Aetna Chioce POS II

[ItsFinallyMyTime 5]

How long does Aetna take to reply (approve) once everything is submitted? I have Aetna Chioce POS II. Anyone been approved witht his insurance - if so how long was the turn around?

[LonghornNiner 75]

I also have Aetna Choice POS II and it didn't take long at all. Since I had never been on a weight loss program or diet, Aetna had me go through a 90 day program that included eating a certain amount of calories a day and they also wanted me to lose a little weight before surgery. I also had to get a psych evaluation and go through a nutrition class. I was told this 90 day program was necessary to make sure I would succeed post-op. Not everyone has to do the program so you will probably have to wait to see if Aetna will need to you complete it first. I was approved the first time with completion of 90 day program. Good luck to you and I hope everything works out for you

[ItsFinallyMyTime 5]

Thanks LonghornNiner,

I did get a list of things to do prior to surgery. I have done them all and will complete the list on April 17th. It included the 90 day Nutritional counseling, 2 yr weight history, psyche eval, sleep study, plus two visits to actual DR doing surgery. They (the Nicholson Clinic) told me once all that was submitted they would send to Aetna for approval and schedule surgery as soon as they get approval. I am just trying to figure out how quick Aetna is at approving once everything is submitted

[LonghornNiner 75]

if you've done everything on the list, you should get an answer quite soon. like I mentioned before, I got approved within a week.

[thickums87 9]

I also have this insurance and is new to weight loss surgery. Could you list the steps you had to do in order to get approved?

[LonghornNiner 75]

your doctor will give you a list of what you need to do and Aetna should send you one as well .. good luck

[thickums87 9]

Ok, thanks

[ItsFinallyMyTime 5]

OK update... I completed the intro visit at Dr Nicks, 90 days of Nutritional counseling ( 4 visits total), the Psyche Eval (1 visit), the sleep study (1 overnight visit), second visit to Dr Nick, gathered 2 yr weight history ( by the way if you don't have adequate documented weight history - your primary doc can just write a note on letterhead stating your weights). My case was submitted to Aetna on April 23rd and was approved May 7th. This was a 14 day turn around, but I did stay on Aetna and the ins negotiator at my DR office almost daily... the file on top will get the attention . This Journey began with first visit with DR Nick on Dec 20th 2012 and was approved May 7th (138 days, or 19.7 weeks for the process) Surgery is scheduled for May 22nd. I am now in 2 week pre-op diet and SOOOOOOOOOOOOOOOOO EXCITED!

[thickums87 9]

I have the same insurance but the doctor that I'm going with is saying that I have to do the diet for a total of 6 months and that it if required by my insurance...What is wrong! :-(

[buplee 556]

I had the same Aetna plan and I was only supposed to submit to three months nutritional counseling. I was then told that I had no comorbities even with a bmi of 49. It took me 18 months of fighting with Aetna after two denials for approval. I finally had to hire a healthcare advocate and threatening to sue before Aetna reversed their decision.

[shasha 5]

I have the same ins also ...it took me all the above...with one appeal befor i WAS APPROVED... 4 WEEK BATTLE WITH AETNA...Thank GOD its approved

[jgcraftmom 41]

It all depends in your situation. It took less than a week for my approval. Good lunch to all!

[ItsFinallyMyTime 5]

Aetna has two choices that will qualify you for surgery. One is the path I choose, and the other is the 6 months of Dieting. You can find Aetna's guidelines on their website by doing a search once you are in the website for bariatric surgery. It details all the requirements for your plan. But whatever you have to do... stay on them cause you are your best advocate!

[thickums87 9]

So you did the multi disciplinary regiment...

[OKSleever 144]

It took me a week to get approved with a 36/37 BMI and 2 co-morbidities. I did the 90 day track.