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UMR and Aetna Better Health of WV



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So I'm confused on the insurance thing for the requirements. I have went on my insurance page and printed off the requirements and it says I must meet the following criteria: preoperative evaluation that includes a detailed weight history with dietary and physical activity and Psychosocial-behavioral evaluation OR participation in a multi-disciplinary surgical preparatory regimen. So can I choose to do the surgical preparatory regimen for 3 months or does the insurance want you to do both??? Aetna also says the same thing. I have been on the phone with my insurance company almost everyday trying to get everything figured out. I go talk to the surgeon next week to talk about everything and I would like to have my ducks in a row before going to see him.

Any help would be greatly appreciated

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I’m sure you’ve already gone to the doctor. However, I’m in WV and my surgeon gave me all the information I needed on a sheet. I have my entire surgical plan laid out.

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I also have Aetna Better Health of Virginia. I have researched the requirements a million times. I also read that it is either the 6 month physician supervised blah blah OR the 3 month multidisciplinary surgical blah blah. So it sounds like a choice RIGHT? However, when I call Aetna they say that its at the discretion of my surgeon as to what program he wants me to do. Or whatever he puts on my pre-authorization. When i went for my consultation on 6/30 he said 3 months. But no one has been able to contact my insurance for the exact requirements.

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