Hello,

I am in the process of starting my journey. I have my first meeting with the surgeon on Sept. 26. I have Aetna POS I am really nervous that they are going to deny me. Can anyone who has gotten approved by aetna tell me in detail what they did?

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 ?

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

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.

Thanks for clearing that up, kjsweigart; and much luck to you, Khaled.

I was approved in less than 24 hours !!

Congratulations!!!

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 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?

Approved today! 4 visits with surgeon, 1 psych eval, 1 nutrition eval and labs and tests ordered by surgeon

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.

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 September 8, 201510 yr by dede0314

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!

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?

Puddles - it's from the time you start your doctor supervised program, so for you, from July forward. Good Luck!

Gigi

Thanks!!

This process is a bit more complicated as I am living in Australia, but dealing with US insurance as we are working over here. I saw surgeon the beginning of July and started the process, but went home on leave for 30 days so did not start seeing everyone else until I got home the end of Aug. I am having to gather all the paperwork and submit it, rather than a care coordinator as they have a totally different medical system over here than we do at home and do not deal with our insurance directly. Really do not want to mess up the chances I have for approval so trying to make sure I have everything in order. If I do 90 days from when I saw NUT that is the end of November, verses being able to submit in October.