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

My paperwork was officially submitted to Aetna yesterday, so while I am twiddling my thumbs waiting to hear something (an approval, HOPE-HOPE-HOPE!), please share your Aetna experience!

  1. How long did it take for you to get an answer once your paperwork was submitted?
  2. Has anyone with a high BMI and co-morbidities been denied? If so, why?
  3. Do your ears hang low, do they wobble to and fro? <g>

  • Replies 242
  • Views 34.8k
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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.

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!!!!

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!

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!

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

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

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

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!!!!!

Don't be discouraged, things will work out

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?

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?

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!

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.

Aetna looks for documented weight that should be fine.

Thanks guys. I should be good money then. Have my psych evaluation and last weigh in to go and that is on Jan 11th. I'm so motivated.

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