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cajungirl
LAP-BAND Patients
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Your best bet is to call Aetna and get the numerical code for obesity surgery requirements. The site spells it out very clearly to include co-morbidities and required BMI and either 3 or 6 month diet and exercise program that they require. You'll need to get copies of 3-5 years of records from your primary care MD to show your height and weight. They may require copy of your pharmacy records to show either blood pressure or diabetic or cholesterol meds that you take. You may not even need a sleep study - wait till your bariatric MD prescribes it and Aetna will cover it. I'm in the last month of my 3 month program and am hoping for approval in late Nov. God Luck !
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So I just got home from overnight visit in the sleep clinic...and I passed--bummer ! No sleep apnea. With a BMI in the high 30s, I have to say I'm a bit worried about approval but I'm gearing up for the battle. I'm not ready to take NO for an answer !
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I have Aetna, too, and am wondering what I'll do if I am denied. My BMI is borderline in the high 30s and I'm doing all the preop regime and losing weight. Anyone lived through a denial ?