I am currently going through the process to have lapband. Starting my 6 month supervised diet this week. Done my sleep apnea, stress test, pulminary function test, and a few more. Waiting for results. I have aetna NAP choice POS II. I want to make sure since i am spending all of this money for these test and supervised diets (around $ 800) that i have every thing that aetna needs to approve me for the surgery. The only thing that i worry about is the proof of being 40+ bmi for 5 years, even though i have. There were a few years in between that i didn't go to the doctor (not even the female doctor ) so i not for sure if i can come up with these records. So i would just like to here anyones experience with aetna good or bad. I really want this surgery so information would be very appreciated and helpful.

Congratulations ohbearly!!! That's awesome!!!!! Let us know when your surgery date is scheduled. Mine is next Wednesday, 5/21! Woo-hoo!! :tongue2:

Wow congratultaions on your fast approval. My Dr.'s office still hasn't sent in my information to Aetna yet so I am still waiting for that to be done. But good luck with the surgery!

Okay - sometimes I read the board and get really excited --- and other times I get nervous thinking I may not be approved...BMI is 35.7 and I was tested for Sleep Apnea - which I still think I may have but I was so miserable and restless during the testing that I didn't sleep at all that night...very bad experience for me by the way.

At any rate, just completed 3 month supervised plan, submitted 2 years as is now the requirement from Aetna, pysch evaluation and follow-up and nutrition counceling. Everything was in order and sent to Aetna on Monday. The Insurance person at True Results (Dr. Carter) said that she has been very pleased with Aetna's turnaround time - 2 weeks or under...so now I'm just waiting to see. Nurse at True Results said that it's a difficult call right now since BMI is just over the limit and I don't have any co-morbesities - but that they have seen several cases that they thought would never get through approval - and yet they did - but also, some cases where they thought it would fly through and was denied. I know our Aetna plan covers LBS...just hoping my paperwork gets in front of someone in a very good mood! As soon as I hear - ya'll will probably here me crying or whooping it up here in Southlake, Texas!!!

Jak - best of luck to you - the waiting game with the insurance is the hardest part! I'll keep my fingers crossed for you! And I'm right across the 114 in Grapevine, so here's to hoping I hear whooping and not crying!

Tina

Good luck to everyone waiting on approval with Aetna, or are chugging through the approval process. Hang in there.

Hello Everyone,

Well my Dr.'s office finally submitted the paperwork in. But they didn't submit my diet according to Aetna. They only submitted a summary letter of it. Did anyone have that happen to them and they had to provide the medical records? Also does anyone know the number to the predertimantion section? I just want to call and find out what is going on. I don't want to talk to member services.

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as of May 22

Hey Miss Meliss....You are so lucky everything went great .... I stuck with the surgeon who my PCP referred me to and he is making me do the 6 mo diet bc that is "their rule". I was going to switch surgeons but its so much of a hassle. Well I almost have 2 months down so 4 more to go i guess. I am really afraid however that if i gain any weight ill be denied by Aetna. What do you think? How is the band for you - everything going ok?

Amy, I actually gained a pound in my 3 month diet and exercise program. The reason we are having this surgery is because we can't consistently lose and keep it off. I also thought that insurance looked at this as a way to see if you could follow a regimented plan. I was worried. My doctor submitted and I was approved in a week. My BMI going in was 41.3. I am now on my 5th week of a six week pre-op-op diet. I am to have surgery next Wednesday. I am down 25 pounds and have a BMI of 37.8. It's hard to predict what insurance will do. Just be sure you document everything! Make sure your surgeon's office is checking the documentation. I have heard of so many people being denied or delayed because their documentation was not complete. I just wanted to let you know that I was a person who did not lose on the 3 month supervised diet. Best to luck! Tom from Ohio

I had my final doctor appt. last Thursday. During the six month diet I lost a few pounds there, and gained a few pounds back. However, my doctor was always very encouraging. I was sticking to my high protein diet and walking at least three times a week. But the kicker was this... I went on a 7 day cruise in June and was still able to loose a whopping 2lbs!!! My doctor was so impressed (probably just to make me feel better:) he said he was going to submit that I was able to go on a cruise and still have to willpower to loose weight! haha

Keeping my fingers crossed for approval it's been almost a week. Wednesday is my birthday so that would be a wicked cool present!

Thanks for all the info. I have a couple questions. I jus started a new job and (in 90 days) I will have Aetna Insurance. I have been wanted to get the band for years now and havn't been able to in the past due to isurance issues, can't afford it myself. But, I am more than ready. What can I start doing now so that in 3 months when my insurance is effective, I can get this thing scheduled?? Any and all help... Thanks, Jennifer

Should I be doing a 3 month diet with my primary doctor or a dietician/ nutrionalist? Thanks, Jennifer

First, you need to find out if you will be required to do the 3 month diet plan, or six month. I did the six month, and after all was submitted, I was approved in two weeks. Just so you know the tme line...Info Meeting was Jan/08 and restarted 6 month diet plan (Dr's nurse did not record all the previous weigh-ins) Finished June, Submitted in July, Surgery Date in August. So, it is not a real fast thing. Do you have your surgeon yet? And have you talked this over with your PCP? This is all so important. But the most is what Aetna requires for you and your plan.

Yeah, I've been thru this before with my old insurance a few years back. I started a new job recently and am waiting for my insurance to be effective in 3 months, but I wanted to get started at least. I have a history of dieting for 6 months like 3 years ago with my doctor, although one month weigh in is missing in there, but I doubt they will use that. The last time was with my primary care doctor, i wanted to see if I should go with a dietician. Thanks, Jennifer

If you click on this link it will take you to the aetna website and show you the requirements for the surgery Obesity Surgery