:confused: Hey everybody!

My husband and I are going through this together. Our last appointment for the 6 mo. plan is Jan. 20th and I get more nervous by the day. I'm worried about insurance not wanting to pay for 2 surgeries. Anyone have experience with this? Here are our stats. Me: 40BMI @ consult, severe sleep apnea, psych eval (done), dietician appt. (done), and 11 lbs. lost during 6 month diet (currently 39 BMI). My husband: 44 BMI at consult, diabetes, high BP, fatty liver, psych eval (done), dietician appt. (done), 15 lbs. lost during 6 month diet. I think my husband's good to go, but I'm nervous about my approval. Have any good info or tips for us? We have Aetna Select POS II plan.

Thanks for any info!

I have no familiarity with aetna but I can tell you that if you meet the criteria, they have to approve you. They will evaluate you ALONE and your husband ALONE. YOU may think you're a package deal but to Aetna, you're just 2 more clients.

You both apply separately as mentioned above. You both meet Aetna's requirements too so I think it's looking good for you both.

I have Aetna too. One thing that is kind of confusing to me is why people are nervous about being approved AFTER they do the 6 month diet. From what I understand w/Aetna, you can submit for approval before the 6 month diet and know you are approved (contingent on completing the diet). I believe this is what my surgeon's office will do as a first step, but I will confirm just to make sure. So, do you know if you already have this pre-approval (before completing the diet). Maybe ask your surgeon's office, just in case. It seems they should all do this so you won't waste your time/money on the 6 month diet unless you know you are approved otherwise.

Anyway, it sounds like you would be approved anyway as long as you can also show 2 years history at a high enough BMI and that you have no exclusion. Boy, this insurance stuff can be confusing, though!

My husband and I both had surgery this year. Mine was on 10/22/08 and his on 12/23/08. We had cinga insurance. they gave us a little scare with my hubby, denied him but we appealed and they came through. Made no sense to me since his bmi was 55 and mine was 38. I was diabetic though.He has a cpap machine for sleep apnea.