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Attention Aetna And Federal Blue Cross Sleevers....

Was anybody successful convincing Aetna or Federal Blue Cross to waive the pre-op diet/wait time?

Thanks

Dana

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  • finallysleeved
    finallysleeved

    My primary refused to write me a letter even being 90 pounds overweight, but I found out i had sleep apnea but continued to see the primary and after the third month he said ok, go have the surgery an

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I have federal BCBS and I had either to get my DR to write a letter saying yes he is fat and needs the surgery, which he refused to do, or wait three months in a row visiting him each month to weigh and prove that my diet and exercise was not working. after the three months I got the sleeve, good luck changing their minds.

  • Author

Hi,

Thanks for getting back to me. Which doc refused--- surgeon or primary? Did you call Federal Blue Cross and they told you that or did the office call? I called Fed BC today and the woman was clueless. All she did was send me the official policy criteria, which I already had. I explained that I needed to know if there are any exceptions to the 3 month pre-op diet. She she did not know and did not know who would know.

Thanks!

Dana

My primary refused to write me a letter even being 90 pounds overweight, but I found out i had sleep apnea but continued to see the primary and after the third month he said ok, go have the surgery and the surgeons office got the primary DR;s notes and it was a done deal. My weight stayed pretty much the same over three months, the best way is to see your primary Dr, and also see your surgeon and explain to him that your having to wait the three months and then you will be fine assuming your BMI is high enough.

  • Author

My primary refused to write me a letter even being 90 pounds overweight, but I found out i had sleep apnea but continued to see the primary and after the third month he said ok, go have the surgery and the surgeons office got the primary DR;s notes and it was a done deal. My weight stayed pretty much the same over three months, the best way is to see your primary Dr, and also see your surgeon and explain to him that your having to wait the three months and then you will be fine assuming your BMI is high enough.

Thanks! I see my surgeon tomorrow!

are you in Louisiana? none of my family wanted me to have the surgery because of how major it is, But but moving forward, I learned that I had Hpylory in my stomach, then learned i had sleep apnea and then during the sleeve surgery my surgeon discovered a hyatal hernia. so then my family changed their minds. I am 3 weeks out and have lost almost 40 pounds and only have like 35 more to get my goal weight, getting the food down is a new challeng, a few bites and im way full. good luck.

I have federal bcbs. They insisted on 3 preop nutrition visits and a letter from my primary saying i need the surgery, because I have a bmi less than 40 with hypertension. Also had a psych eval, the ekg and upper GI endoscopy were for the surgeon. My last Nut visit is sept 6 and then papers to insurance

same here, saw the nutrition people two times, the psych Dr, had the scope in my stoamch, two nights of sleep study one with and one without the mask, three DR visits then pre op, it is a lot to do, the after the surgery I got the bill and it was over 44 thousand dollars total. I paid 150 to the surgeon and 150 to the hospital.

same here' date=' saw the nutrition people two times, the psych Dr, had the scope in my stoamch, two nights of sleep study one with and one without the mask, three DR visits then pre op, it is a lot to do, the after the surgery I got the bill and it was over 44 thousand dollars total. I paid 150 to the surgeon and 150 to the hospital.[/quote']

44 thousand dollars???? Holy cripe!

by the way I just fixed a big protein shake anybody want to share it with me? :blink:

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