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AETNA and weight gain.



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For those of you who have AETNA, be careful about your weight gain. I have AETNA open access and I called the insurance company to verify because I was told previously that it was ok as long as there is no net gain at the end of my 3 months. WRONG! There cannot be any weight gain during your 3 month or 6 month weigh-ins with your PCP or surgeons office. You will be denied. Make sure you have lost weight each time you go in to weigh-in. With that being said make sure you know what your policy entails.

Edited by Ladiec2

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I have Aetna as well and at my first appointment with my nutritionist, she told me that I could not gain even one pound during my six month approval process.

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I have Aetna as well and at my first appointment with my nutritionist, she told me that I could not gain even one pound during my six month approval process.

Just curious, with your policy did you not have the option to do the 90-day weight loss regimen?

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No I didn't. My insurance is through my employer and the plan requirement for us is six months. I think the six months is to weed out as many people as possible. Like I said I cannot even gain one pound.

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I had my surgery in June 2014 but prior to being approved, I was denied by Aetna. No one told me that I had to lose weight. So being in the blind about it on my last visit/weigh in, it was documented and I received word that I was denied by the insurance company and I was under the 3 month program. My doctor had to do a peer to peer with the insurance and they overturned their decision. I truly love my doctor because he knew that this was something that I truly needed. I am going into my 7 month and everyday I am thankful to both the doctor and the insurance company :)

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I spoke the the WLS "guru" from Aetna yesterday and she told me that there can't be a gain from the first weigh-in to the last. She said those are the weights they look at. It's a little frustrating that different people get different answers.

Edited by majorsmama

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