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It is true about the variation in info. Just keep calling until you hear you're approved!

The info. Pretty much is the same but some representatives would "give more" info. More details does that make sense??!! ;). Good Luck!!!!

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I've been approved!!! I go this week to get my date! I'm so excited to get this show on the road! :)

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Congrats. I fought with Aetna for 18 months before hiring a healthcare advocate and threatening to sue and to go to the media before I was approved.

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Congrats. I fought with Aetna for 18 months before hiring a healthcare advocate and threatening to sue and to go to the media before I was approved.

I have Aetna...I am one more visit away from submitting. I have already confirmed that my plan covers WLS and my surgeon's office confirmed this and also confirmed a 3 month period of doctor visits and other requirements(which I have met, including a letter from my primary doctor recommending WLS) My BMI is 41, my suregon and insurance coordinator seem confident that I will be approved. Can I ask why you were denied for 18 months? None of my business really I am just curious/worried about what I may be up against.

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I was denied twice because I had no other illnesses. I do not have high blood pressure, diabetes, or sleep apnea, so I was deemed too healthy. This even though I have been up and down my entire adult life and had a bmi of 49. I ultimately hired a healthcare advocate who helped me fight them and finally got approved.

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I was denied twice because I had no other illnesses. I do not have high blood pressure, diabetes, or sleep apnea, so I was deemed too healthy. This even though I have been up and down my entire adult life and had a bmi of 49. I ultimately hired a healthcare advocate who helped me fight them and finally got approved.

well that is very discouraging. I know all health insurance plans are different depending on what your employer chooses. Everything I have read about Aetna says BMI of 40+ or 35 + with co-morbitities. I certainly hope my surgeon and insurance coordinator wouldn't waste their time or mine. Keeping my fingers crossed and happy you are finally approved.

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Thank you and best wishes to you. I work for a fortune 40 insurance company so coverage was not an issue. Aetna was just being a jerk about. My company guideline deemed a bmi of 40 sufficient enough will no other comorbities.

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I'm so happy for you ! Congratulations!

Thank you!! :)

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    • 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. 
       
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    • 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.
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    • BeanitoDiego

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    • ChunkCat

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    • 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!
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