anybody eles with Aetna insurance?

[sueob1968 3]

I have an Aetna plan...the requirements will be different based on what your employer selected.

Originally' date=' they told my coordinator that I didn't have any requirements...just had to have "tried and failed" to lose in the past. When the coordinator submitted all of my paperwork, they told her I would be denied, because I didn't complete a 6 month diet.

We went ahead and submitted any way, so I could appeal once we had a denial in writing. It went to the physician director who did a peer-to-peer review with my surgeon and PCP and it was approved as medically necessary, without the diet.[/quote']

That is awesome...I am happy to hear your good luck-- It gives me a little hope that I won't be in limbo or in debt for the next 2 years.

[sueob1968 3]

Wow now I am nervous. I did a medically supervised diet within the twp years and got down to a BMI of 30 at the lowest. .. although that didn't last long. ... crossing my fingers!

I hope you get approved. Please keep posting...so I know...or email me. I wonder if your low weight was submitted. Hopefully, it wasn't, so it won't be denied...for the little bit of time you were down.

[Caligirl530 6]

Going in to swallow the camera today a little nervous! We submitted to insurance this week, so fingers crossed!

[0tracy0 6]

I have Aetna. I was just denied about 2 weeks ago because I lost weight about 2 years ago through diet and execercise. I have since gained every pound back and then some. My doc is doing a peer to peer review to see if she can get it overturned.

[RebecaSparkles 247]

I just found out that you can go to a lawyer to help you get your denial appealed. The one office I was looking at said that they do that on every denied case because it's discrimination and they lay out the costs of not doing the surgery to the insurance company.

[Caligirl530 6]

I have Aetna. I was just denied about 2 weeks ago because I lost weight about 2 years ago through diet and execercise. I have since gained every pound back and then some. My doc is doing a peer to peer review to see if she can get it overturned.

If you dont mind me asking.... whst is y our BMI and what did you get down to 2 years ago

[sueob1968 3]

That's a thought. How much does the lawyer charge?

[sueob1968 3]

BMI has been above 30, but not 35.... I was above 35 when I started seeing a weight mgmt specialist. he is a medical doctor.

[0tracy0 6]

If you dont mind me asking.... whst is y our BMI and what did you get down to 2 years ago

I got down to about 165. My BMI right now is over 50.

[0tracy0 6]

If you dont mind me asking.... whst is y our BMI and what did you get down to 2 years ago

I got down to about 165. My BMI right now is over 50.

[TrophyWife 11]

Ok, I have a question about everyones aetna approval experience. I have had my paperwork submitted to Aetna for approval 2 weeks ago today. I am right on the edge of the approval requirements and in my opinion could go either way. I am so on edge and reading things into everything. Taking so long because they are considering all options... haven't gotten to me yet.....needing more info... on and on. So here is my latest.

Friday I received a letter from Aetna and could hardly breath as I opened it. Inside was a letter telling me that a nurse would probably be contacting me to discuss how to use my insurance benefits to better my health. And in the part that says why they are sending it to you is several explanations, recent claims, preparing for surgery, etc, etc. So did anyone else get one of these on their journey to approval? Is the any signifigance to this or is it just something kicked out of a computer? I am going crazy waiting for the other shoe to drop. GET ON WITH IT ALREADY!

[sueob1968 3]

Ok' date=' I have a question about everyones aetna approval experience. I have had my paperwork submitted to Aetna for approval 2 weeks ago today. I am right on the edge of the approval requirements and in my opinion could go either way. I am so on edge and reading things into everything. Taking so long because they are considering all options... haven't gotten to me yet.....needing more info... on and on. So here is my latest.

Friday I received a letter from Aetna and could hardly breath as I opened it. Inside was a letter telling me that a nurse would probably be contacting me to discuss how to use my insurance benefits to better my health. And in the part that says why they are sending it to you is several explanations, recent claims, preparing for surgery, etc, etc. So did anyone else get one of these on their journey to approval? Is the any signifigance to this or is it just something kicked out of a computer? I am going crazy waiting for the other shoe to drop. GET ON WITH IT ALREADY![/quote']

I am not sure. After I was denied, they had a nurse call me to offer suggestions for losing weight. It doesn't sound like the same thing. While I appreciate the help, I would have preferred an approval. I submitted an appeal, it eas denied. Now I am waiting for a lawyer to call me back, hoping I can get help overturning their decision. (Aetna).

[Caligirl530 6]

Omg .... I submitted to Aetna on Thursday and was approved yesterday surgery set for the 22nd of April!!!! Ohhh lord thank you!!!

[TrophyWife 11]

Congratulations!! I am 12 days submitted and still no word. Did you find out through insurance or through your surgeon? I have considered calling insurance, but the nurse @ surgery center said to wait, but it is killing me. So excited for you.

[Caligirl530 6]

I found out through my surgeon office. It was completely unexpected so fast! I was worried because in the past two years at one point I got down to a 30 bmi during a medically supervised diet attempt but it came back and then some. So we submitted my weight including some from 2008 just to show this has been a battle for a long time... and it worked!!!! I will have hope for you too keep me posted! !!