistently keep your doctor's appointments. I guess to measure how seriuos you are about the WLS. I also have Aetna and I must say, everything ran smoothly.

Mary, I received my approval letter from Aetna today! I had my last monthly visit to my PCP on 11/7/08 and the approval is dated 11/19/08, the turnaround time was pretty swift. I don't know if your Aetna is the same as mine, but I'd be happy to tell you everything I did to get approved. I hope everyone had a wonderful Thanksgiving!

I live in Memphis, TN and I have Aetna also. I just completed everything and turned in all my paperwork to the doctor to be sent to the insurance company. When I started the journey, my BMI was slightly over 40 with no comorbidities, or so I thought! If you don't have any known comorbidities, I would suggest you go to your PCP and have them check you for EVERYTHING! It turns out that I have slightly elevated blood pressure that could be weight related and a bad left knee that has been carrying to much weight. Don't give up. Find another doctor if you have to. I have come to realize that a weight issue is usually accompanied by something else!

Hi Blair28, I'm pretty much where you are in the process. I've already gone to the seminar and to the surgeon for the initial consultation. Right now, I'm in the middle of the 6 month medically supervised diet that my insurance requires. My PCP says that I probably won't be approved until December, at the earliest. It can be a daunting task to fill oit all the forms, but if you are like me and really want the surgery, it will be well worth it! Just stay positive and get all the information you can.....this forum is a good source of information. Hang in there and stay encouraged! Tasha

I don't know the answer to that, but I have the same concern. I just recently started the 6 month diet process, (2 months ago) and haven't lost any weight. My problem the second month was that I dislocated my kneecap and was forced to wear an immobilizer for 3 weeks, so I couldn't do much for the month. I wish you good luck and I will be glad when I get to where you are! Tasha

Hi Jen, I also have Aetna insurance, but mine is Open Access Aetna Select. My BMI had to be greater than or equal to 40.....I came in right at 40! Because of that, I wasn't required to have any co-morbid factors. I am about to start my third month of medically supervised weight loss. I am required to lose 10 pounds in this time span. In a nutshell, if your Aetna is like my Aetna, you should be ok beacuse of your co-morbid factors. Tasha

Hi all! My name is Tasha and I am from Memphis, TN. I am preparing to be "banded" in December or January. I learned of the post from my husband who had a patient today, he works in post op at a local hospital, who was having her band REMOVED! That did make me not want to have the surgery, but I wanted to be in contact with others like me and this forum is the perfect way to do that. I look forward to learning and sharing with you all! tashanicole1271