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!

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

Congratulations!\

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

If you submitted the documentation, were there specific forms?

Just got approved. Surgery date June 29th. I better start getting my thing together.

@@handymannynyc1 . . . CONGRATULATIONS!!!

Thanks. Let's get healthy woo hoo

Congrats to those of you who have been approved!!!! When the time comes for my case to be approved, the success you all have had gives me hope of being approved with little to no issues.

Again Congrats!!!

Rhonda

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

Congratulations!\

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

If you submitted the documentation, were there specific forms?

The doctor submitted everything

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

Congratulations!\

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

If you submitted the documentation, were there specific forms?

The doctor submitted everything

Thank YOu Bunny! I was feeling a bit invisable as no one responded.

I am overseas with American insurance. They have a very different system here. Not sure how I will go about this, but I will figure it out on my own I guess.

Thank You again!

So, question. I did a three month program specifically for diet and exercise at a facility. I have the paperwork that shows what I weighed at the beginning and at the end of that time, and recent weigh-ins at the Dr.s have shown that I have not gained all of it back. Most, but not all. Is that sufficient for Aetna do you think? Or will I still have to do the three month program? I have all the other clearances scheduled, just getting anxious about that one. Thoughts???

I'm with Aetna as well. From my understanding you have to provide a 2 year weight history as well as follow a doctor's supervised diet program for 3 months. I'm unsure if you're able to follow a program that's not your surgeon. During the 3 months, there can be no weight gain or you'll be denied. Not sure if this info is helpful.

@@thbrown223 Thanks!

The two year weight history is no longer required.

3 to 6 month monitored by your surgeon.

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.

Edited July 3, 201511 yr by muzical1

@@muzical1

I'll try...thanks!!

@ how is it going after your surgery?