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Aetna Help!

I am currently on my last month seeing my nutritionist for the 3 month program required by Aetna for WLS. So far all together I have gained 4lbs over the two months I have been seeing her and have yet to lose any.( I started at 391.6 my last WI was 395.6). I explained to my nutritionist that I was experiencing Water retention thus the reason for my weight gain. I struggle with PCOS which I've learned also makes it hard for me to lose weight. Last week I also found out that I may have ovarian cancer which my GYNO says is due to my size. I am currently 26 and on my parents medical plan which will end for me in 2015 so this is my last shot. If I don't get this surgery this year I will not have the opportunity again. I have seen different stories of people being denied due to gaining weight. Can anyone shed some light on this please? If I lose weight this month will I still be approved although I gained weight the first two months?

TIA

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  • blondiebabs
    blondiebabs

    I too have Aetna, the FL state workers version. You should lose some weight when you do the liver shrink diet. I think as long as you are at least a lb less than you were when you started you will b

  • brown eyed gal
    brown eyed gal

    I have Aetna. I went to my initial appointment on July 17, I specifically asked Dr. if I needed to "diet" now. He said no. So... I haven't been eating as well as I normally do. THEN two weeks aft

  • Hello all! I was also denied by Aetna for weight gain. I don't know where u all live, but I was given a lil tip from a friend on sending my appeal into Aetna... CONTACT YOU STATE REP AND UR STATE SE

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  • Author

They said the nutritionist wrote down that I started at 385 which I dont agree with and that my last weigh in was 392. So basically I gained 7lbs.

  • Author

What makes me the most angry is that I was told it didn't matter if I gained or not.

I would ask them to delay sending the package to insurance for 2 weeks. Make believe you are on a 2-week pre-op diet. You can knock the 7 lbs. off by then.

  • Author

I would ask them to delay sending the package to insurance for 2 weeks. Make believe you are on a 2-week pre-op diet. You can knock the 7 lbs. off by then.

Unfortunately, it has already been submitted. Im trying to remain optimistic my bmi is 58.8 with pcos and high blood pressure. I hope thats enough.

Unfortunately, it has already been submitted. Im trying to remain optimistic my bmi is 58.8 with pcos and high blood pressure. I hope thats enough.

OK, why not go on the diet, and IF they turn you down, do the Protein drinks & get a new number to go along with your appeal.

  • Author

That's my plan. I'm going to do my best to get back under "385" which apparently I started at in case that I am denied. Tomorrow I am calling the nutritionist to set up another appointment.

That's my plan. I'm going to do my best to get back under "385" which apparently I started at in case that I am denied. Tomorrow I am calling the nutritionist to set up another appointment.

Any word on ur approval??

  • Author

Any word on ur approval??

No not yet. But I am desperately contemplating calling them today and seeing if its been processed yet. Today is day 5.

Any word on ur approval??

No not yet. But I am desperately contemplating calling them today and seeing if its been processed yet. Today is day 5.

Can't hurt!! Praying for your approval!!
  • Author

Can't hurt!! Praying for your approval!!

Thank you!

  • Author

As of today I am APPROVED for surgery seven days after submission! I am so happy when she told me I yelled in excitement. I was discouraged for a moment but it happened! I have an appointment with my surgeon on August 21st so hopefully sometime next month I will be saying hello to a new me!

<p>As of today I am APPROVED for surgery seven days after submission! I am so happy when she told me I yelled in excitement. I was discouraged for a moment but it happened! I have an appointment with my surgeon on August 21st so hopefully sometime next month I will be saying hello to a new me!</p>

OMG!! CONGRATS!!! U must be thrilled!!

So happy for you!! :)

  • Author

OMG!! CONGRATS!!! U must be thrilled!!

So happy for you!! :)

Thank you! Any word on your appeal yet?

Not yet...but I will keep fighting!!

I'm calling Aetna now...they got my appeal letter last Friday. Pray for me!!

  • Author

Not yet...but I will keep fighting!!

I'm calling Aetna now...they got my appeal letter last Friday. Pray for me!!

Don't give up I am sure it will all be worth the fight for us both. Let me know if you find out anything and I will keep praying you get your approval soon.

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