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

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Bmarion662    76

Bmarion662
Posted

I have Aetna approved on the Feb 4th good till Aug 4th

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Miss Piggy    30

Miss Piggy
Posted

Bumping back up :)

I have my psychologist, nutritionist & PT appointments tomorrow with my final appointment on April 11th and then it's off to Aetna. SOOOOOOOOOOOO beyond nervous. Any other Aetna updates :D

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mwrarr    244

mwrarr
Posted

I finally was approved!!! :) AND...I will be sleeved one week from today, which will be exactly to the day, 15 months since I started this whole process!!

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Seanja    117

Seanja
Posted

Good luck to all. Aetna is great @ approving. You should have no problem. I will be sleeved next week tuesday. Cant wait.

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Kelly33    4

Kelly33
Posted

I just called Aetna and they just received my precert yesterday. The doctors office never sent it out when they were suppose to. I spike with a rep and he stated that its under nurse review. I am praying that I get approved.

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Caligirl530    6

Caligirl530
Posted

I am tracking down my two years of weight and I will be submitting to insurance next week. Wish me luck in 2011 I did a medically supervised diet an lost some weight and got my BMI to 30 although it did not last long I am hoping it does not affect my approval

ps.

my BMI is 39 and I have sleep apnea...

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2013myyear    0

2013myyear
Posted

I have been dealing with Aetna and the Doctors office. I am supposed to have my surgery a week from today and they denied the pre cert on Monday because I guess 3 months of weigh in is not 90 days. Between dealing with them and the surgeons office, I am driving myself crazy. My insurance is ending the end of the month and the coverage is much better with this plan versus my husbands. It has just been a nightmare. I have spent so much time with Aetna and getting the run around. We are just trying to schedule a peer review and you can't get anyone live. This week is not looking like it will happen. So frustrating.

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mwrarr    244

mwrarr
Posted

I have been dealing with Aetna and the Doctors office. I am supposed to have my surgery a week from today and they denied the pre cert on Monday because I guess 3 months of weigh in is not 90 days. Between dealing with them and the surgeons office' date=' I am driving myself crazy. My insurance is ending the end of the month and the coverage is much better with this plan versus my husbands. It has just been a nightmare. I have spent so much time with Aetna and getting the run around. We are just trying to schedule a peer review and you can't get anyone live. This week is not looking like it will happen. So frustrating.[/quote']

Oh man...I feel for ya. That's what happened to me. I 1st was supposed to have it in October, but was req'd additional cardio testing due to family history. That took too long to schedule in, so it was pushed to Dec. 2 weeks before, they said they were missing part of the 2 year history. All the way up to mid-Feb I still wasn't sure it ever would happen bc time was running out on the appeal. It was so depressing, chaotic, unnerving...you name it!

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amgood    30

amgood
Posted

My info was submitted to Atena Friday. I'm so excited and nervous. Hope to hear something soon. I'm wanting to wait until the end out May first of June to have my surgery anyway. School gets out then and I will be able to spend some time with my kiddo.

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0tracy0    6

0tracy0
Posted

I was denied twice by Aetna. I just found out today that my appeal was approved. Thank God!!!!

Mocha-NJ reacted to this

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Kelly33    4

Kelly33
Posted

I was denied twice by Aetna. I just found out today that my appeal was approved. Thank God!!!!

Yay....do u have a date?

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LifeBackNye7    44

LifeBackNye7
Posted

Process went fairly smooth for me. Before searching for a surgeon I inquired with Aetna to see what their qualification were since all plans are different. For my specific plan I had to get a psy, pulmonary and meet with my surgeon 3 times for 90 days to discuss weight nutrition and ect. Oh and also 2 years of weight history. It took four days for an approval. I was sleeved on 4/1/13 ;) Start to finish took 4 months which includes the 3 months of visits with my surgeon. Good Luck to all those waiting for an appoval

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brandyrn73    13

brandyrn73
Posted

My coordinator submitted to Aetna today for the second time. I was denied last year for a BMI <40 with no co-morbidity. I'm now 39+ BMI with sleep apnea. Yay for sleep apnea! Lol here's hoping for an approval this time!!

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Go To Topic Listing Insurance & Financing

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    • Aunty Mamo

      Aunty Mamo

      Iʻm roughly 6 weeks post-op this morning and have begun to feel like a normal human, with a normal human body again. I started introducing solid foods and pill forms of medications/supplements a couple of weeks ago and it's really amazing to eat meals with my family again, despite the fact that my portions are so much smaller than theirs. 
      I live on the island of Oʻahu and spend a lot of time in the water- for exercise, for play,  and for spiritual & mental health. The day I had my month out appointment with my surgeon, I packed all my gear in my truck, anticipating his permission to get back in the ocean. The minute I walked out of that hospital I drove straight to the shore and got in that water. Hallelujah! My appointment was at 10 am. I didn't get home until after 5 pm. 
      I'm down 31 pounds since the day of surgery and 47 since my pre-op diet began, with that typical week long stall occurring at three weeks. I'm really starting to see some changes lately- some of my clothing is too big, some fits again. The most drastic changes I notice however are in my face. I've also noticed my endurance and flexibility increasing. I was really starting to be held up physically, and I'm so grateful that I'm seeing that turn around in such short order. 
      My general disposition lately is hopeful and motivated. The only thing that bugs me on a daily basis still is the way those supplements make my house smell. So stink! But I just bought a smell proof bag online that other people use to put their pot in. My house doesn't stink anymore. 
       
      · 0 replies
      1. This update has no replies.
    • BeanitoDiego

      BeanitoDiego

      Oh yeah, something I wanted to rant about, a billing dispute that cropped up 3 months ago.
      Surgery was in August of 2023. A bill shows up for over $7,000 in January. WTF? I asks myself. I know that I jumped through all of the insurance hoops and verified this and triple checked that, as did the surgeon's office. All was set, and I paid all of the known costs before surgery.
      A looong story short, is that an assistant surgeon that was in the process of accepting money from my insurance company touched me while I was under anesthesia. That is what the bill was for. But hey, guess what? Some federal legislation was enacted last year to help patients out when they cannot consent to being touched by someone out of their insurance network. These types of bills fall under something called, "surprise billing," and you don't have to put up with it.
      https://www.cms.gov/nosurprises
      I had to make a lot of phone calls to both the surgeon's office and the insurance company and explain my rights and what the maximum out of pocket costs were that I could be liable for. Also had to remind them that it isn't my place to be taking care of all of this and that I was going to escalate things if they could not play nice with one another.
      Quick ending is that I don't have to pay that $7,000+. Advocate, advocate, advocate for yourself no matter how long it takes and learn more about this law if you are ever hit with a surprise bill.
      · 0 replies
      1. This update has no replies.
    • BeanitoDiego

      BeanitoDiego

      Some days I feel like an infiltrator... I'm participating in society as a "thin" person. They have no idea that I haven't always been one of them! 🤣
      · 0 replies
      1. This update has no replies.
    • ChunkCat

      ChunkCat

      Thank you everyone for your well wishes! I totally forgot I wrote an update here... I'm one week post op today. I gained 15 lbs in water weight overnight because they had to give me tons of fluids to bring my BP up after surgery! I stayed one night in the hospital. Everything has been fine except I seem to have picked up a bug while I was there and I've been running a low grade fever, coughing, and a sore throat. So I've been hydrating well and sleeping a ton. So far the Covid tests are negative.
      I haven't been able to advance my diet past purees. Everything I eat other than tofu makes me choke and feels like trying to swallow rocks. They warned me it would get worse before it gets better, so lets hope this is all normal. I have my follow up on Monday so we'll see. Living on shakes and soup again is not fun. I had enough of them the first time!! LOL 
      · 0 replies
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    • BeanitoDiego

      BeanitoDiego

      Still purging all of the larger clothing. This morning, a shirt that I ADORED wearing ended up on top. Hard to let it go, but it was also hard to let go of those habits that also no longer serve my highest good. Onward and upward!
      · 0 replies
      1. This update has no replies.

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