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Aetna Nervous



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Hello,

I am so nervous. I just found this forum, and I am hoping to talk to people who have gone through the same thing. Today is my last weigh in for my 6 months. I have done the 6 month check in, bloodwork, the pre-tests, and nuturician. I have my psych evaluation on the 17th. One month I was up two pounds, stayed the same last month, but will be up 4 pounds today. However, overall I am 14 pounds down even with the gain. I am afraid that aetna will deny me for this, and only having a BMI of 38 and 41 in the past two years. However, I have PCOS and I had to go off my pills for the surgery this made me gain weight. Any advice?

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I also have my last appt today and have Aetna. So nervous!!! Best of luck to you, Ihope it works out for both of us!

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Thank you... what were your requirements?

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3 months with nutrician, psych evaluation and pulimnary. I gained a few pounds the first month but then lost. My BMI is at 41 with high blood pressure. I aleady had major surgery this year so my deductable and maximum payout has been met. I am worried they will take that into consideration since they would have to pay 100%. I have a pre-set surgery date of November 1st. Really hope everything falls into place.

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I bet you will be fine! It sounds like you are right on track. I know I gained a few pounds due to PCOS and going off birth control. I am worried that. I am also worried because aetna is new to my doctors office. I only was told one appointment of psych and nut. and not sure how to check. I feel like I am going to get denied. Let me know how it goes

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3 months with nutrician' date=' psych evaluation and pulimnary. I gained a few pounds the first month but then lost. My BMI is at 41 with high blood pressure. I aleady had major surgery this year so my deductable and maximum payout has been met. I am worried they will take that into consideration since they would have to pay 100%. I have a pre-set surgery date of November 1st. Really hope everything falls into place.[/quote']

I have Aetna also..and had surgery in March on my wrist so all my deductibles and max payout were also met...I had no problem with them approving and paying for my band last month...best of luck to the both of you

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Good luck to you guys. I also have Aetna, and they paid 100% with no problems back in June.

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I have Aetna also..and had surgery in March on my wrist so all my deductibles and max payout were also met...I had no problem with them approving and paying for my band last month...best of luck to the both of you

Thank you I feel alittle more confident.

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I bet you will be fine! It sounds like you are right on track. I know I gained a few pounds due to PCOS and going off birth control. I am worried that. I am also worried because aetna is new to my doctors office. I only was told one appointment of psych and nut. and not sure how to check. I feel like I am going to get denied. Let me know how it goes

I only had one appt with the psych also, but had to meet with the nutrientist 3 times. Went to the doctors yesterday and papers will be submitted today for approval. How did your doctors appt. go?

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Shelby how did it go yesterday? Thanks guys I feel a little bit better. I gaine two pounds yesterday but in the 6 months down 18 pounds overall. Not too bad. However, my doctor thinks the insurance may be upset with a gain. Who knows they are not really sure with Aetna because they have only worked with them a few times. They had to move my appointment for psych and nutrician back to the 17th. How long did it take for your approvals or denials with Aetna?

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Shelby how did it go yesterday? Thanks guys I feel a little bit better. I gaine two pounds yesterday but in the 6 months down 18 pounds overall. Not too bad. However, my doctor thinks the insurance may be upset with a gain. Who knows they are not really sure with Aetna because they have only worked with them a few times. They had to move my appointment for psych and nutrician back to the 17th. How long did it take for your approvals or denials with Aetna?

Everything went very well, down a few pounds, doctor and nutrientist feel condfident I will get approved, ut we will see. They said I should hear something by the end of next week. They mentioned that Aetna will only approve one baratric surgery in ones lifetime so if this lap band doesn't work they will not approve another surgery and that they are very strict on weight loss prior to surgery. Since you are down a total of 18 lbs I think you should be fine. Keeping my fingers crossed for you. I mean come on if we can lose the weight why would we need lap-bands. Wake up Aetaa.

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I have Aetna they approved in three days and all I had wad a year with my pain management Dr , two years charted weight and phych eval. They paid 100%

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Thanks for the encouragement! I have my psych and nutrician on the 17th.... hopefully it won't be soon after that I will know!

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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.
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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.
      · 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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