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Aetna 2015 Weight Requirements

Hi everyone!

I'm in the home stretch of the VSG pre-approval process and the worry that Aetna will deny me has started to creep in. I'm getting a bit panicky!

I started the process with a 41 BMI. No co-morbidities.

My 2013 and 2014 BMI was 38 (I was on Diet2Go in 2014 and Nutrisystem in 2013).

I've provided the surgical coordinator with BMI records for 2013 and 2014, but she doesn't believe they are needed. I'm not so sure. More so, I'm worried that not having a 40 BMI in 2014 and 2013 will cost me surgical approval.

Has anyone had experience with Aetna in 2015? Whatever experience you can share would be helpful.

Thanks in advance!

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    I was approved!!!!! Surgery is June 9th!

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    I have Aetna and so far my pre-op journey has been such a pain! I finished with all of the requirements (blood work, sleep study, 4 weight loss appointments at least 30 days apart with the doctor, 2

  • handymannynyc1
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    @@marybowlus I in NY and the people at work that got the surgery done said it took a week to two weeks before approval.

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Hi! I am new to the group. I just submitted my insurance forms to aetna. I am hoping to get approved. My BMI is 36 and I have sleep apnea. I struggled with my weight since I was 16. Now at 42, I am tired of dieting and not losing. I called insurance today and it still is pending. Did anyone get approved with a borderline BMI and sleep apnea?

Well, it's been one week and one day and Aetna still show my paperwork as pending . . . Guess it's time to relax, enjoy the weekend and pray I've got a favorable answer this upcoming week.

  • Author

Mary - here's hoping you hear something on Monday. Fingers crossed!

I have managed to stay busy all weekend but as the work week approaches I find myself thinking about the pending decision with Aetna. Thanks for all of the encouragement! I pray that tomorrow is the day I know one way or the other! Will keep you all posted!

I have Aetna and so far my pre-op journey has been such a pain! I finished with all of the requirements (blood work, sleep study, 4 weight loss appointments at least 30 days apart with the doctor, 2 required psych evaluations with two different psychologists, an EGD, a cardiac stress test, leg ultrasound or Doppler on my legs for blood clots and medical clearance from my cardiologist, pulmonologist and endocrinologist) in April. I have insulin dependent diabetes for 41 years, hypertension and CAD with a stent. My BMI at my first weigh in was 41. My surgeon scheduled me for surgery on May 4th knowing everything they wanted was completed and then sent for approval. Wrong! My last weigh in appointment with my doctor was one day too early, because we calculated wrong because of the short month of February. I had to schedule another appointment for another final weigh-in but could not be scheduled until May 14. My coordinator also told me not to gain an ounce over my original weight or I would not be approved (no problem - I lost 21 lbs which took me down to BMI 38 which was fine). I was rescheduled for surgery on May 20 after my first date was cancelled. Needless to say I've been on pins and needles waiting for approval which finally came this afternoon because my coordinator has been on the phone with them constantly until they gave her an answer. The day after tomorrow is my day! All I can say is make sure every whim your insurance company wishes for is taken care of perfectly! The stress alone with this process is enough to send us all to our local psych ward!

Hi everyone!

I'm in the home stretch of the VSG pre-approval process and the worry that Aetna will deny me has started to creep in. I'm getting a bit panicky!

I started the process with a 41 BMI. No co-morbidities.

My 2013 and 2014 BMI was 38 (I was on Diet2Go in 2014 and Nutrisystem in 2013).

I've provided the surgical coordinator with BMI records for 2013 and 2014, but she doesn't believe they are needed. I'm not so sure. More so, I'm worried that not having a 40 BMI in 2014 and 2013 will cost me surgical approval.

Has anyone had experience with Aetna in 2015? Whatever experience you can share would be helpful.

Thanks in advance!

. I have United Healthcare//Oxford & got approved for revision (band to sleeve) BMI is 28. Surgery is May 27th. Got approved in 8days!!!! Yeaaah Boyyyyyyy!!!!!

Edited by ASLEEVE4ME2015

Congrats and good luck to you! I'm still waiting to hear from Aetna. My surgeon's office called Friday but when I called today Aetna told me they have until the 21st to make a decision. Praying for patience!

Approved! Yahoo!!!

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