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

Aetna...What did you do to get approved?



Recommended Posts

1. General practitioner weight loss appointment 1 x every month for 5 months. Never gained but showed a loss. Dr had me on phentermine for 3 of the months so I wouldn't gain during this time period. Btw this was a new Dr that I had just obtained last October so no two year weight history was necessary.

2. Nutritionist 1 x every month for 3 months.

3. Psych doc approval. Already had been seeing him for 1 1/2 yr. So only 1 visit was necessary.

4. 1 overnight sleep test to establish sleep apnea.

+ Established knee problems

+ Meds for bi-polar cause weight gain. Make me extra hungry!

I was approved in 4 days after paper work submitted.

Hope this helps. Good luck!

Share this post


Link to post
Share on other sites

I have a question about this: is this a 1 pound weight gain over-all; or any 1# weight gain at any time during the trial?

In other words, say I started at 100# and ended up at 99#, but during 1 month I went up to 101# - would this be a disqualifier? Or is the net loss at 99# the magic number? Hope I have made myself clear....

Correct. It is a 3 month or six month program depending on doctor. Mine was 3 months.


I finished the three month supervised diet, unfortunately I gained one pound. Would this little gain get me denied ?

Share this post


Link to post
Share on other sites

It is the net amount. I gained in middle but ended up 1 lb under. Approved no problem.

That's good. In my last visit, I lost a couple of pounds.

I was submitted on Tuesday morning.

Share this post


Link to post
Share on other sites

I was approved in less than 24 hours !!

Share this post


Link to post
Share on other sites

I just submitted my paperwork for approval on 7/9 and waiting anxiously for approval. I had 4 visits with my surgeon, 1 nutrition eval, and 1 psych eval along with other tests and labs. Did anybody else get approved with 4 surgeon visits and 1 nutrition eval? I'm starting to get worried because I see most people had 3 visits with nutritionist.

Share this post


Link to post
Share on other sites

I just submitted my paperwork for approval on 7/9 and waiting anxiously for approval. I had 4 visits with my surgeon, 1 nutrition eval, and 1 psych eval along with other tests and labs. Did anybody else get approved with 4 surgeon visits and 1 nutrition eval? I'm starting to get worried because I see most people had 3 visits with nutritionist.

I had 4 Nut Visits but don't worry, they might have put it down for u. Is the office your with well known?

Share this post


Link to post
Share on other sites

I also have Aetna through my employer and I have one last NUT visit before they will submit my auth request. Was it hard for you to get your approval I am a little nervous about being denied. I have an extremely high BMI of 48. I weigh 258 and I am only 5 ft even, but I don't have any comorbidities. Please let me know. I am getting anxious and I am so ready to get this surgery done.

Share this post


Link to post
Share on other sites

I actually just got my approval today... I've been fighting with Aetna since February trying to get approved. I gained 9 pounds during my supervised nut visits so I got denIed. I just won the external review. I think as long as you don't gain weight during the process and do everything they require you should be okay.

Edited by dede0314

Share this post


Link to post
Share on other sites

I actually just got my approval today... I've been fighting with Aetna since February trying to get approved. I gained 9 pounds during my supervised nut visits so I got denIed. I just won the external review. I think as long as you don't gain weight during the process and do everything they require you should be okay.

That part about not gaining weight is a little crazy, we wouldn't be here if we could just stop gaining weight on our own.... just saying... my wife and I were both approved, and were sleeved last December. At our last weigh in prior to approval, she was 10 lbs up from where she started, we had both been on that rollercoaster all our lives. A quick trip to GNC for a 7 day cleanse did the trick! We are both down over 100lbs now, and living much healthier lives!!! FYI if this happens to you, don't let Aetna hold your past against you!

Share this post


Link to post
Share on other sites

Question – I saw my surgeon the beginning of July, but could not see the NUT until the end of August. The 90 day program outlined by Aetna – does anyone know if that is 90 days from seeing the NUT, or is it from when the process began with doc?

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

  • Trending Products

  • Trending Topics

  • Recent Status Updates

    • jparadigm

      Happy Wednesday!
       
      I hope everyone is having a lovely week so far! 
      It's been a bit of a struggle this last week...I'm hungry ALL the time.
      · 1 reply
      1. BlondePatriotInCDA

        Have a great Wednesday too! Sorry you're hungry all the time, I'm pretty much the same..and I'm sick of eating the same food all the time.

    • ChunkCat

      Well, tomorrow I go in for an impromptu hiatal hernia repair after ending up in the ER over the weekend because I couldn't get food down and water was moving at a trickle... I've been having these symptoms on and off for a few weeks but Sunday was the worst by far and came with chest pain and trouble breathing. The ER PA thinks it is just esophagitis and that the surgeon and radiologist are wrong. But the bariatric surgeon swears it is a hernia, possibly a sliding one based on my symptoms. So he fit me into his schedule this week to repair it! I hope he's right and this sorts it out. He's going to do a scope afterwards to be sure there is nothing wrong with the esophagus. Here's hoping it all goes well!!
      · 2 replies
      1. AmberFL

        omgsh!! Hope all goes well!! Keeping you in my thoughts!

      2. gracesmommy2

        Hope you’re doing well!

    • jparadigm

      Hello lovlies!
      Today is a beautiful day in west Michigan! I hope you all have a beautiful Tuesday and rest of your week!! 🤗
      · 0 replies
      1. This update has no replies.
    • Clueless_girl

      Having gall bladder surgery in a few days and I so hope the recovery is easier than the one from the modified DS! I could use a bit of luck/pep talk for a change. I'm starting to be able to walk around without experiencing dizziness, but it would be great if the random pain in my chest and abdomen would go away!!
      · 0 replies
      1. This update has no replies.
    • Dawn 1974

      4/4/2024 - new patient orientation. Wt 313
      4/5/2024 - got all my lab work done.
      · 0 replies
      1. This update has no replies.
  • 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

    ×