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

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LesIsMore    22

LesIsMore
Posted

Denied by atena 39.5 bmi high cholestral n high blood pressure peer to peer was thurs no word yet

What's involved in a peer to peer?

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ChrisBthin    44

ChrisBthin
Posted

Approved...today by Aetna...Surgery on Tuesday. ..

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ChrisBthin    44

ChrisBthin
Posted

Thanks!

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laffypatty    47

laffypatty
Posted

Initially denied....approved this morning after peer to peer!!!!!!!!!

37 BMI

Tons of comorbids but nothing that Aetna usually considers. So grateful!!

Tentative surgery date of June 5th

Miss Piggy,

Would you mind sharing with me some of your comorbids that Aetna doesn't usually consider. I have none on their "list," but lots of orthopedic problems related to excess weight. Thanks for any info. Feel free to private message me if that makes you more comfortable.

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buplee    556

buplee
Posted

My bmi was 49 with no comorbities and I was initially denied by Aetna twice. I was only required to undergo three months of nutritional counseling but ultimately went though 12 months. I was denied the first time because my surgery was outside of process by 4 days due to a holiday weekend, and told to go through three more months of nutritional supervision.

I'm fought with Aetna for 18 months before hiring a healthcare advocate at great cost, who threatened to sue and go to the media. She also wrote a scathing letter to the Chief Medical Officer stating the same and detailing the huge liability to Aetna based on my medical history. I had a knee replacement, spinal/neurosurgery, and several of procedures which were mostly weight related. i received a call from the medical review and appeals department overturning the denial one week after the letter was received by the CMO. I was finally sleeved on 2/19/13 and I am down 80 lbs so far.

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quackstitch    10

quackstitch
Posted

so you can use the weight from a hospital procedure? I might need to do that-- for bcbs MI

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Bellanthin    112

Bellanthin
Posted

Appppppprovvvvedddddd

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LesIsMore    22

LesIsMore
Posted

Appppppprovvvvedddddd

Congrats. How long did it take, what is your surgery date, and with what Dr? So exciting!!!

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Bellanthin    112

Bellanthin
Posted

Congrats. How long did it take' date=' what is your surgery date, and with what Dr? So exciting!!![/quote']

well my original dtae was may 21 ive been fighting since then no date yet cause i called atena and found out couldnt wait any longer for letter ill update on surgery date i was denied the day before surgery

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becky2013    11

becky2013
Posted

Doc. submitted paper work on Friday 7/12/2013. Still waiting to hear something from Aetna. If approved I think my surgery date will be 8/12/2013. Will be so happy to get this done and hope to get off my BP meds, CPAP machine, Fluid pills, and hope my Knees feel better. I pray that the Lord guides the Doctors hands while he preforms this surgery on everyone having the surgery. NO LEAKS!! AMEN

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ChrisBthin    44

ChrisBthin
Posted

Aetna takes up to 15 days...

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becky2013    11

becky2013
Posted

Well found out today that Aetna denied my surgery due to not completing the 90 days.

I counted up and I had completed 97 days. Doc will appeal and there will be a Pier to Pier review.

Sure hope it doesn't take to long for them to approve this. Surgery was scheduled for Aug. 12, 2013.

Can hardly wait to get this weight off and new improved health. Come on AETNA help me make this happen. :unsure:

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ChrisBthin    44

ChrisBthin
Posted

Well found out today that Aetna denied my surgery due to not completing the 90 days.

I counted up and I had completed 97 days. Doc will appeal and there will be a Pier to Pier review.

Sure hope it doesn't take to long for them to approve this. Surgery was scheduled for Aug. 12' date=' 2013.

Can hardly wait to get this weight off and new improved health. Come on AETNA help me make this happen. :unsure:[/quote']

Someone had there dates wrong!!! Call them yourself they will answer any questions you have.

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Go To Topic Listing Insurance & Financing

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    • Alisa_S

      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.
      · 0 replies
      1. This update has no replies.
    • Alisa_S

      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

        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

      CaseyP1011

      Officially here for a long time, not just a good time💪
      · 0 replies
      1. This update has no replies.
    • KimBaxleyWilson

      KimBaxleyWilson

      Three months and four days ago... I was in Costa Rica having a life changing surgery! Yesterday we had a followup visit with Dr. Esmeral via video chat and this morning my middle number changed.  I'm down 47lbs and two pants sizes. I can wear a Large tshirt for the first time in like... 14 years! Woot!! Everything is going great. I have zero regrets. I went down to the riverwalk with a friend and walked 2 miles on Monday without even getting fatigued. And no more snoring or chugging pickle juice for crazy leg cramps! I need to go to the gym more... I'm making new shirts next week so that will motivate me. LOL But I'm also just not as TIRED all the time! I have a LONG way to go...but seeing the progress on the scales and in the mirror is a huge motivator!! Thank you all for cheering me on and supporting me!!
      · 0 replies
      1. This update has no replies.
    • bellaamey

      bellaamey

      https://alluniqueguide.com/java-burn-coffee-reviews/
      · 0 replies
      1. This update has no replies.

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