Well, here's my update: I've spoken to no fewer than six Aetna people about what this situation is. I've discovered that PCP documentation is NOT sufficient for this program; there has to be a combination of the following:
1. PCP or other physician-monitored weight loss program,
2. Diet supervised by a nutritionist with periodic reviews;
3. Counseling by a licensed counselor/psychologist with periodic reviews;
4. Exercise program with documentation by an outside party (gymnasium, trainer, etc.)
The last portion of it is what really sticks in my craw at this point. My husband and I have participated in this program for two months and have had quite a bit of success; he lost 30 pounds, I lost 20. However, we have been exercising using our home equipment and not paying for a separate gym. Evidently this is insufficient; therefore, we have to pay yet someone else for yet another set of documentation.
It turns out that our first surgery date was cancelled and therefore we do not need to get our stuff in until the end of July; we found a local fitness trainer to work with us for the next couple of months. He has agreed to review our last month's progress (as thankfully we did document what we did at home) and provide notes on it. That, plus two more months of monitoring gives us three months of exercise documentation and four months of everything else. I REALLY hope that this will be enough; according to Aetna and the surgery center, they are pretty quick with approvals once you get all of this documentation in.
BTW, I did find out one piece of good news...Aetna PPO coverage for the bariatric surgery itself has a $150 co-pay, at least according to our insurance policy. We were very concerned that we would be liable for 20% of the hospital fee for the surgery, which would have been about $3k apiece.
Thanks again to everyone for their input and their stories!
You might ask why we don't just stick out the six months; it's for professional scheduling reasons, if we don't get this done in early fall we'll have to wait until early next year. Otherwise we would have bailed on all of this and just waited it out.