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Aetna Question!



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I am in the process of getting approval with Aetna. My doctor told me stay confident that I will get approval but I was curious about one thing. I currently have a 40.5 BMI and meet all the requirements for my doctor. My one concern is that they require a 2-year of BMI history of being over weight. Do you have to have a 2 year weight history of a BMI over 40 or just an overweight BMI?? Over the past two years I have gained about 40 lbs due to a thyroid problem, which in turn makes it much harder to loose weight. Some of my weights from 2010 and 2011 only show a 33-34 BMI. Do you think this will keep me back from getting approval? Any feedback from others who have been approved by Aetna would be greatly appreciated!!!

Thank you in advance!

-Mandy

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It's difficult to say...I had to submit 3 years of medical records, most of which of that time I did not even have my weight recorded. They placed alot of "weight" (please excuse the play on words...) on my physician's letter of medical necessity which stated that my weight issues had been present and steadily have gotten worse during the time he has been my doctor (around 9 years).

Do you have any weight related comorbidities? When I was approved by Aetna for my surgery, my BMI was under 40, however I had several weight related comorbidities.

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I got Aetna also and after my paper work was submitted they approved my surgery in less than 4 hrs! They can get your weight history with your primary doctor! My surgeon ask my physician to write a letter saying that she recommended me to have the surgery, I also needed to provide a list of all the diets I did how many pounds I lost and how many pounds I re gain! I was really surprise of how quick they approved me! Good luck

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I hope you get approve, Aetna takes about close to 30 days to get back to you. They want two years of a BMI exceeding 40 or 40 with commorbolities. But you never you may be lucky and get approved with your first submitted. Keep us posted! Good luck!!!

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I hope you get approve' date=' Aetna takes about close to 30 days to get back to you. They want two years of a BMI exceeding 40 or 40 with commorbolities. But you never you may be lucky and get approved with your first submitted. Keep us posted! Good luck!!![/quote']

I guess all depends on the plan I got ppo aexcel and after all my paperwork was submitted I got approved in less than 4 hrs!

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I guess all depends on the plan I got ppo aexcel and after all my paperwork was submitted I got approved in less than 4 hrs!

Sent from my iPad using LapBandTalk

That is great! What was your BMI and did u have iny commorbilities?

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That is great! What was your BMI and did u have iny commorbilities?

BMI 44 and no health issues at all except my BMI Lol

Sent from my iPad using LapBandTalk

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    • Alisa_S

      On day 4 of the 2 week liquid pre-op diet. Surgery scheduled for June 11th.
      Soooo I am coming to a realization
      of something and I'm not sure what to do about it. For years the only thing I've enjoyed is eating. We rarely do anything or go anywhere and if we do it always includes food. Family comes over? Big family dinner! Go camping? Food! Take a short ride or trip? Food! Holiday? Food! Go out of town for a Dr appointment? Food! When we go to a new town we don't look for any attractions, we look for restaurants we haven't been to. Heck, I look forward to getting off work because that means it's almost supper time. Now that I'm drinking these pre-op shakes for breakfast, lunch, and supper I have nothing to look forward to.  And once I have surgery on June 11th it'll be more of the same shakes. Even after pureed stage, soft food stage, and finally regular food stage, it's going to be a drastic change for the rest of my life. I'm giving up the one thing that really brings me joy. Eating. How do you cope with that? What do you do to fill that void? Wow. Now I'm sad.
      · 0 replies
      1. This update has no replies.
    • Alisa_S

      On day 4 of the 2 week liquid pre-op diet. Surgery scheduled for June 11th.
      Soooo I am coming to a realization
      of something and I'm not sure what to do about it. For years the only thing I've enjoyed is eating. We rarely do anything or go anywhere and if we do it always includes food. Family comes over? Big family dinner! Go camping? Food! Take a short ride or trip? Food! Holiday? Food! Go out of town for a Dr appointment? Food! When we go to a new town we don't look for any attractions, we look for restaurants we haven't been to. Heck, I look forward to getting off work because that means it's almost supper time. Now that I'm drinking these pre-op shakes for breakfast, lunch, and supper I have nothing to look forward to.  And once I have surgery on June 11th it'll be more of the same shakes. Even after pureed stage, soft food stage, and finally regular food stage, it's going to be a drastic change for the rest of my life. I'm giving up the one thing that really brings me joy. Eating. How do you cope with that? What do you do to fill that void? Wow. Now I'm sad.
      · 1 reply
      1. summerseeker

        Life as a big person had limited my life to what I knew I could manage to do each day. That was eat. I hadn't anything else to look forward to. So my eating choices were the best I could dream up. I planned the cooking in managable lots in my head and filled my day with and around it.

        Now I have a whole new big, bigger, biggest, best days ever. I am out there with those skinny people doing stuff i could never have dreamt of. Food is now an after thought. It doesn't consume my day. I still enjoy the good home cooked food but I eat smaller portions. I leave food on my plate when I am full. I can no longer hear my mother's voice saying eat it all up, ther are starving children in Africa who would want that!

        I still cook for family feasts, I love cooking. I still do holidays but I have changed from the All inclusive drinking and eating everything everyday kind to Self catering accommodation. This gives me the choice of cooking or eating out as I choose. I rarely drink anymore as I usually travel alone now and I feel I need to keep aware of my surroundings.

        I don't know at what point my life expanded, was it when I lost 100 pounds? Was it when I left my walking stick at home ? Was it when I said yes to an outing instead of finding an excuse to stay home ? i look back at my last five years and wonder how loosing weight has made such a difference. Be ready to amaze yourself.

        BTW, the liquid diet sucks, one more day and you are over the worst. You can do it.

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    • KimBaxleyWilson

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