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

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



Recommended Posts

Ladies i am proud to say.... IAM OFFICIALLY APPROVED! I called this morning just to get my case number and she said.. ohh. You have been authorized. No need to call anymore!

YEAH!!

Ladies i am proud to say.... IAM OFFICIALLY APPROVED! I called this morning just to get my case number and she said.. ohh. You have been authorized. No need to call anymore

CONGRATS! Sooooooooooooooooo happy for you!!!. Now check that off your list..lol, have you found about when your surgery date is?

Share this post


Link to post
Share on other sites

gold- I do not have a date yet. I just have the "dummy" date that Aetna gave me which is Jan 28th. If it is in January, I would be too ecstatic. My Birthday is Jan 3 so that is an awesome birthday present.

Share this post


Link to post
Share on other sites

I'm just glad you got that part out of the way, and now you can mentally

prepare yourself and get ready. Follow up with your doctor though and see

what date they have for you. It sounds like they have already notified

Aetna without letting you know anything, having you all nervous for nothing

smh.... but it DOESNT MATTER BECAUSE YOU HAVE A DATE!!!!! YEAH!!!!

Share this post


Link to post
Share on other sites

I finally got my approval & surgery date....January 22 is the big day! Excited, nervous, anxious, scared, ecstatic, embarrassed... I'm feeling every emotion possible all at once!! Wow, this is really gonna happen!

Share this post


Link to post
Share on other sites

I finally got my approval & surgery date....January 22 is the big day! Excited' date=' nervous, anxious, scared, ecstatic, embarrassed... I'm feeling every emotion possible all at once!! Wow, this is really gonna happen![/quote']

Lol congrats boo!!! Happy for you!

Share this post


Link to post
Share on other sites

Congratulations.........

Share this post


Link to post
Share on other sites

So... I finally heard & it's not great news. I was denied bc my coordinator jumped the gun & submitted with missing pieces of information. They obviously didn't read the bulletin from Aetna which specifically states that they req 2 consecutive years wts. They only had medical records from 2009, which means I've been lied to &/or given misleading information multiple times by Aetna & my surgeons coordinator & her assistant. Last wk I had to re-request my records for my dr office (from old dr), which makes me crazy bc why did no1 realize that only having 2009 records was odd?!?? I switched drs a year ago. Im uber frustrated.

So now, we wait for the records...& hope it's not too late for the appeal...bc I've lost my trust in my coordinator at this point.

Guess yet ANOTHER date is gonna pass that I am not being sleeved on...this makes 3. Maybe January? I'm not even daring to imagine anymore. It doesn't feel real anymore... Very sad.

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

Share this post


Link to post
Share on other sites

Wow trust me I know how u feel I was denied two times only to be approved later....so dont give up.

Share this post


Link to post
Share on other sites

Thank you :} I *really* needed to hear that... I've been so much mess internally over this that I didn't even tell my BF until last night. I figured I'd better let him in on it, considering 12/26 is 10 days away & I won't be having surgery after all (I assume...I don't think they'd still do it that quickly even if it was approved tomorrow) onward & upwards I suppose...

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

Share this post


Link to post
Share on other sites

Well officially DENIED. My two year weight history didn't work for Aetna. I knew 2010 wouldn't because the only time I went to the doctor was when I found out I wa pregnant and then there after all prenatal visits....

The office was just going to wait since we had a weight history for 2011 and 12 and resubmit the 1st of the year but Aetna told me that they won't take my weight for 2011 either cause the only one on file is 6wks postpartum. And when sick during those years I always opted for an urgent care cause it was usually a quick option and even though they weighed me, they never documented it!

Oh well! I'm ok with it, I am now a self pay and traveling for surgery and it will be much cheaper still then the out of pocket expense here.... Not to mention having to meet the 2013 deductible again if I stay here!

Good luck everyone with with your approvals. Date is set for February 18th! Hope to see you all on the losers bench!!!!!

Share this post


Link to post
Share on other sites

Don't be discouraged, things will work out

Share this post


Link to post
Share on other sites

Just wondering if anyone has been successful in getting Aetna to pay for WLS when there is a bariatric surgery exclusion in the insurance policy, put on there by the employer. I am under my hubby's insurance (Aetna PPO), which is completely awesome ($5 copay!), with the very big exception that his employer has excluded WLS from their insurance. My PCP wants to try and submit a letter to see what Aetna does (I've spoken with Aetna, they have said they will deny it, based on our insurance policy). I'm not sure I'm up for a humongous fight, only to have it denied.

Does anyone have experience with this?

Share this post


Link to post
Share on other sites

So I am almost done with my 90 day supervised weight loss visits. I have a BMI of 46 with high blood pressure and sleep apnea. Everything seems set for Aetna to approve me except for my 2yr weight history. The only thing I have is my health assessment that I'm required to take through my job and Aetna that shows my weight for the past 2 years. Is this acceptable?

Share this post


Link to post
Share on other sites

They should definitely accept a work health assessment weight without a problem, especially with comorbidities. Especially when they accept weight history from weightloss programs like weight watchers and Jenny Craig. You should be fine as long as you submit it all together. Otherwise the process will drag on. Good luck!

Share this post


Link to post
Share on other sites

So I am almost done with my 90 day supervised weight loss visits. I have a BMI of 46 with high blood pressure and sleep apnea. Everything seems set for Aetna to approve me except for my 2yr weight history. The only thing I have is my health assessment that I'm required to take through my job and Aetna that shows my weight for the past 2 years. Is this acceptable?

Aetna looks for documented weight that should be fine.

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

    • Clueless_girl

      Losing my hair in clumps and still dealing with "stomach" issues from gallbladder removal surgery. On the positive side I'm doing better about meeting protein and water goals and taking my vitamins, so yay? 🤷‍♀️
      · 0 replies
      1. This update has no replies.
    • BeanitoDiego

      I've hit a stall 9 months out. I'm not worried, though. My fitness levels continue to improve and I have nearly accomplished my pre-surgery goal of learning to scuba dive! One dive left to complete to get my PADI card 🐠
      I was able to go for a 10K/6mile hike in the mountains two days ago just for the fun of it. In the before days, I might have attempted this, but it would have taken me 7 or 8 hours to complete and I would have been exhausted and in pain for the next two days. Taking my time with breaks for snacks and water, I was finished with my wee jaunt in only 4 hours 😎 and really got to enjoy photographing some insects, fungi, and turtles.
      · 0 replies
      1. This update has no replies.
    • Mr.Kantos

      Just signed up. Feeling optimistic.
      · 0 replies
      1. This update has no replies.
    • Frugal

      Welcome to Frugal Testing, where we are committed to revolutionizing the software testing landscape with our efficient and affordable solutions. As a pioneering company in this field, we understand the challenges faced by startups, small to medium-sized businesses and any organization working without budget constraints. Our mission is to deliver top-notch testing services that ensure the highest quality of software, all while keeping your costs in check.
      Frugal Testing offers a comprehensive suite of testing services tailored to meet diverse needs. Specializing in different types of testing including functional testing, automation testing, metaverse testing and D365 testing, we cover all bases to guarantee thorough software quality assurance. Our approach is not just about identifying bugs; it's about ensuring a seamless and superior user experience.
      Innovation is at the heart of what we do. By integrating the latest tools and technologies, many of which are cutting-edge open source solutions, we stay ahead in delivering efficient and effective testing services. This approach allows us to provide exceptional quality testing without the high costs typically associated with advanced testing methodologies.
      Understanding each client's unique needs is fundamental to our service delivery. At Frugal Testing, the focus is on creating customized testing strategies that align with specific business goals and budget requirements. This client-centric approach ensures that every testing solution is not only effective but also fully aligned with the client's objectives.
      Our team is our greatest asset. Composed of skilled professionals who are experts in the latest testing techniques and technologies, they bring dedication, expertise and a commitment to excellence in every project. This expertise ensures that our client’s software not only meets but often exceeds the highest standards of quality and performance.
      Frugal Testing is more than just a service provider; we are a partner in your success. With a blend of quality, innovation and cost-effectiveness, we are here to help you navigate the complexities of software testing, ensuring your product stands out in today's competitive market. 
      · 0 replies
      1. This update has no replies.
    • ChunkCat

      I have no clue where to upload this, so I'll put it here. This is pre-op vs the morning of my 6 month appointment! In office I weight 232, that's 88 lbs down since my highest weight, 75 lbs since my surgery weight! I can't believe this jacket fit... I am smaller now than the last time I was this size which the surgeon found really amusing. He's happy with where I am in my weight loss and estimates I'll be around 200 lbs by my 1 year anniversary! My lowest weight as an adult is 195, so that's pretty damn exciting to think I'll be near that at a year. Everything from there will be unknown territory!!

      · 3 replies
      1. AmberFL

        You look amazing!!! 😻 you have been killing it!

      2. NickelChip

        Congratulations! You're making excellent progress and looking amazing!

      3. BabySpoons

        So proud of you Cat. Getting into those smaller size clothes is half the fun isn't it?. Keep up the good work!!!!

  • 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

    ×