Introducing myself...

I'm 36 yrs old... current weight is 255. I'm worried because I'm 5'10" and my BMI has only ever hit 40 when I was pregnant. I suspect I have sleep apnea and will be getting a sleep study done soon. How bad is it that I want to be diagnosed with that so I can qualify?! This is such an emotional roller coaster. I don't know what I'm asking... I guess just some support from those who have been through Aetna.

Typically, from what I've seen if your Bmi is lower than 40, insurance will approve 35 and above with a co- morbidity. Do you have high blood pressure, cholesterol or anything? Welcome! Good Luck!

Only HBP during pregnancy... I'm hoping to be diagnosed with sleep apnea so that would qualify me. I feel like my head is spinning and I'm just starting the process, lol!!

Thank you!!!

I totally understand. I'm waiting on insurance approval. My paperwork was submitted on 1/11. I am obsessed reading all the posts and trying to pass the time until I get the determination from them. I got denied in July because I didn't meet the 5 year weight history. I skipped going to the doctor one year so re-applying now that we are in a new year! Best of luck to you!

Surgery postponed!! Can't seem to get a reply from the insurance company ohh my gosh! I was supposed to be sleeved on Tuesday, January 15th and here I still sit on Thursday, January 17th. Since then I thought all was going to be good. During this journey I have been diagnosed with sleep apnea, anxiety, arthritis, hiatal hernia and chronic gastritis besides high blood pressure and a BMI of 42... I thought, all the making of a quick approval but apparently not. I've been told by the doctor again maybe next week.. Monday they say by Thursday and now yesterday they said maybe next week ughh. Aetna Ins.

Until then I am still on my protein shakes doctor said that I could have a little bit of vegetables green... I was so frustrated that by the time I got off work at 5 I went to my mother's and I ate a small salad with lettuce tomatoes onions and garlic sprinkled with a vinegarette... And 1 cup of fat free chicken broth.. And 2 cup reg chicken broth . Yes I ate all of that Yesterday only.... After drinking 3 of my protein shake earlier that day ... Today back to protein shake and water and jello. Uggh... I started all liquid diet January 2nd 2013 at 221down and since a week ago til..today...208lbs. I seem to have been at a standstill for the past week anyway. Uggh! NJ HERE.

Introducing myself...

I'm 36 yrs old... current weight is 255. I'm worried because I'm 5'10" and my BMI has only ever hit 40 when I was pregnant. I suspect I have sleep apnea and will be getting a sleep study done soon. How bad is it that I want to be diagnosed with that so I can qualify?! This is such an emotional roller coaster. I don't know what I'm asking... I guess just some support from those who have been through Aetna.

Aetna is one if the easy insurance company I was approved in 24 hrs w really no health issues I'm 5'8 280 pounds I just have pre hypertension

I was approved in. 2 days by Aetna

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Take a deep breath. All will work out. I am very surprised you got a surgery date without having prior approval from the insurance company. Usually they will not schedule a date until your pre-approval comes thru. The best thing I did was to go to Aetna's website and look up info on bariatric surgery requirements. Then I called Aetna and they told me what my employer signed up for and if they even pay for bariatric surgery. Once I was assured and knew what the criteria was I set about making sure I had the 5 years of history records, The list of attempts of types of diets I had tried and failed, The different diagnosis from Diabetes to High blood pressure to bad knees and sleep apnea to allergies etc.. I collected several progress notes from the general doctor; cardiologist (pacemaker); even the neurologist. I collected clearance letters from all 3. I saw the Psych eval as instructed; I had the EKG, Endoscopy done and my gallbladder checked for stones as requested. I followed the instructions of the insurance secretary at my Docs office to the letter and felt confident that I would get approved with a BMI over 52. It took 2 weeks and 2 phone calls to Aetna to move the paperwork but it came thru fine. Hope this helps.

Surgery finally happened Yesterday... They called me Monday approx. 8 hours after my previous post..saying ready to go Tuesday..January 22, 2013. Still in the hospital had to stay an 2013. day do to vomiting and excuciating pain. . I managed to get down maybe 1 oz. of soup broth.

Congratulations! You are now on the other side!!! We are here for you. Get in the chat room if you can stay awake a little and talk to everyone. They may have some ideas and lots of empathy. It will get better so don't try and rush it. Sip Sip. They likely have you still on a drip for fluids? I was in the hospital for a week so I had IV for 4 days before they stopped to see if I would drink enough. That was 12/16/12 so hang in there... it does get better.

Introducing myself...

I'm 36 yrs old... current weight is 255. I'm worried because I'm 5'10" and my BMI has only ever hit 40 when I was pregnant. I suspect I have sleep apnea and will be getting a sleep study done soon. How bad is it that I want to be diagnosed with that so I can qualify?! This is such an emotional roller coaster. I don't know what I'm asking... I guess just some support from those who have been through Aetna.

I got approved 37 BMI thru Aetna I am 2 weeks post surgery and I had my approval within 24 hrs

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Awsome! Congrats!!!!! Keep us posted.

Introducing myself...

I'm 36 yrs old... current weight is 255. I'm worried because I'm 5'10" and my BMI has only ever hit 40 when I was pregnant. I suspect I have sleep apnea and will be getting a sleep study done soon. How bad is it that I want to be diagnosed with that so I can qualify?! This is such an emotional roller coaster. I don't know what I'm asking... I guess just some support from those who have been through Aetna.

Hi. I've made my initial consult meeting for March.....couldn't get in sooner. Good luck with the insurance. I have Empire NYS insurance and I'm hoping all goes well. Anyone have experience with them?

Welcome Dee, No, I have Aetna but the same principles should apply if they follow the guidelines and your policy covers bariatric surgery. Call Empire and get the details and restrictions if any. That should ease your mind a bit. Hope it all works well..

I have Aetna and when I called the company they said they will cover it 100%! I am still waiting for approval but the insurance person at my doctors office said not to worry about it all should be well. It may be your company who determines what they will cover and what they won't. I don't think it's Aetna itself but the agreement your company and the insurance company got into.

Hi TalibahT, Your right, it does depend on the agreement between company (employer) and Aetna and even though Aetna says it will cover 100% there are guidelines that still must be followed to obtain the pre-certification so a good insurance secretary at the Doctors office should know what those guidelines are and let you know. Follow to the letter and you should have no problems. Good Luck!