Jump to content
×
Are you looking for the BariatricPal Store? Go now!

Aetna Sleevers - Share Your Approval And/or Denial Experiences Here!



Recommended Posts

Good thing you called!

Share this post


Link to post
Share on other sites

Good thing you called!

Right I call every few days just to make sure there on there p amd q's I had to pay for my weight class 40 a month and 50 to the nut amd 387.50 which included my deductible to aetna and my edg... so some one some where god willing and able better approve me.

Share this post


Link to post
Share on other sites

Jokingly, my husband said maybe Aetna is just holding out as long as they can asking for more documentation since its getting so close to the end of the year, that was once January hits you have to meet your deductible all over again!

Ummmm starting to wonder if that is the case! I wouldnt put it past the insurance company to do something like that!

My office send release forms to a few other places to get my weight history hopefully she will have more to submit to Aetna come Friday!

Share this post


Link to post
Share on other sites

I wonder how long it takes to schedule the surgery once approved. I will be submitting the first week of DEC wondering the same thing if they will push to next year the thing is though if there are compications or follow up appointments they will be covered al year next year as you will meet the out of pocket

Share this post


Link to post
Share on other sites

Depends on your doc's schedule. Only date I could get is Dec 18 but I'm hoping for a cancellationon the 11th. Plus there's all the pre-op stuff. I had to wait 3 weeks for the EGD appt. See if you can make that appt now if you haven't already.

Share this post


Link to post
Share on other sites

after a week of eating raw fruits and veggies i lost the proper weight and today my paper work will be submitted to Aetna for final approval....2 more weeks BUT im keeping my fingers crossed for a shorter turn around from Aetna

Share this post


Link to post
Share on other sites

So aetna denied me!! :'( I cried and yelled and cursed but whats that going to help? I need a two year weight history and I have 14 days to get one. So my surgeons office is calling faxing the ER's ive visted in that time frame so im praying I get approved upon receiving that information... ive come to far to give up... im not fat by choice I have pcos that got jump started when I took the depo shot... I dont have an issue with food but the hormonal imbalance has cause me to gain and I ended up with diabetes I cant have kids, I have one and thats by the grace of god. I have facial hair and I cant live like this any more... please pray for me.

Share this post


Link to post
Share on other sites

So aetna denied me!! :'( I cried and yelled and cursed but whats that going to help? I need a two year weight history and I have 14 days to get one. So my surgeons office is calling faxing the ER's ive visted in that time frame so im praying I get approved upon receiving that information... ive come to far to give up... im not fat by choice I have pcos that got jump started when I took the depo shot... I dont have an issue with food but the hormonal imbalance has cause me to gain and I ended up with diabetes I cant have kids' date=' I have one and thats by the grace of god. I have facial hair and I cant live like this any more... please pray for me.[/quote']

I have aetna, have you reached out to your primary care doctor. Ask them to fax your weightloss doctor your records for past 2 yrs. each time you've visited even for a cold they always weigh you. This will show them what your weight has been doing over the last few years.

Hope you get approved, ill pray for you sweetie.

Share this post


Link to post
Share on other sites

Headmistress, I feel you! Same issue here! They didnt deny me yet but said I have 45 days to submit 2 yr weight history and will not except my prenatal weight which was 1 of the 2 yrs... Never saw my PCP during that time so I'm hoping the few minute clinics I went to during that time had some weight history for my surgeon to submit. Don't give up hope....

Share this post


Link to post
Share on other sites

Headmistress' date=' I feel you! Same issue here! They didnt deny me yet but said I have 45 days to submit 2 yr weight history and will not except my prenatal weight which was 1 of the 2 yrs... Never saw my PCP during that time so I'm hoping the few minute clinics I went to during that time had some weight history for my surgeon to submit. Don't give up hope....[/quote']

Ok so I called around to hospital emergency rooms where I know I was seen at in 2010 2011 and one alreasy sent her my weight for 2010!!!! There were really fast but I explained to them what was going on and that I didn't have 7-10 days to wait for a letter so they said tell the surgeons office to fax a letter head over requesting the info and they will send it upon the hour and {{{{BOOM}}}} they did!!!! So now im just waiting on 2011 and I will be home free!!! So freaking excited now and I feel so much better thanking god thanking god thanking god.... hopefully I get a December surgery!!!!

Share this post


Link to post
Share on other sites

My stuff got sent to Aetna on 10/31. Today they said it just got passed from the nurse reviewer to the medical director. Hope that's a good sign!

Share this post


Link to post
Share on other sites

My stuff got sent to Aetna on 10/31. Today they said it just got passed from the nurse reviewer to the medical director. Hope that's a good sign!

Yea thats the last step!! Praying for you babes.

Share this post


Link to post
Share on other sites

APPROVED!

I'm praying for you all to join me ASAP!

The waiting is the hardest part.

Share this post


Link to post
Share on other sites

I just found out mine was submitted this morning!! I'm so excited/nervous/anxious.... I hope....

weight.png 347*294/284/135 (*347HW/294SSW) | @Mwrarr | mwrarr.wordpress.com

Share this post


Link to post
Share on other sites

APPROVED!

I'm praying for you all to join me ASAP!

The waiting is the hardest part.

CONGRATS!!! :}

weight.png 347*294/284/135 (*347HW/294SSW) | @Mwrarr | mwrarr.wordpress.com

Share this post


Link to post
Share on other sites

Create an account or sign in to comment

You need to be a member in order to leave a comment

Create an account

Sign up for a new account in our community. It's easy!

Register a new account

Sign in

Already have an account? Sign in here.

Sign In Now

  • Trending Products

  • Trending Topics

  • Recent Status Updates

    • vsg.with.sharon

      Hey everyone!
      I’m new here! Looking for some friends! 🥰
      · 0 replies
      1. This update has no replies.
    • LeighaTR

      Four days post surgery. I am sipping as fast as I can and getting NO WHERE near the goal of 60 - 80 grams of protein or the 64 oz of liquids. I just feel FULL. I don't know if it can still be the gas build up (I would think by now that would be gone) but it is a struggle to drink. And so far I have not had the nausea or spasms and don't want to wander into that territory by pushing too hard with liquids. I about passed out today as it was my most "strenuous" day. Went from second story to basement for shower and I was sure I was going to pass out. Looking back on my last few days I have had a total of less than 1000 calories. Am I just not getting enough nourishment in me? Once again a friday where I can't get ahold of the doc until Monday rolls back around so I am hoping maybe someone here has some experience on how to keep energy going. I do have fibromyalgia too and that may be where some added fatigue comes into play. How did you all fair with the goals the week after surgery?
      · 0 replies
      1. This update has no replies.
    • Doughgurl

      2 days until I fly out to San Diego to have my Bypass Surg. in Tiajuana Mexico. Not gonna lie, the nerves are starting to surface. I don't fear the surgery itself, or the fact that I'm traveling alone, but its the aftermath that I'm stressing about the most, after this 8 week wait. I'm excited to finally be here, but I am really dreading the post surgical chapter. I know its going to be tough, real tough and I think I'm just in my head to much now that the day i here. Wish me luck, Hopefully I'm one of the lucky ones, and everything goes smoothly. Cant wait to give an exciting update,. If there is anyone else have a June bypass or even a recent one, Id love to have someone to compare war stories with. Also, anyone near San Antonio Tx? See ya soon with the future me. 💜
      · 3 replies
      1. Phil Penn

        Good Luck this procedure is well worth it I am down to 249.6 lb please continue with the process..

      2. Selina333

        I'm in Houston so kind of near you and had the sleeve in Dec. Down 61 lbs. Feeling better. Was definitely worth it. I hope the everything is going well for you. Update us when you can!

      3. Doughgurl

        I am back home after my bypass surgery in Tiajuana. I'm post op day 4. Everything went great! I guess I'm one of the lucky ones who have not encountered much pain at all, no nausea thus far and I'm having no problem keeping down broths and water. Thank you for your well wishes. I cant wait to keep up this journey and have a chance at better health and simply better quality of life. I know there will be bumps in the road ahead, and everything won't be peaches and cream, but at least I have a great start so far. 😍

    • LeighaTR

      I am new here today... and only two weeks out from my sleeve surgery on the 23rd. I am amazed I have kept my calories down to 467 today so far... that leaves me almost 750 left for dinner and maybe a snack. This is going to be tough for two weeks... but I have to believe I can do it!
      · 0 replies
      1. This update has no replies.
    • Doughgurl

      Hey everyone. I'm new here so I thought I should introduce myself. I am 53y/o and am scheduled for Gastric Bypass on June 25th, 2025. I'm located in San Antonio, Texas. I will be having my surgery in Tiajuana Mexico. I've wanted this for years, but I always had insurance where bariatric procedures were excluded. Finally I am able to afford to pay out of pocket.  I can't wait to get started, and I hope I'm prepared for the initial period of "hell". I know what I have signed up for, but I'm sure the good to come will out way the temporary period of discomfort and feelings of regret. I'd love to find people to talk to who have been through the same procedure or experience before. So I look forward to meeting you all. Hope you have a great week!
      · 2 replies
      1. Selina333

        I'm so happy for you! You are about to change your life. I was so glad to get the sleeve done in Dec. I didn't have feelings of regret overall. And I'm down almost 60 lbs. I do feel a little sad at restaurants. I can barely eat half a kid's meal. I get adults meals often because kid ones don't have the same offerings at times. Then I feel obligated to eat on that until it's gone and that can be days. So the restaurant thing isn't great for me. All the rest is fine by me! I love feeling full with very little. I do wish I could drink when eating. And will sip at the end. Just a strong habit to stop. But I'm working on it! You will do fine! Just keep focused on your desire to be different. Not better or worse. But different. I am happy both ways but my low back doesn't like me that heavy. So I listened (also my feet!). LOL! Update us on your journey! I'm not far from you. I'm in Houston. Good luck and I hope it all goes smoothly! Would love to see pics of the town you go to for this. I've never been there. Neat you will be traveling for this! Enjoy the journey. Take it one day at a time. Sometimes a few hours at a time. Follow all recommendations as best you can. 💗

      2. Doughgurl

        Thank you so much for your well wishes. I am hoping that everything goes easy for me as well. We don't eat out much as it is, so it wont be too bad in that department. Thankfully. Also, I hear you regarding your back and feet!! I'd like to add knees to the list. Killing me as we speak! I'm only 5' so the weight has to go. Too short to carry all this weight. Menopause really did a doosey on me. (😶lol) My daughter also lives in Houston. with her Husband and my 5 grand-littles. I grew up in Beaumont, so I know Houston well, I will be sure to keep in touch and update you on my journey. I may need some advice in the future, or just motivation. Thank You so much for reaching out, I was hoping to connect with someone in the community. I really appreciate it. 💜

  • Recent Topics

  • Hot Products

  • Sign Up For
    Our Newsletter

    Follow us for the latest news
    and special product offers!
  • Together, we have lost...
      lbs

    PatchAid Vitamin Patches

    ×