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Aetna Please Help!



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Hello everyone I have a question I have my third visit on 2/23 and was previously told my doctor office that I had 3month supv diet and that the first visit counts... now after all that they call to tell me know that I would have to do another visit that the first visit didn't count...anyone know if the first visit counts this office seems not to know things...first the told me I needed 6 months of supervised visits then I called insur co and they told me 3 months so I called the dr office back and they said "Oh well that person misspoke it is 3 months" Now I am rethinking going through them since they seem like they don't know what they are doing..

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I have Aetna and my policy has two options: 3 month or 6 month. The 3 month is more involved but that is the one I chose. I met with the nutritionist 3 times. I think it depends on what you did on the first visit.

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I have Aetna and I was required 6 mos dr visits, psych eval, nutritionist visit and last two years of dr visits with weight recordings.

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I have Aetna POS and they have a 100% no on any WLS. Be grateful you have it covered either way.

I would ask for it in writing to cover any future issues.

I personally went to MX to avoid all this.

Good Luck to you!

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Yea I was wondering the same thing if the first visit was covered....hopefully they will say

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Waiting for approval now. Had the last of 3 visits yesterday. I had my first appointment in Oct but didn't realize that the 3 appointments hade to be "consecutive" months. I had a delay in making my 2nd appointment in Nov and couldn't get in. Had to start the whole thing over in December. They want 3 appointments in 90 Days, consecutive months. You also have to have a letter from a PCP, psych eval, documented weight history for 3 years. The surgeon also required a sleep study. I'm not familiar with the 6 month plan but I know that was an option. If they approve, and I'm told they prob will (BMI 49 with comorbids) then they will pay 90%. I'm crossing every finger and toe. Your plan might be different. But Aetna is one of the few who do pay.

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Ok so your first visit counted? because then that would be 90 days.....I have to call my insurance company to see if my first visit with dr count

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The first visit to the doctor did NOT count. It was the 3 visits of supervised weight loss with the Nutritionist and the doc or in my case, nurse practitioner. I went for initial appointment in August. I have a connective tissue disorder that the surgeon needed to investigate before he'd take me on. I didn't find out until Sept that he would so then I had an appointment in early Oct. I had to get BP meds started and a sleep study and I left that appointment without scheduling the next (never do that again) and when I called in mid Nov to go back, they were full ( holidays). So the whole damn thing started over in December (except I didn't have to see surgeon again). Just make all 3 appointments and KEEP them. This practice is very busy, they can't squeeze you in unless someone is having complications.

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I have a question. I know with the PCP you have to see him/her the same time every month. But what about the nutritionist. Do you see them the same time every month too. I've called/email my Dr's office several time with no answer. I just started my journey two weeks ago.

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I also have Aetna and I had to see a nutritionist. personal trainer and my doctor once a month for 3 months. I missed December due to scheduling, but I filed the insurance anyway. I did see the other 2 in 3 months, the doctor was 4 months. I have doubts I'll be approved as I've been told Aetna is very strict. I have a BMI of 38 with no co-morbidities. I'm not holding my breath.

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Good luck to everyone...

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I have a question. I know with the PCP you have to see him/her the same time every month. But what about the nutritionist. Do you see them the same time every month too. I've called/email my Dr's office several time with no answer. I just started my journey two weeks ago.

I didn't have to see the PCP every three months, just the nurse practitioner at the surgeon office and the Dietician. I had to have a letter of support from my PCP though.

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So after the 3 months of everything I needed to do I was denied because I don't have enough health issues to qualify. Oh well--I've been saving money for a long time just in case this was how it was going to be. March 19th - here we go :

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I'm so sorry. That stinks.

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      On day 4 of the 2 week liquid pre-op diet. Surgery scheduled for June 11th.
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      On day 4 of the 2 week liquid pre-op diet. Surgery scheduled for June 11th.
      Soooo I am coming to a realization
      of something and I'm not sure what to do about it. For years the only thing I've enjoyed is eating. We rarely do anything or go anywhere and if we do it always includes food. Family comes over? Big family dinner! Go camping? Food! Take a short ride or trip? Food! Holiday? Food! Go out of town for a Dr appointment? Food! When we go to a new town we don't look for any attractions, we look for restaurants we haven't been to. Heck, I look forward to getting off work because that means it's almost supper time. Now that I'm drinking these pre-op shakes for breakfast, lunch, and supper I have nothing to look forward to.  And once I have surgery on June 11th it'll be more of the same shakes. Even after pureed stage, soft food stage, and finally regular food stage, it's going to be a drastic change for the rest of my life. I'm giving up the one thing that really brings me joy. Eating. How do you cope with that? What do you do to fill that void? Wow. Now I'm sad.
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      1. summerseeker

        Life as a big person had limited my life to what I knew I could manage to do each day. That was eat. I hadn't anything else to look forward to. So my eating choices were the best I could dream up. I planned the cooking in managable lots in my head and filled my day with and around it.

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        BTW, the liquid diet sucks, one more day and you are over the worst. You can do it.

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