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Aetna POS II - Sent to Medical Director for Final Approval

Anyone that has Aetna, does the Medical Director review the pre cert prior to approval or if they are going to deny you ? Ive heard that the only reason they send it to the Medical Director is because they are going to deny you ? Can anyone give feedback.....

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This is exactly what I went through with Aetna. Same plan also. I didn't have as much recent weight history as they required. Spoke with an RN having my case. Explained it to her in detail and pleased my case. She took it to her medical director and I got approved within a week or so. Surgery was Oct. 8. Down 40 lbs. Feel great. Healing from the issue out. No regrets. Good luck!

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Thanks you hear so many rumors you don't know what to expect sometimes , I'm trying to be patient but the insurance waiting has been the worst so far

I just re-read my post. Freaking auto-correct on my phone makes me look like I write like a 3rd grader. Sorry for all of the typos.

BCBS new York silver plan. Submitted Oct 3 and still waiting. Anyone going through this with the same plan in New York. Ugh!

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