Hi All

I have been researching for a while and I have my first appointment with a surgeon today to discuss getting sleeved.

I have Aetna insurance. My BMI is right at 40. (5’3, 224) From what I understand, I have to have 4 consecutive months with a dietitian under my belt. As long as I’m at BMI 40 they will cover the cost. I’m worried I will lose too much weight in the 4 months then I won’t be eligible. If I’m between 35-40 BMI I have to have a comorbidity and I don’t have one. For whatever reasons (insurance ugh) I cannot get a straight answer from Aetna. Maybe all my questions will be answered today just wondering if anyone has any insight on this topic.

My insurance required all my weights for the past two years, plus all my nutrition visits to be above 40. Any one below would disqualify me.

I ended up paying cash, and traveling to Florida. It's a huge risk if you drop below. Don't trust us, nor your Dr, get it from your insurance company yourself to be safest.

Best wishes!

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My insurance required all my weights for the past two years, plus all my nutrition visits to be above 40. Any one below would disqualify me.

I ended up paying cash, and traveling to Florida. It's a huge risk if you drop below. Don't trust us, nor your Dr, get it from your insurance company yourself to be safest.

Best wishes!

Sent from my XT1254 using BariatricPal mobile app

That whole 2 year thing frightens me... do you have aetna?

No, I have blue cross blue shield Federal. Its spelled out very clear in my policy, so I knew it up front. It would have really shucked had I gone through the process, then found out.

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Dee_Rose this is the link to the Aetna Obesity Policy

http://www.aetna.com/cpb/medical/data/100_199/0157.html

Dee_Rose this is the link to the Aetna Obesity Policy

http://www.aetna.com/cpb/medical/data/100_199/0157.html

I have read through this and I only half way understand it ( I also have a college degree am I nuts?) My dr says Aetna only needs 4 consecutive months of dietitian and this says 6?? Nothing about 2 years... for my situation I don’t think... I’ll call them again... they are not so great on the phone.

1 hour ago, Dee_Rose said:

I have read through this and I only half way understand it ( I also have a college degree am I nuts?) My dr says Aetna only needs 4 consecutive months of dietitian and this says 6?? Nothing about 2 years... for my situation I don’t think... I’ll call them again... they are not so great on the phone.

I just got approved!!!!!!!!!!!!! That was so fast. I sent you a private message with info.

I just got approved!!!!!!!!!!!!! That was so fast. I sent you a private message with info.

Oh wow awesome!!! That was so fast too!!!

BGMOM12 aetna- thank God they didn't forget ya! Congratulations on your date, when is it so we can pray for a smooth surgery.?? Oh I'm so happy, always happy when somebody gets scheduled. Takes my mind off my own bumpy road to RnY.

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I have read through this and I only half way understand it ( I also have a college degree am I nuts?) My dr says Aetna only needs 4 consecutive months of dietitian and this says 6?? Nothing about 2 years... for my situation I don’t think... I’ll call them again... they are not so great on the phone.

I am in health care and it makes about as much sense as mud.

1st. Not all Aetna plans cover weight loss surgery. It is specific to your policy.

2nd. You must have a BMI if greater than 40. If your BMI is between 35-40 you have to have one of the following. A. High Blood Pressure not controlled by a minimum of 3 medications. B Heart disease like coronary artery disease. C Type 2 Diabetes.

3rd. You have to have been part of a doctor supervised weight loss program for at least 6 months during the last 2 years and been in one for at least 90 continuous days.

So basically if your policy covers it and your BMI is greater than 40 and you have been under a doctor supervised weight loss plan for 6 months at any time during the past 2 years they should approve it.

I have Aetna and just started for conversion. I was told not to gain even half an ounce from my initial weight at the first appt.

I also have Aetna and I only had to do 3 consecutive months of Nutrition counseling before scheduling a surgery date. My BMI is 45 so I didn't have to worry about the pre-surgical weight loss. I hope all goes well for you. Aetna has actually been pretty good about answering my questions so far.

On 2/27/2018 at 8:11 PM, kakatlady612 said:

BGMOM12 aetna- thank God they didn't forget ya! Congratulations on your date, when is it so we can pray for a smooth surgery.?? Oh I'm so happy, always happy when somebody gets scheduled. Takes my mind off my own bumpy road to RnY.

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Thank you for the will wishes!!!!!!!!!!!! I go 3/28. I am so excited.

And well you should be, I'm sure we will all be praying for you on that day. Hey I just started a March Success stories thread this AM, hopefully my surgical act will get together and I can be one of you guys. At any rate congratulations again on your date.

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