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I had my finial visit with the Dietitian. She told me that my paperwork will be prepared today and give to Dr. McGill tomorrow for his approval. Once he sign off on my paperwork it will be submitted (by Friday) to Aetna for pre-certification. I'm a little worries because my final Weight 257/BMI is 41.5 with no Co-morbidities. During the 4 month process my weight did fluctuate.

  • Feb. 1, 2018 - Weight 261 / BMI 42.21 (Visit with Surgeon Dr. Kevin McGill)
  • Feb. 26, 2018 - Weight 261 / BMI 42.21 (1st Dietitian Visit)
  • Mar. 22, 2018 - Weight 263 / BMI 42.4 (2nd Dietitian Visit)
  • Apr. 23, 2018 - Weight 262 / BMI 42.3 (3rd Dietitian Visit)
  • May 29, 2018 - Weight 257 / BMI 41.5 (Final Dietitian Visit)

Does any know if Aetna will deny me because my weight fluctuated during the 90 day Multi-disciplinary surgical preparatory regimen?

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not the fluctuation that will be the deciding factor. Every Insurance company has a policy with the min. BMI and number of comorbidities required with each BMI level. The lower your BMI the more other issues you need to get approval. Don't know Aetna's policy but the weight fluctuations will only an issue if you happen to drop below their cut off BMI.

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Aetna requires a BMI of 40 or more without any co-morbidities.

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Industry standard is 40 BMI or above with no co-morbidities or 35 BMI with co-morbidities (though companies vary about which and how many co-morbidities are required.) Some companies will reserve some procedures for higher BMI's but anything outside of the industry standards are ripe for appeal, both within the company and to state regulators.

I didn't lose anything on Aetna's 6 month diet requirement and that was no problem, though that was seven years ago so policy details may have changed in the interim.

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Got my approval today. Surgery is scheduled for June 19th.

Edited by michelle0721

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Congrats!!!!

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Thank you

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      On day 4 of the 2 week liquid pre-op diet. Surgery scheduled for June 11th.
      Soooo I am coming to a realization
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      On day 4 of the 2 week liquid pre-op diet. Surgery scheduled for June 11th.
      Soooo I am coming to a realization
      of something and I'm not sure what to do about it. For years the only thing I've enjoyed is eating. We rarely do anything or go anywhere and if we do it always includes food. Family comes over? Big family dinner! Go camping? Food! Take a short ride or trip? Food! Holiday? Food! Go out of town for a Dr appointment? Food! When we go to a new town we don't look for any attractions, we look for restaurants we haven't been to. Heck, I look forward to getting off work because that means it's almost supper time. Now that I'm drinking these pre-op shakes for breakfast, lunch, and supper I have nothing to look forward to.  And once I have surgery on June 11th it'll be more of the same shakes. Even after pureed stage, soft food stage, and finally regular food stage, it's going to be a drastic change for the rest of my life. I'm giving up the one thing that really brings me joy. Eating. How do you cope with that? What do you do to fill that void? Wow. Now I'm sad.
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      1. summerseeker

        Life as a big person had limited my life to what I knew I could manage to do each day. That was eat. I hadn't anything else to look forward to. So my eating choices were the best I could dream up. I planned the cooking in managable lots in my head and filled my day with and around it.

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        BTW, the liquid diet sucks, one more day and you are over the worst. You can do it.

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      Officially here for a long time, not just a good time💪
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