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Aetna comirbidities

Hello,

I'm new here.... been trolling for a few days. I was wondering if anyone knows if the only comorbidities Aetna will accept are hypertension, sleep apnea and diabetes. I have a BMI of 36 and I have asthma, joint pain and a hiatal hernia. I think I may have sleep apnea but I haven't been diagnosed. I plan on doing a sleep study to find out if I do.

I called Aetna and spoke to a representative about them covering the surgery and under my plan they do.

I found the NIH website that listed all the comorbidities that are considered relevant for weight loss surgery with a BMI under 40.

Anyone get approved by Aetna with a BMI under 40 and another comorbidity that the three they list?

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One of the comorbidities listed for my approval through Aetna was weight related arthritis. My conditions also included GERD.

I believe that your physician would need to be specific to identify that any joint pain you are experiencing has a causal relationship to your weight when they submit your letter of medical necessity.

Asthma, and as far as I know a hiatal hernia are not considered to be conditions related to obesity for insurance approval.

Best wishes for your approval..

  • Author

Thank you.

I will be sure to discuss that with my PCP when I see him for my referral on Friday. Can't wait to get this process started!

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