Jump to content
×
Are you looking for the BariatricPal Store? Go now!
$99 Yearly Supply Alert! 🌈 "1 per Day!" Bariatric Multivitamins

I am so confused!

kaclimer

By kaclimer, in Insurance & Financing

Recommended Posts

kaclimer    0

kaclimer
Posted

I went to Dr. Hamn's seminar last week and saw him today for my consult. They gave me a sheet that told me what my insurance (Aetna HMO) required. It had all the usual (BMI of 35-40 or more, 6 month supervised diet, nutritional eval, psyc eval) but the part that is confusing is they said I needed to show the 'presence of severe obesity that has persisted for at least 5 years.' And that they need a copy of at least one office visit for each of the last 5 years that has my weight on it. Not a letter from the doctor saying I have been over weight, they need to see the actual medical records.

My problem--I have seen the doctor every year EXCEPT 2005! I saw them in 2001, 2002, 2003, 2004, 2006, and 2007.

My question--The official criteria on Aetna's website does not say I have to do that. It says 'Presence of severe obesity that has persisted for at least 5 years defined as any of the follow': BMI exceeding 40, or BMI greater than 35 with co-morbidities. I am wondering if I am going to be out of luck since I might not have consecutive years, or is that a rule the doctor requires to gather the information? For goodness sakes, I was obese in 2001, 2002, 2003, 2004 and 2006, one would reason that I would have been obese in 2005. :biggrin1:

Anyway...I was wondering if anyone else had to provide that kind of information. Especially with Aetna.

Share this post

Link to post
Share on other sites

AnnaB6    1

AnnaB6
Posted

Yes I know I also have Aetna POS and I can't seem to locate 2005 records I rarely go to the doctor. I think I have seen my obgyn more than I have seen my pcp. I hope everything goes well for you please keep me posted.

Share this post

Link to post
Share on other sites

Alexandra    55

Alexandra
Posted

That is not going to matter. If the last doctor note you had was back in 2000 it would be an issue, but you're totally good. You've got more medical backup than many people do!

Share this post

Link to post
Share on other sites

FurEllie    0

FurEllie
Posted

Yes I know I also have Aetna POS and I can't seem to locate 2005 records I rarely go to the doctor. I think I have seen my obgyn more than I have seen my pcp. I hope everything goes well for you please keep me posted.

Did your OB/GYN weigh you? Mine always does (darnit) and it seems like that would be proof enough you were overweight then.

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
Go To Topic Listing Insurance & Financing

  • Trending Products

  • Trending Topics

  • Recent Status Updates

    • ChunkCat

      ChunkCat

      I have no clue where to upload this, so I'll put it here. This is pre-op vs the morning of my 6 month appointment! In office I weight 232, that's 88 lbs down since my highest weight, 75 lbs since my surgery weight! I can't believe this jacket fit... I am smaller now than the last time I was this size which the surgeon found really amusing. He's happy with where I am in my weight loss and estimates I'll be around 200 lbs by my 1 year anniversary! My lowest weight as an adult is 195, so that's pretty damn exciting to think I'll be near that at a year. Everything from there will be unknown territory!!

      · 3 replies
      1. AmberFL

        AmberFL

        You look amazing!!! 😻 you have been killing it!

      2. NickelChip

        NickelChip

        Congratulations! You're making excellent progress and looking amazing!

      3. BabySpoons

        BabySpoons

        So proud of you Cat. Getting into those smaller size clothes is half the fun isn't it?. Keep up the good work!!!!

    • BeanitoDiego

      BeanitoDiego

      I changed my profile image to a molecule of protein. Why? Because I am certain that it saved my life.
      · 1 reply
      1. BabySpoons

        BabySpoons

        That's brilliant! You've done amazing!! I should probably think about changing my profile picture at some point. Mine is the doll from Squid Games. Ironically the whole premise of the show is about dodging death. We've both done that...

    • eclarke

      eclarke

      Two years out. Lost 120 , regained 5 lbs. Recently has a bout of Norovirus, lost 7 pounds in two days. Now my stomach feels like it did right after my surgery. Sore, sensitive to even water.  Anyone out there have a similar experience?
      · 0 replies
      1. This update has no replies.
    • Eve411

      Eve411

      April Surgery
      Am I the only struggling to get weight down. I started with weight of 297 and now im 280 but seem to not lose more weight. My nutrtionist told me not to worry about the pounds because I might still be losing inches. However, I do not really see much of a difference is this happen to any of you, if so any tips?
      Thanks
      · 0 replies
      1. This update has no replies.
    • Clueless_girl

      Clueless_girl

      Well recovering from gallbladder removal was a lot like recovering from the modified duodenal switch surgery, twice in 4 months yay 🥳😭. I'm having to battle cravings for everything i shouldn't have, on top of trying to figure out what happens after i eat something. Sigh, let me fast forward a couple of months when everyday isn't a constant battle and i can function like a normal person again! 😞
      · 1 reply
      1. kezbeth

        kezbeth

        I may have to have gall bladder surgery during my weight loss surgery. Not thrilled about it either but do not want 2 recovery times. Just want it over with.

        Thanks for your post. I may need to rethink my decision... :(

  • Recent Topics

  • Hot Products

  • Sign Up For
    Our Newsletter

    Follow us for the latest news
    and special product offers!
  • Together, we have lost...
      lbs

    PatchAid Vitamin Patches

    Bariatric Forums

    For Patients

    Health Professionals

    Search Surgeons

    Bariatric Surgeons: Want to research a weight loss surgery surgeon? Enter their last name below to start!

    ×