Has anyone had Aetna cover the lapabnd recently? I have Aetna and was just wondering what the requirements are

I have Aetna, 2 years ago they required me to have a 6 month diet, and a nutritionist. My son, also, has Aetna, he just finished his 6 month diet, and is waiting for approval, now. So, from what I can tell, they require a 6 month diet, and 40 BMI and then will determine from there. Good luck, Karen

Thanks karen, I have my appt with the nutitionist on monday. I was kinda hoping to get it donebefore the end of the year. I saw some posts that they require a 3 month diet.

I have Aetna, 2 years ago they required me to have a 6 month diet, and a nutritionist. My son, also, has Aetna, he just finished his 6 month diet, and is waiting for approval, now. So, from what I can tell, they require a 6 month diet, and 40 BMI and then will determine from there. Good luck, Karen

I have Aetna too and was banded on 5-26-11 and I only had to have 4 dr visits. Each plan is a little different. I would call and talk to them yourself.

I have Aetna as well and i did a 3month diet,sleep study,see a psychiatrist, see a nutritionist and show proof of my weight history for the Past two years.then i was approved.

I have Aetna also. I too would suggest that you find out the specifics of your plan. Go on their website, I was able to find the information there. I was banded Jan 28. I had to do the 3 superivosed program which included the psychologist, 3 preop classes and weigh in at those classes. I also was assigned an Aetna case manager that calls periodically to check on my results and answer questions also. I was pleased that Aetna had a very fast turn around in their approval. My first visit was in August and I could have got my band in December. The staff at my Bariatric clinic were/are excellant and knew how to get this all done. I did nothing but show up and fill out what they asked.

Besides the 3 month requirement, they used a bmi of 40 or 35 if you have 2 or more comodalities (blood pressue, diabeties, cholesterol, sleep apenea, etc).

I have Aetna had to see the surgeon for 6 months before surgery. I then followed all of the dr's requests, nutritionist, psychologist, endoscopy, get a letter from my primary dr. supporting the surgery. At the end of the 6 month period the Dr's office submitted the paperwork to Aetna in 24 hours I got a call that I was approved. They scheduled my surgery for about a month later.

Do you all think that I should start with my pcp or should I got straight to a bariatric surgeon?

I went Aetna's online to look for a bariatric surgeon, so this way I would know what Dr. is in my network. When I found one, I went to his seminar and then made an appointment. My first consultation with him, he talked to me more about the surgery and told me I would qualify. They gave me a packet of what his requirements were. I called Aetna to find out what there requirements were. I went to his office once a month for 6 months and took all the tests and requirements that they wanted. Lucky for me Dr. Gritsus and his staff were very professional and nice. I spoke to my primary during that time and told him what I wanted to do and he said he thought it was a good idea. He wrote me a medical letter of necessity for Aetna. So maybe you should start with Aetna and then look for a good bariatric surgeon in your area or ask your primary dr. for a suggestion. Whenever I go to a Dr. I always check online or call Aetna to make sure they are in my network, so I won't get billed. I just had to pay my co-pay everytime I seen him. Good luck in your journey.

Do you all think that I should start with my pcp or should I got straight to a bariatric surgeon?

Has anyone had Aetna cover the lapabnd recently? I have Aetna and was just wondering what the requirements are

My Aetna policy did not cover Lapband surgery.

Thanks everyone for the great info. Does anyone regret having the lapband? What are the biggest obstacles to overcome once you have it.

My plan didn't cover it in Dec 2010, but with the new plan year on Jan 1, 2011 it did!

My Aetna policy did not cover Lapband surgery.

I have aetna ***- so everything had to go through my pcp. I think they required everything you could imagine for me- 6 month diet with pcp, seeing a pulmonoligst, cardiologist, gastro, nutritionist, psychiatrist, lots of tests and a sleep study. I did it all and got approved with a relatively low bmi (like 36-37). They did deny me at first but the surgeon called to fight for me and got it approved

wow thats great for you and encouraging for me!!!! I hope that i can get mine covered as well.

My plan didn't cover it in Dec 2010, but with the new plan year on Jan 1, 2011 it did!

Do you all think that I should start with my pcp or should I got straight to a bariatric surgeon?

I would go straight to the surgeon. The surgeons office will know exactly what to submit to the insurance since they deal with it everyday. I have Aetna & had surgery done june 2010, my husband will have his done in August. We went straight thru the surgeons office for all the required appointments - the only info he needed from the PCP was a 2 year weight history. They weight history did not even need to be an official letter either - the PCP made copies of his exam sheet for us.

Thanks everyone for the great info. Does anyone regret having the lapband? What are the biggest obstacles to overcome once you have it.

No regrets. The head hunger part has been difficult - just old bad habits are hard to break but as this last year has progressed it is becoming easier for me.