Jump to content
×
Are you looking for the BariatricPal Store? Go now!

Impatiently waiting for Aetna



Recommended Posts

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!

Share this post


Link to post
Share on other sites

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!!!

Share this post


Link to post
Share on other sites

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?

Share this post


Link to post
Share on other sites

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 .

Share this post


Link to post
Share on other sites

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

Share this post


Link to post
Share on other sites

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!!!!

Share this post


Link to post
Share on other sites

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?

Share this post


Link to post
Share on other sites

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???

Share this post


Link to post
Share on other sites

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 ;-)

Share this post


Link to post
Share on other sites

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!

Share this post


Link to post
Share on other sites

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.

Share this post


Link to post
Share on other sites

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!

Share this post


Link to post
Share on other sites

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!!!

Share this post


Link to post
Share on other sites

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

Share this post


Link to post
Share on other sites

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.

Share this post


Link to post
Share on other sites

Create an account or sign in to comment

You need to be a member in order to leave a comment

Create an account

Sign up for a new account in our community. It's easy!

Register a new account

Sign in

Already have an account? Sign in here.

Sign In Now

  • Recent Topics

  • Most popular:

  • Recent Status Updates

    • SabrinaGoddess

      I hate these Lovenox shots.  That is all! LOL
      Feeling like a pin cushion.
      I know they are needed and it's only 10 days worth but I really hate giving myself shots. It's one of the reasons I want to be healthy because diabetes runs in my family

      · 2 replies
      1. Jenpet

        Weight Loss Queen

      2. Jenpet

        Weight Loss Queen

    • SabrinaGoddess

      Yas, I am HOME! Traveling back home was interesting but I made it.
      For the first time in my flying life we had NO drink service due to the turbulence! It was crazy. I had to call the steward to bring me water. You CAN NOT let yourself get behind on drinking! That would be dangerous.
      My new blog post is up! https://sabrinagoddess.com/day-3-4-post-op-doc-visit

      · 0 replies
      1. This update has no replies.
    • SabrinaGoddess

      I am OFFICIALLY SLEEVED! (surgery was Dec 9th, 2019)
      It was an easy procedure for me and I am not having complications. If you want to see part one of my journey go here: https://sabrinagoddess.com/life-on-the-other-side-post-op-wls
      I will be making new posts during this whole process!

      · 5 replies
      1. GreenTealael

        💚CONGRATULATIONS💚

      2. Billy Bob

        Glad you survived . lol

      3. SabrinaGoddess

        @billybob I am thriving and breathing! That's a blessing!

      4. BayougirlMrsS

        yeahhhhhh we are only 3 months apart on the sleeve journey. I found it has been way easier to lose with the sleeve than it was with the band...... although i loved my band. Sleeve was the easiest SX i ever had too.....

      5. SabrinaGoddess

        @bayougirlmrss I was told this is the fastest weight loss surgery, but I am not really looking for extremely fast. I want it to be healthy. This is our new tool and we can use it wisely for sure. Are you taking your biotin and vitamins?

    • SabrinaGoddess

      TOMORROW IS MY DAY! (note this did not post properly so I am still  posting it after the fact)
      I am so very excited! My sister is here with me and my son. I am so excited. My anesthesiologist called me tonight to discuss our plans for tomorrow. I am not feeling nervous at all. Just excited for the future!
      I did buy a few bottles of CFpreop which is really suppose to help you stay hydrated. It's pricey but I feel it's worth it. I tried the Watermelon tonight. I have to stop all liquids after midnight and I go into the hospital at 5:30am for check in. My surgery is at 8am.
      SO HAPPY for this journey!
      You can get the CFpreop on Amazon if anyone is interested. It comes in Watermelon and White Grape.
      Read my night before thoughts on: www.SabrinaGoddess.com

      · 2 replies
      1. Jenpet

        Weight Loss Queen

      2. Jenpet

        Weight Loss Queen

    • Arabesque

      Today I said I’m an XS or size 8 (Aust) at a clothing store. I never thought I’d say those words and say them with confidence. And when I commented a dress was too big on me I was told it was the smallest size. As was the belt I wanted. 
       
      I tried on a slim fitting singlet dress yesterday & was shocked to realise the lumpy bits on the dress were my hip bones. I have an hour glass shape so I always had hips but never ones that stuck out on the front of my body! 

      I’ve been a size 10 before - for about 5 minutes. While I am now confident about saying I’m an 8, clothes shopping is all still a bit freaky for me. It’s not that I’m focussed on the size on the label. I’m well aware the cut/line of the clothes and the designer’s style will dictate what size I need or if it will suit my body shape. The size is the starting point & it’s starting at an 8/XS/38 which is a big mind set change. It’s thinking a pair of pants will be too small & discovering they are almost too big. 

      While I’m still coming to terms with my actual new body shape and size, I’m very happy to be in this new reality. 
       
      · 4 replies
      1. ms.sss

        Yay!!

      2. ms.sss

        ...ah! I see you are from Brisbane! We lived there for a year when Mr. got a work contract there.

        I have fond (and not-so-fond, lol) memories of the weather there this time of year. It it crazy hot yet?

      3. Arabesque

        Hit 42degress last weekend but this week has been in the rather pleasant low 30s (relatively of course😜). Could still wear jeans but thank goodness for air conditioning. Worse is the drought. Everything is dying or dead. Very sad & depressing.

      4. ms.sss

        I feel ya.

  • Trending Topics

  • Together, we have lost...
      lbs
    ×