Questions on Aetna HMO Approval Process...

[MomofJax 0]

I have high BP, have for over a year now and have higher than 40 BMI... I live in Texas and have Aetna HMO... will I still need to do the 6 months supervised diet? What exactly is that all about anyway? What kind of "diet" do they want you to do?

[bigunc 0]

Try looking at the AETNA Clinical Policy Bulletin on Lap-Band.

I too have Aetna and was confused on the requirements. Part of the requirements depend on co-morbitities you may have. I was required to attend 3 months of supervised exercise.

Try the link below.

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

[Neeley 0]

I have Aetna is NJ and yes it is a 3-6 month doc supervised diet, depends on the doctor which diet plan you are put on, it can be a 3 month diet depending on how the surgeon interacts with the insurance company. I will say I am glad I had the waiting period it does give you time to really get your head wrapped around it!

[smurfett68tx 0]

I just finished all the stuff that aetna requires and its 6mo of medically supervised weightloss or mine was three mo of nutrition/dietician supervised diet. Do you have a Dr. yet? They can help alot with all the ins jargin....I just got approval yesterday....and only completed all the requirements on tues last week...Got a date 2/25/08

best wishes

[SpecialK 22]

My surgeon's office submitted my packet for Aetna HMO POS II approval today. Say a prayer its approved please!

[goodtimes 0]

momofjax-i wanted to ask you about aetna insurance. my sister lives in texas and she said that they turned her down for surgery. any advice would help so i can let her know

[goodtimes 0]

bigunc-so their requirements are more indepth and seems more stricter.

[bigunc 0]

My experience with Aetna has been good. I guess I am one of the lucky ones. I was fortunate that the Nurse Coordinator is a Lap-Band patient herself. She made sure every possible angle was covered. She kept me on track thru the whole process with phone calls and reminders. She let me know when she had every piece of documentation required and what was the next step.

In the beginning she told me Aetna had specific requirements that had to be met and made sure I met as many as possible. I was told that the five year weight record and diet history was very important.

The hardest part for me was the 3 months of supervised exercise. My Cardiologist would not allow anything that would elevate my heart rate above 120 bpm. The Nurse set me up with physical therapy where I was monitered after every step. I was approved 5 working days after the Nurse submitted the paper work.