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!

My surgeon's office called me. I'm scheduled for June 18th. They wanted to do it the week of June 2nd but I'm on vacation the next week and I've already booked my trip so I couldn't cancel. I'm just so thankful to be at this point! Thank you for your encouragement and support! It is greatly appreciated!!!

Congratulations

Congrats @@marybowlus

congratulations! I am still waiting, I hope I get good news. I have called Aetna twice a day. May 27 will be the 15th day deadline.

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

I was reading intently hoping you were approved. Congratulations! I have Aetna as well. I'm in the very beginning stages of this process. I can only pray that I'm approved.

Trying to get all the data together to submit to Aetna and am wondering if anyone can give me some hints or information.

I have a BMI of 39, recently diagnosed with fatty liver. My PCP is willing to write a letter recommending weight loss surgery. I have documentation for a minimum of the last 4 years of GMI greater than 35, except for one period of time when I was on a 900 calorie medically supervised diet and lost 50 lbs that was approximately 2.5 years ago. I have regained all of that weight back. I have documented lab values with pre-diabetes and increased cholesterol. In my documentation it clearly shows when I lost weight my lab values were greatly improved.

Some of my questions are:

Do you submit all of the data, or does your physician?

If you submitted the documentation, were there specific forms?

Does anyone know how particular Aetna is regarding the medically supervised diet – does it have to be within the last two years?

I am sure I will think of more, I am just trying to get all of the paperwork together. Just not sure where to start. To add confusion to all of this I am presently living out of the country, but have insurance through work, which is a US company. So part of the reason I am asking so many questions, it is difficult to just pick up the phone and call the insurance company.

Thank you!

Mary@marybowlus. So how many days from submission to approval? I will be ready for submission the first week of July. I really need a mid July surgery date to fit my calendar. Thanks

Submitted on May 7th and approved on May 21st. It was two weeks exactly but I've heard others say it can be done quicker. I hope that's your case. I called every day but I don't think that helped. I would definitely call 24-48 hrs after paperwork is submitted just to make sure they got it.

I was the same as you with Aetna... My BMI was 42 with no co-morbidities... I did my 3 month weight management program and Aetna approved me with no problem... It took like 2 weeks... I had my Sleeve surgery on 4/29/2015... I hope that helps...

Thanks for the responses. Hoping for 2 weeks then. Have two more nutritionist appts, exercise physiology eval, blood work and EKG. Hoping to get all the extras done by last nut appt

Staying busy helped to pass time! Good luck on everything!

I was just approved by Aetna a 5/15 letter for vsg. I guess the office submitted very quickly since my final nutritionist appt was 5/11! I was very worried about the net gain issue since I gained about 3-4lbs all of which was after my Lapland was removed on 4/15.

I was the same as you with Aetna... My BMI was 42 with no co-morbidities... I did my 3 month weight management program and Aetna approved me with no problem... It took like 2 weeks... I had my Sleeve surgery on 4/29/2015... I hope that helps...

Hi. Did they submit your weight history. My bmi is about the same but i am worried about my weight history not being over 40 the past two years.

I was the same as you with Aetna... My BMI was 42 with no co-morbidities... I did my 3 month weight management program and Aetna approved me with no problem... It took like 2 weeks... I had my Sleeve surgery on 4/29/2015... I hope that helps...

Hi. Did they submit your weight history. My bmi is about the same but i am worried about my weight history not being over 40 the past two years.

I did submit 2 years of weight management documentation, but 1 year my BMI was like 35, then I got pregnant and wham-o it went to 42... It was an easy process and the insurance would rather pay for it than to have a legal battle over weight management.... it will be a success!!!

Finally after 16 days and many phone calls, I was approved for my june 4 surgery.