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Pending Aetna/Preferred One?



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Hello,

I'm a newbie here and I'm currently awaiting a decision from Aetna for gastric bypass. My prior authorization was sent and received on 11/6/20. I called on Thursday morning out of curiosity to see if they had gotten it and they had. They said it can take up to 14 business days and most of the time it will take that time. From what I've been reading a lot of people seem to get their decision back pretty quickly. I'm getting nervous that they will deny it and that I'll have to fight with insurance. I can't think of a reason they would deny it as I met all the requirements, my BMI is 62.3, I have severe sleep apnea, high cholesterol, PCOS, arthritis, and insulin resistance, My question is did anyone else's take this long to come back? Did you end up getting approved or denied? if they denied you why did they state they denied you? I'm going stir crazy with this one. I need this surgery so badly. 😓

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My approval from Aetna took about 5 business days. My BMI was about 60. Try not to stress out too much, imho you should be approved. With the whole covic mess going on it may be slowing things down.

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1 hour ago, Uomograsso said:

My approval from Aetna took about 5 business days. My BMI was about 60. Try not to stress out too much, imho you should be approved. With the whole covic mess going on it may be slowing things down.

I didn't really think about that. When did you get your approval?

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if your policy covers it, I'm not sure why they would deny it since it sounds like you met all the requirements. If they say it normally takes 14 business days, then I'd at least give them that long before starting to worry about it. I wouldn't compare them to other insurance companies - it could be that they have a lot more subscribers than other companies, or it could be they're being slammed with COVID cases right now. Just give them a few more days...

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