How to avoid the 6 month diet requirement?

Rainydayz · April 9, 2011

My insurance (Aetna) says 6 months and 3 have to be consecutive. I have some from 2009 so I'm hoping I'll only have to do 3-months now. I'm the same way as you. I'm unemployed right now and want to get this over with. I'm out of school so I should be looking for a job. But I really want to get this done and over with first.

rsr53 · April 24, 2011

I have Medicaid, so 6 months is mandatory. Had that when dr submitted paperwork, but still got denied. Mine is a revision surgery. I have appealed it, and was told my surgeon is going to personally consult the ins doctors to push my case through for the sleeve hopefully next month. I believe my ins co did not get all of the documentation completely the initial time it was sent via fax. You should confirm with ins that that all of your paperwork is submitted, then have your doctor appeal for a surg auth. Good luck! Ronda

My insurance (Aetna) says 6 months and 3 have to be consecutive. I have some from 2009 so I'm hoping I'll only have to do 3-months now. I'm the same way as you. I'm unemployed right now and want to get this over with. I'm out of school so I should be looking for a job. But I really want to get this done and over with first.

DrMommy · April 24, 2011

There are ways around everything. For me.....it is all in the doctor. The first doctor I went to blew me off and told that she has never seen anyone get bariatric surgery through insurance and I was just better off to pay out of pocket (I have Aetna *** in California btw). I changed medical groups and went to a new doctor. Long story short....through Aetna I was supposed to go through a 6 month monitored program. I was approved today (3 weeks since going to my primary physician for the specialist referral) and I will have surgery in 6 weeks after I get the psych eval, meet with a nutritionist, and do a sleep study.

For me I was very honest with my doc...I told him how I had been researching this for over a year and how ready I am. He pushed me through. It sucks that so much is left up to the will of the docs.