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Does Anyone Have Aetna Insurance? And Did You Have Any Problems Getting Approved?



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I'm currently jumping through hoops, I have the final visit of my 3 month medically supervised diet this Thursday, then paperwork goes to my surgeon's office then on to Aetna for approval. I'm anxious that they won't approve the surgery.

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I finish up the classes next Thursday and then it goes on to Aetna. Crossing my fingers for both of us.

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Hi! I have Aetna and I was approved on the first try a year ago. I had to do 2 sleep studies a psych visit nutrition appointments and a few other things but it was worth it to get approved right away! i had a high bmi, and co-morbidities (pre diabetes and sleep apnea) and they told me the more things wrong with me, the easier it is to approve the surgery. I am a year out and still have yet to receive any kind of bill. Good luck to you all!

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I have Aetna ppo and was denied three times. it was because the Dr office want sending everything they needed. Once I got everything needed, it was approved within a week.

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I have Aetna hope all goes well for me ... It scares me

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I have Aetna. No diabetes, no hypertension and a BMI of 40 and was approved first time within 5 days.

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I have Aetna, BMI of 42 when I started in February of this year, with high triglycerides, diagnosed with sleep apnea in March, no other comorbidities. I finished my 90 day nutrition classes in May, and was approved first time. My surgeon is Dr. Kim, and given how many surgeries he performs his office are experts at putting all the paperwork together.

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Toni I hope I get approve like u .. I have a Bmi of 44 w no other health promblems besides pre hypertension

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I have Aetna. My BMI is 50+, prediabetic and high cholesterol. I am in the middle of my 90 days here, visiting the Dr, doing the NUT visits, scheduled Psych eval, and completed sleep study. Hopefully, these few months will go by quickly and I won't have any issues getting approval.

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As long as your doctors office send in all the required information you should be fine. I had to have six months of weights showing BMI of 40. That was it.

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Mine went through with no problems. I did the three month route and as others have said, the main thing is for the doctor to submit all the right paperwork to them. I also had Dr. Kim. His office was so efficient and handled it all for me. Read the clinical policy bulletin on your Aetna website and just make sure you are covering everything.

Good luck and keep us posted!

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I called and got all the paper work about what was needed before I even attended the first seminar. My BMI is 39, I have sleep somewhere and can't use the clap because I'm severely clostraphobic, high bp and fibromyalgia. I've done everything by the numbers so hopefully there will be no issues with approval. Thanks for sharing how your approvals went. I can't imagine that with both my family doctor and my surgeon filing the appropriate paperwork that I will have ant problems

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Mine went through with no problems. I did the three month route and as others have said, the main thing is for the doctor to submit all the right paperwork to them. I also had Dr. Kim. His office was so efficient and handled it all for me. Read the clinical policy bulletin on your Aetna website and just make sure you are covering everything.

Good luck and keep us posted!

I have Aetna, BMI of 42 when I started in February of this year, with high triglycerides, diagnosed with sleep apnea in March, no other comorbidities. I finished my 90 day nutrition classes in May, and was approved first time. My surgeon is Dr. Kim, and given how many surgeries he performs his office are experts at putting all the paperwork together.

I am with Dr. Kim also but just started and have my first nutrition class this Thursday. I have done the sleep study and was diagnosed with sleep apnea. Had my 2nd sleep study last weekend to be fitted for the CPAP mask, which I took home with me and am now using. (uGh!)

How long after you were approved did it take for you to get the surgery scheduled?? Do you have to get on a waiting list or were you able to schedule it quickly? Also, which hospital are you using for the surgery? I checked and it looks like Forest Park is not "in-network" for Aetna. Hoping Dr. Kim does surgeries at other hospitals because I don't want to get stuck paying out-of-network coinsurance :(

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Dr Kim did my surgery. When I found out I was approved, I emailed my surgery coordinator 5 minutes later and she replied in a few minutes with a surgery date. Dr Kim does go to other hospitals because of the insurance. Are either Wise Regional in Decatur or Baylor Trophy Club in network for you? Be careful! My UnitedHealthcare provided ZERO coverage for out of network hospitals for bariatrics. Good luck!

G.

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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. LeighaTR

        I hope your surgery on Wednesday goes well. You will be able to do all sorts of new things as you find your new normal after surgery. I don't know this from experience yet, but I am seeing a lot of positive things from people who have had it done. Best of luck!

    • 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.
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