Hello all,

I have been completing my requirements for the lapband put forth by Aetna. During this process I have been reading the posts on lapbandtalk.com regarding Aetna, their process, denials, appeals, etc. The posts were about 50/50 on who was approved and who wasn't, who had to got through a lot to get the approval and so on. I was slightly worried, but still keep the hope that I would be approved the first time, even if it took a year. I have to say that I am very impressed by Aetna now that my surgery has been approved. I started the 6 month supervised diet in June, the last appt. was Nov. 26th. I went in to my lapband doctor on Dec. 2nd, turned in my records for the six month diet (yes, i handed it to them (doctor's staff) myself), talked to the doctor about what would come next, etc. The clinic turned all my paper work in, along with my dictation from the lapband, recomendation from my PCP, etc. on Dec. 10th. I called Aetna every Friday to get an update on my case. On Dec. 30th, about noon, an Aetna rep. called me and informed me that I had been approved. A few days later, a got my approval letter from Aetna.

The main purpose of the post is to encourage those going through the process with an Ins. company to keep pushing and have hope. If you get denied, try again. I truly believe that what really helped me get the approval the first time is the fact that I have a really good, experienced lapband doctor, and I completed everything required by the Ins. company BEFORE anything was submitted. The only thing Aetna did not have me complete is the Psy. Eval., because I don't have a history of mental illness....but, my lapband doctor requires it before surgery to make sure that the patient is prepared to go through with the surgery and to understand what is all involved post surgery.

Don't give up, if it is meant to be, it will happen.

Erika:thumbup:

Edited January 15, 200917 yr by mlonginotti

I also have Aetna PPO and was approved really fast , with no hassles whatsoever. I was actually a little surprised by the quick approval. Now i dont feel bad about the outrageous cost of insurance that Ive been paying over the years. Im finally gonna get something out of it :tongue:

hi...I was wondering how long it took to get your final approval? your timing and mine sound the same. However, I went to my first nutritional and weightloss in oct 2008. my second wls in nov. 3rd in dec. and last this past monday....the docs office sent everything in to ins today. I called ins. today and they told me that my case is pending now ..they just got it. so how long did it take you from the time ur docs office sent in pre cert. to ins til ins. gave u the approval? let me know...im so anxious already! the docs office told me anywhere from 3-14 days. I have aetna PPO, so far it has been smooth...they do cover this surgery 100%...let me know..thanks!

i also have aetna ppo and it took them one day to approve me (submitted paperwork on friday, got approval this afternoon). my paperwork was 100% in order though which is what i hear the key is. good luck - hope to hear good news!

wowee thanks...i will keep blog posted...i hope i am as lucky on the time. i am sooooo ready!!

oooops quick question? what state are you in? i am in texas dr. benevides from true results

i'm in NY-surgery is at NYU

good luck!

Hello All and Congratulations to all of you who have been approved:thumbup:.

My name is Maria and I just found out that Aetna has denied my request. I have Aetna POSII.

I am 5' 6" and currently weight 270lbs. My BMI is about 40. I fortunately (or unfortunately) do not have any medical concerns. I have a family history of Diabetes, High Blood Pressure and Cholesterol, but Aetna seems to think that this is not enough. They are looking for a 2 year weight history. I tried to get my records from a free clinic that I used to go to before I got insurance, but they purge their records after 2 years. It has been about 2 years since I have gone there. I have one year of history that I have been able to obtain but that may not be enough. Aetna also requested a 6 month diet plan. March will be my sixth month, keep your fingers crossed for me. Once I go to my visit on March 10th my doctor will submit my request again.

Wish all you guys and gals the best.

Hi Maria,

I am sorry to hear that you were denied. DO NOT give up. Get a list of what they want you to have and have it resubmitted. It may be fustrating, but it will be worth it in the end.

My fingers are crossed.

Erika

Hello All and Congratulations to all of you who have been approved:thumbup:.

My name is Maria and I just found out that Aetna has denied my request. I have Aetna POSII.

I am 5' 6" and currently weight 270lbs. My BMI is about 40. I fortunately (or unfortunately) do not have any medical concerns. I have a family history of Diabetes, High Blood Pressure and Cholesterol, but Aetna seems to think that this is not enough. They are looking for a 2 year weight history. I tried to get my records from a free clinic that I used to go to before I got insurance, but they purge their records after 2 years. It has been about 2 years since I have gone there. I have one year of history that I have been able to obtain but that may not be enough. Aetna also requested a 6 month diet plan. March will be my sixth month, keep your fingers crossed for me. Once I go to my visit on March 10th my doctor will submit my request again.

Wish all you guys and gals the best.

Hi Everyone, I have Aetna as well. I was banded 03/27/08. I am now down 107lbs. The approval process was pretty fast. I think the key was that I had asked prior to going to any doctor what I need to do to get approved. So when I did go to the doctor all of the required information was submitted. I waited about a month and a half. I had to wait to hear because they claimed that they did not receive something. This is another thing make sure you make copies of every evaluation and paper you receive that way you can fax the insurance company directly instead of waiting for the doctor's office to do it. Then the insurane company can not aruge that they did not receive something. Good luck everyone. You CAN do this.

Thank you potatie for you words of encouragement. Congratulations on your great success. :tt2:

I am trying to get all the weight history they are looking for. So hopefully that will be enough for them.

All I know is that I'm not going to give up, no matter how long it takes. :tt2: Hopefully not too long.

Thank you all for your words of encouragement.

-Maria