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Impatiently waiting for Aetna



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The first sleep study that is done is just to see if you have sleep apnea or some kind of sleep disorder depending on the results if you have severe sleep apnea they do a study withe the CPAP machine and I'm all for it the more severe the better my chances of an approval I'm hoping! Since I don't have the 2 year history they require.

I also do not have the two-year history of obesity, although since my physician is not submitting my file for approval until January 2014, he is hoping to have the two years (2013-14) count. Good luck!

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Wish me luck guys! On my way to the hospital!! Will be sleeved by this evening! This was the longest six months but worth the hard work!! For all of you who have had insurance setbacks hang in there and keep at it!

What and exciting and nervous time! I'm wishing you all the luck and many prayers for a successful surgery! I just got approved on Tuesday and I'm anxious to get a date set! Anyway, can't wait to hear how your surgery went!!!

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Wish me luck guys! On my way to the hospital!! Will be sleeved by this evening! This was the longest six months but worth the hard work!! For all of you who have had insurance setbacks hang in there and keep at it!

Nh20013,

Finally! Today you are on the losers bench. I will keep you in my thoughts and prayers for an quick recovery. How are you doing?

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Thank you I just got home from the hospital and everything went well.. Not much pain .. Did get the trapped gas everyone talks about but walked some and it went away. Came home without the drain so thar was great! Oh and nausea a few times .

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Thank you I just got home from the hospital and everything went well.. Not much pain .. Did get the trapped gas everyone talks about but walked some and it went away. Came home without the drain so thar was great! Oh and nausea a few times .

Hi nh200013,

Welcome home to your new life :-). So glad the pain has been manageable. Bummer about the nausea. Thanks for the update. Keep up the good progress

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So I found out today that as of November 19th I have FINALLY been APPROVED FOR SURGERY!!!!!!! YAY!!!! I'm so excited that I almost screamed on the bus!!! I'll definitely be calling my surgeons office I'm the morning to let them know and have them call and get me scheduled before January 1st!

My surgeons surgery scheduler called me at 7:30 tonight and we set my date. I'll be getting sleeved on December 16th! HAPPY HAPPY JOY JOY!!!!

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My surgeons surgery scheduler called me at 7:30 tonight and we set my date. I'll be getting sleeved on December 16th! HAPPY HAPPY JOY JOY!!!!

Woohoo SoPeachy28 is on her way! What a perfect gift. When do you start your pre-op diet?

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Woohoo SoPeachy28 is on her way! What a perfect gift. When do you start your pre-op diet?

Thank you so much UberBuffaloGal!!!! They wanted to do it the day after my bday on the 13th. But I plan on celebrating so I took the next date! I have to do a 2 week pre-op diet, so as of 12/3 which is my daughters bday I'll be on full liquids. No cake for me, lol!!!!!

Have you heard anything from Aetna yet UberBuffaloGal? What's your progress???

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Thank you so much UberBuffaloGal!!!! They wanted to do it the day after my bday on the 13th. But I plan on celebrating so I took the next date! I have to do a 2 week pre-op diet, so as of 12/3 which is my daughters bday I'll be on full liquids. No cake for me, lol!!!!!

Have you heard anything from Aetna yet UberBuffaloGal? What's your progress???

SoPeachy28

How's the pre-op diet going? I am so jealous :-). What date is ur surgery? I am having a second sleep study Dec30. So won't even turn in final appeal till mid January probably. I am okay no matter what. God has a plan :-). Tho it would be nice to have such a great tool to help me lose this weight. Good luck girl, you've got this ;-)

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SoPeachy28 How's the pre-op diet going? I am so jealous :-). What date is ur surgery? I am having a second sleep study Dec30. So won't even turn in final appeal till mid January probably. I am okay no matter what. God has a plan :-). Tho it would be nice to have such a great tool to help me lose this weight. Good luck girl, you've got this ;-)

Hey UberBuffaloGal!!!!

It's been quite a while! I was hoping to hear that you were approved and waiting to have surgery! I'm so sorry that Aetna is still being non-compliment. Your very right God does have a plan, a great one and your definitely in it!!!! Pre op diet is hard but this is week two and I got it under control. The first 3-4 days are rough. So be ready! My surgery date is 12/16! Hopefully it stays that way, during my pre op with Anesthesia my potassium came back low. So hopefully it was a false reading!

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Hey UberBuffaloGal!!!!

It's been quite a while! I was hoping to hear that you were approved and waiting to have surgery! I'm so sorry that Aetna is still being non-compliment. Your very right God does have a plan, a great one and your definitely in it!!!! Pre op diet is hard but this is week two and I got it under control. The first 3-4 days are rough. So be ready! My surgery date is 12/16! Hopefully it stays that way, during my pre op with Anesthesia my potassium came back low. So hopefully it was a false reading!

Hi SoPeachy28,

Sorry so long the holidays are crazy over here in Casa Buffalo, lol. Namely my family is crazy and I need time to recover.

So why is low potassium bad? What does it mean and how does it affect surgery?

I really admire you! Two weeks of pre-op, Wow!

I am reading a book called "Life Interrupted" and it is about how after the fact we can see how God has guided our path, but how sometimes in the moment we want our will not his. Lol, that is so my life right now.

Anyway, enough about me, SURGERY!!! You must be so excited. What time do you go in? Ill b praying for you. I am in California, What time zone r u in? Keep in touch when you can. All the best.

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Hi SoPeachy28, Sorry so long the holidays are crazy over here in Casa Buffalo, lol. Namely my family is crazy and I need time to recover. So why is low potassium bad? What does it mean and how does it affect surgery? I really admire you! Two weeks of pre-op, Wow! I am reading a book called "Life Interrupted" and it is about how after the fact we can see how God has guided our path, but how sometimes in the moment we want our will not his. Lol, that is so my life right now. Anyway, enough about me, SURGERY!!! You must be so excited. What time do you go in? Ill b praying for you. I am in California, What time zone r u in? Keep in touch when you can. All the best.

Hey UberBuffaloGal!!! It's always good to hear from you! Trust me I truly understand. So they say low potassium and effect your heart rhythm I didn't really read too much into it I just knew they said it could cause surgery to become pushed back. That sounds like a great book I'm going to purchase it on kindle. I understand with this surgery you get to the point where your like I want this but God will drop it in your lap at the right time! You will be doing this in no time, don't you worry about it! I am super excited about the surgery. It was originally for 10:30 a.m. Eastern time, but on Friday I got a call that someone was cancelled so it was moved up to 9 a.m. So check in is at 7. I'm so nervous and anxious and scared and excited all rolled up into one ball. I'm ready though! You'll be telling me these same things next month hopefully!!!!! I will definitely keep you posted! Well it's 10:51 pm here and I'm going to shower and wash my hair and have my last SF Popsicle and have a bottle of water!!! goodnight UberBuffaloGal!

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I have Aetna and a BMI of 50 with sleep apnea, hypertension and arthritis. I'm still doing my 90 days (it just started officially because of a scheduling snafu). I was sure I would be easily approved but now I'm worrying after reading this! To come all this way and not be approved would be so heartbreaking. I have Aetna through Vanderbilt univ med center which is where I'm having surgery. I'm hoping that might help. Did anyone with Aetna and a higher BMI get approved easily??? I thought the higher BMI might help?

Best of luck tomorrow! Sending good thoughts!!!

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I have Aetna and though I am post-op now, I am still not 100% sure I am approved. I was able to go through something called the "Hernia Program", which was offered at the office I visited. Essentially because I had a hiatal hernia, this was included in the surgery and was submitted to Aetna along those lines. I paid a total of $2900 to the main surgeon, $1000 to the accompanying surgeon, and $1000 to the hospital, as my share. The rest is supposed to be paid by insurance, but honestly I haven't heard from Aetna yet about the status of the claim.

Just an FYI, my BMI is 48, and I have been diagnosed with sleep apnea since 2007. Somehow though those two criteria were not the critical deciders on whether I would be covered. It was strictly determined by the presence of that hiatal hernia.

Edited by Wolfy

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I thought Aetna required a BMI of over 40 or a BMI under 40 with 2 co-morbids. But by reading this thread, it sounds like it was more complicated than that.

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