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Aetna insurance question



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Hello.

I'm wondering about Aetna's insurance coverage for the sleeve. I have read the posts about Aetna, but here is my dilemma.

I don't have insurance yet. My husband will be getting insurance through his work, but that won't be until June 1st. I wonder if I can call them and ask about our plan before it starts. No problem in trying I suppose. But what I'm really wondering is if I can start the three month pre-approval process before they even cover us? It's about 3 months until our coverage starts, so I was thinking during this time, I can get a jump on the process, by seeing a nut, doing exercises, logging my food, etc.

I guess I just have to call them to find out all of this stuff.

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Hi! I was in the same boat as you. I decided I wanted the sleeve back at the end of November of this last year. My employers' coverage through BlueCross does not cover WLS at all, so I made plans to switch to my husband's Aetna coverage on January 1, 2011. My surgeon's office offered a free consultation with their insurance specialist. I took my husband's card and the insurance specialist was able to go by his coverage to tell me exactly how much was covered, what my deductible would be, my maximum out-of-pocket, etc. However, I was not allowed to make an actual appt. until after Jan. 1 when I was officially added to the policy.

You might try that with your surgeon's office. At least you would know where you stand BEFORE you go into the 3 month program. It goes by faster than you think! It's hard to believe I am already halfway through!!

Good luck and let me know how it goes.

Lisa

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You can call Aetna yourself and talk to them! I think, but don't quote me, that you could do a 6-mo dr' plan before hand with your gen Dr and that would count, I don't know about the 3 mo baratric dr plan right before.

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Aetna does cover the sleeve.It reqiures a 6 month or 3 month supervised diet program.I too have Aetna and am in my second month of classes .They said Aetna is very hard to get an approval so document everything.The more you have to show them , the better off you will be .so from start to surgery we are looking at 6 months with the supervised program, and a year with the non supervised program. Good Luck in the long run they will be saving money ,you'd think they wouldn't make it so hard!

Hello.

I'm wondering about Aetna's insurance coverage for the sleeve. I have read the posts about Aetna, but here is my dilemma.

I don't have insurance yet. My husband will be getting insurance through his work, but that won't be until June 1st. I wonder if I can call them and ask about our plan before it starts. No problem in trying I suppose. But what I'm really wondering is if I can start the three month pre-approval process before they even cover us? It's about 3 months until our coverage starts, so I was thinking during this time, I can get a jump on the process, by seeing a nut, doing exercises, logging my food, etc.

I guess I just have to call them to find out all of this stuff.

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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.

    • CaseyP1011

      Officially here for a long time, not just a good time💪
      · 0 replies
      1. This update has no replies.
    • KimBaxleyWilson

      Three months and four days ago... I was in Costa Rica having a life changing surgery! Yesterday we had a followup visit with Dr. Esmeral via video chat and this morning my middle number changed.  I'm down 47lbs and two pants sizes. I can wear a Large tshirt for the first time in like... 14 years! Woot!! Everything is going great. I have zero regrets. I went down to the riverwalk with a friend and walked 2 miles on Monday without even getting fatigued. And no more snoring or chugging pickle juice for crazy leg cramps! I need to go to the gym more... I'm making new shirts next week so that will motivate me. LOL But I'm also just not as TIRED all the time! I have a LONG way to go...but seeing the progress on the scales and in the mirror is a huge motivator!! Thank you all for cheering me on and supporting me!!
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      https://alluniqueguide.com/java-burn-coffee-reviews/
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