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Denied, I really didn't see it coming



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I am so disappointed. Aetna has denied me. We will appeal but for now I am so upset.

I am an optimist, I really didn't think I would be denied. But based on my 2 year history I don't meet Aetna's policy for approval. No co-morbidities. Healthiest fat person I know.

Well except for the severe foot and ankle problems that have me disabled and unable to walk. Problems I have been told will be greatly relieved by permanent weight loss.

I will get more letters and submit them. My dr's office will help me appeal. I am just so upset right now. I thought I would be approved. Heck, I was hoping I would have had the surgery by now.

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I found out yesterday, I was denied by Aetna. I know exactly how you feel. I didn't see it coming at all. They said I have to wait until I rec'v my "official" denial letter - then I can appeal. I'm SO UPSET and right there with you! Good luck to you - I'll add you to my prayer!

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I am so disappointed. Aetna has denied me. We will appeal but for now I am so upset.

I am an optimist, I really didn't think I would be denied. But based on my 2 year history I don't meet Aetna's policy for approval. No co-morbidities. Healthiest fat person I know.

Well except for the severe foot and ankle problems that have me disabled and unable to walk. Problems I have been told will be greatly relieved by permanent weight loss.

I will get more letters and submit them. My dr's office will help me appeal. I am just so upset right now. I thought I would be approved. Heck, I was hoping I would have had the surgery by now.

I am so sorry! You must be devastated. I am around the same BMI as you and same goal weight. Unfortunately my insurance has a blanket exclusion so I am paying out of pocket. (Makes me furious that they can refuse to pay for ANY WLS for anyone, no matter how much they need it, and especially when we pay over $16k per year in monthly premiums and otherwise cost the insurance co. virtually nothing! :))

Anyway, sorry for the rant. Just wanted to let you know, if you are able to consider going the self pay route (even with financing), it is VERY quick and easy. Less than a month from first phone call to surgery date for me, and zero hassles.

Good luck, don't give up! :confused:

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kmiller, I saw your thread. It sounds like hopefully if you can just the proper documentation from your dr--or from a NEW dr. then you can get approved. I can't believe your dr office is being so stinky.

DH has said that if the insurance won't do this then we will self pay but I really don't want to. My insurance covers it, we pay for the insurnace, they should pay.

My WLS did tell me that he thought we could appeal since other insurance's cover based on "musculo/skeletal problems" and he would fight my insurance that they need to cover based on that also in my case. My podiatrist is ready and willing to write a letter on my behalf as is my PCP.

I am lucky to have a great supportive office staff and doctors.

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