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Aetna 2015 Weight Requirements

SleevePerry

By SleevePerry, in Insurance & Financing

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thbrown223    214

thbrown223
Posted

The two year weight history is no longer required.

Really? Aetna sent me a form when I began to inquire about the coverage for the surgery, this was in late April/early May. The form listed that a 2 year weight history is required. My initial surgeon appt was in late May and the patient coordinator asked for it.

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thbrown223    214

thbrown223
Posted

In my experience having my PCP document my need to lose weight over several consecutive years was a good thing. However, his letter to Aetna also needed to indicate the same. My BMI fluctuated between a 38 up to 41 at time of this process. I was approved with no problem. My WL surgeons office knew how to put all docs together to meet their approval and they made sure I followed their checklist . From what I see on this site, that's the biggest part. I even gained 3lbs during my weight management period but ended with a net loss of 1lb submitted to insurance. Try not to stress.

Amazing how you here so much different information. I was told that I could not gain any weight because I would be denied. I don't have to lose weight during my pre op phase, I just have to maintain and not gain.

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khaled    23

khaled
Posted

The two year weight history is no longer required.

Really? Aetna sent me a form when I began to inquire about the coverage for the surgery, this was in late April/early May. The form listed that a 2 year weight history is required. My initial surgeon appt was in late May and the patient coordinator asked for it.

Some people got approved without the two year weight history

Look at this thread

http://BariatricPal.com/index.php?/topic/344120-For-Aetna-people

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Invictus    56

Invictus
Posted

All my "stuff" was submitted yesterday. Advocate said they run about two weeks for approval in her experience. Here's hoping its sooner! Starting preop diet Monday as surgeon gave me a date under the assumption I would be approved.

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khaled    23

khaled
Posted

I was approved in less than 24 hours ! I didn't have two year weight history.

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