Help! In January my insurance (Aetna) declined my pre-authorization for the surgery because I had gained a few pounds (on and off, 5 at the most) during the 6 month diet monitoring period. They told me I would have to start my 6 month diet monitoring over again and resubmit. My 3rd appt for the second 6 month monitoring period is coming up and I'm up in weight from last month. I have been sick and not able to stay on top of the dieting and exercising recently. I am feeling better now and have started with the diet and am joining a gym tomorrow, but I fear it might be too late.

I started this process last June and I am losing hope that this will ever happen. Has anyone else gone through something similar? Any suggestions on how to hang on or keep hope?

Thank you!

Jenna

Consider doing the pre op all liquid diet. I lost 15 lbs in 2 weeks and gives you training for post op. Google pre op liquid diet and meal and will show up.

Aetna only has a " net " loss requirement so unless you gained from your initial weigh in weight I don't understand why they would deny you. I gained twice during the 6 month review period but overall had a loss. I was approved in less than 24 hours. I know several others who did the same? I would clarify reason for denial. as far as current problem with gaining perhaps you need additional support. I know it is tough but it is tough after surgery too so don't give yourself the okay to go off the wagon.

I have Aetna and managed to get approval first time out. To lose my weight, I used a modified version of my pre-op diet (protein shakes (4 a day) and non-starchy veggies). I added limited amounts of lean meats and fruit. I also upped my exercise. It wasn't easy. But I lost the weight Aetna wanted and had approval in less than 12 hours.

It's a net gain but some employers have additional stipulations tacked on. I hate aetna. You can actually lose no weight and get approved but gain a pound and you're done.

I would give serious thought to an appeal. Send in medical records for last couple years especially if you can show it was a momentary lapse