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Who might cover bariatric surgery in Ohio?

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SummaCare
Insurer Policy	SummaCare (HMO)
Insurer Status	Approved after legal action taken (11/01/00)
Surgery Type	Laparoscopic Other
Weeks to approval	9
Pre-Op BMI	62.1
Comorbidities	Sleep Apnea, Hypertension, Edema and more
Policy	Must be medically necessary
Comments	I did have major problems with SummaCare. In fact, I had so much trouble with them that I literally blasted them here on obesityhelp.com. Since my first post, some things are starting to change… I was denied care three times, but here in Ohio, we have a patient HMO dispute law and appeal process called House Bill 4. I was approved through this law and thank GOD for it. I did meet with SummaCare’s CEO and Administrator Marty Hauser on December 1, 2000. He was very professional and it looks like SummaCare is going to start approving this surgery when it is medically necessary. Prior to me and House Bill 4, they were in the habit of denying this surgery and they did not have a specific exclusion. If you are in Ohio and you have an insurer that has turned you down (and there is no exclusion specifically for gastric bypass surgery), then you have Ohio Rights!!! House Bill 4 passed in May of 1999 and it was made law and enforced starting in May of 2000. In short, House Bill 4 states that if a client has a medically necessary dispute with their HMO, the HMO must select one of the 6 approved Independent Review Organizations and submit the claim to them. In addition, the HMO must pay the IRO to do the review, which costs about $800. Thank God I was the first one to exercise their House Bill 4 Rights and my MGB was APPROVED. I self-paid and now the HMO SummaCare had to reimburse me!!!! I had the MGB with the Wonderful Dr. Rutledge (in Durham, NC) on 10-25-00 (http://www.clos.net) To learn more about your House Bill 4 Rights, please go to this web site: http://www.ins.state.oh.us You will need Acrobat Reader to check it out.
Source	Mikayla A
blue cross
Insurer Policy	blue cross (anthem)
Insurer Status	Approved after appeal letter
Surgery Type	Open RNY
Pre-Op BMI	61.2
Comorbidities	Depression, Shortness of breath
Source	Ashley L
Med Mutual
Insurer Policy	Med Mutual (Super Med)
Insurer Status	Approved after legal action taken
Comorbidities	GERD, Coronary artery disease
Source	Sue S
UNITED HEALTH CARE
Insurer Policy	UNITED HEALTH CARE
Insurer Status	Approved after first letter (04/19/05)
Surgery Type	Open RNY
Weeks to approval	2
Comments	AWESOME BABY WITH A CAPITAL " A "...UHC approved it with just one application.. Receive the letter (2 weeks) yesterday, letting me know i have been approved for the gastric..
Source	Luis C
NTCA
Insurer Policy	NTCA (PPO)
Insurer Status	Approved after first letter (11/10/02)
Surgery Type	Open RNY
Weeks to approval	4
Pre-Op BMI	41.8
Comorbidities	elevated blood sugar, hypertension, back/knee pain
Policy	Must be medically necessary
Comments	My experience was less frightning than I figured it would be. The Bariatric center did all the work. All they asked for was proper doccumentation of necessity and psych eval. Just be sure to follow up if you don't hear back within 4 weeks of any step in your journey. You don't want to annoy, but just let them know you are involved in this process too.
Source	Carl H
Access
Insurer Policy	Access
Insurer Status	(04/29/05)
Source	Susan M
Access Medical
Insurer Policy	Access Medical (PPO)
Insurer Status	Approved after first letter (02/23/02)
Surgery Type	Open RNY
Weeks to approval	2
Pre-Op BMI	49.7
MD-supervised programs	3 0
Comorbidities	Sleep Apena, Hypertenison
Policy	Must be medically necessary
Comments	I have been very happy thus far with the insurance company. I had my family doctor send a letter first to them an them Weight Loss center sent the package along with my plea letter. I used the sample on this site and made it work for me. This sample letter is a great begining. This was approved in less than 2 weeks.
Source	Del Ray F
Insurer Policy	Access Medical
Insurer Status	Approved after legal action taken (11/06/03)
Surgery Type	Open RNY
Pre-Op BMI	43.7
MD-supervised programs	1 (10 weeks)
Source	Tammy P
acmg-cumberland healthcare inc,
Insurer Policy	acmg-cumberland healthcare inc, (ppo?)
Insurer Status	First letter sent - still waiting (02/22/02)
MD-supervised programs	3 (26 weeks)
Source	Mary C
Acordia
Insurer Policy	Acordia (ppo)
Insurer Status	Approved after first letter (08/29/99)
MD-supervised programs	3 (52 weeks)
Source	Michelle M
Insurer Policy	Acordia (mike an group)
Insurer Status	Approved after first letter (09/17/99)
MD-supervised programs	2 (50 weeks)
Source	Kim D
Insurer Policy	Acordia
Insurer Status	Approved after first letter (10/21/99)
MD-supervised programs	2 (50 weeks)
Source	Jennifer M
Insurer Policy	Acordia
Insurer Status	Approved after first letter (8/04/00)
Surgery Type	Open RNY
Pre-Op BMI	39.9
Comments	9/6/00 I'm getting very frustrated. The information has been sent to them twice and the review board still has not recieved it. I am starting to wonder if they are stalling. My PSR at BTC says Acordia is usually easy to deal with. I'm trying to stay optimistic. 9/19/00 All right so maybe I was too soon to judge. I recieved my approval letter yesterday. No appeals needed.
Source	Lisa P
Insurer Policy	Acordia (ppo)
Insurer Status	Approved after first letter (07/04/01)
Surgery Type	Open RNY - proximal
Weeks to approval	4
Pre-Op BMI	51.7
Comorbidities	Sleep apnea, hypertension,DJD
Policy	Must be medically necessary
Comments	Easy to deal with. Simple process. No Stall at all.
Source	John C
Insurer Policy	Acordia (Cleveland Health Network)
Insurer Status	Denied after first letter (07/05/03)
Weeks to approval	4
MD-supervised programs	1 (48 weeks)
Comorbidities	Sleep apnea, hypertension, intrinsic asthma, GERD, ventral hernia, arthritis
Policy	Written exclusion policy
Comments	Appeal for medical necessity based on comorbidities underway by my internist and me.
Source	Jan F
Insurer Policy	Acordia (BEECHSTREET)
Insurer Status	Approved after first letter (08/28/02)
Surgery Type	Open RNY
Weeks to approval	3
Comorbidities	HYPERTENSION,SLEEP APNEA , GERDS
Policy	Must be medically necessary
Comments	WELL I HAD NO PROBLEMS THEY WERE GREAT WITH ME SO I CAN'T ANSWER THAT QUESTION THEY WORK FOR ME
Source	Crystal P
Insurer Policy	Acordia (National)
Insurer Status	Approved after first letter (04/07/03)
Surgery Type	Open RNY - distal
Pre-Op BMI	50.7
MD-supervised programs	3 (48 weeks)
Comorbidities	Arthritis, degenerative disc disease, GERDS, moderate sleep apnea, htn
Policy	Must be medically necessary
Comments	2/7/03 Detra called and told me she would be submitting my case to insurance this week, so I am going to be optimistic and say she is submitting it tomorrow the 10th of Feb. She told me to wait one week and then call the insurance company and ask if they approved me. So that is where I stand. Good luck all. Suzza March 5, 2003 Well a lot has changed since I wrote that last entry. Detra has left the surgeons office and has been replaced with a new person named Kerri, who while she comes to us with previous experience, still is new to this system and that has created a lag time in getting things organized and submitted. I spoke with Kerri yesterday to tell her that my sleep study was completed and she told me to have a copy of the report faxed to her. Detra followed up on that herself. Well, I called and they assured me that they routinely send the report to the surgeon and the pulmonologist. So I feel better about that. According to Kerri, as soon as she recieves the report she will sit down with the surgeon, review my case and submit to insurance. If they don't drag their feet hopefully I will have approval by the end of March or beginning of April. I am hoping for a mid April surgery date but I know people who are being scheduled for surgery mid May so I don't hold out much hope for April. As soon as I hear anything new I will post. March 16, 2003 Well, today I have resolved to take the "bull by the horns" I am not waiting another moment for someone else to do for me what I can and will do for myself. I shall compile my own documentation with the help of my PCP and his secretary and plan of presenting it all to the surgeons office by Friday at the latest. I have a big week ahead of me and I am solid in my committment to have this all together and ready by friday. I hope I can stand firm and get this done. I will keep updating. Suzza March 18, 2003 Yesterday I recieved a message on my answering machine from Kerry, the insurance person in my surgeons office. She has my paperwork together for submitting. She told me last Friday that she couldn't submit because there were no reports in my file, and she was unable to retrieve them from the computer system. I called back this morning and she just needs two things from me and then she can submit. Maybe today. What a turn around. I hope it goes in today and then I can better judge the efficiency of this insurance plan. I will update when appropriate. Suzza March 19,2003 Went to my support meeting last night and it was very depressing as we learned that the insurance companies are now prohibiting this surgery. I read a letter from Anthem ins. that was dated Feb 21, 2003 that states they have excluded WLS even if its medically indicated. And it's happening all over. Kerry predicts that she will be submitting my information to insurance by Friday. I will not get my hopes up as it does require that my PCP get the rest of my records in order. More when appropriate. Suzza March 26, 2003 Today is Wednesday and my hopes that my insurance was submitted last week are gone. I stopped by the surgeons office yesterday and it still isn't submitted. So I asked Kerry to pull up the sleep study report from the pulmonologist and also the letter of referral that my PCP wrote and that was all that I needed to submit. She was knee high in charts yesterday trying to do "a count" of how many charts they are behind. She tells me I am number one on her list to get ready so I believe her. I just don't know when that will happen. I don't think it will be this week. Maybe next. I feel bad because work anticipated my surgery taking place roughly mid April and that isn't going to happen. Well, nothing more I can do except nag and I hate doing that. Maybe a gentle reminder on Thursday. I don't want to put any more pressure on Kerry than she already has but I am getting no better for the waiting. More later. Suzza March 27, 2003 I got a good Spring gift today. My paperwork was finally submitted to the insurance company today around noon. I pray to God that 1) It gets there 2) that it doesn't get lost after it gets there 3) that it goes before committee quickly 4) that they have mercy on me and OK me swiftly and 5) they notify me right away that I am a go for surgery. More when appropriate! Suzza April 1, 2003 I just got off the phone with Tammy at Acordia and she verified that they recieved my chart this morning and they are sending out letters to let me and the doctors office know that they have the chart. She also saide to give them 7-10 days to review it and then call back. I think I will opt for the 7 days. I have alot of things going on next week. Repeat sleep study on Sunday and Cardiac testing on Thurdsay. I think I will call on Wednesday or Friday to see if there is any news. Until then, I keep praying for the good news. Suzza April 7, 2003 Just got off the phone with Paula from the insurance company. I asked her to check to see if my surgery had been approved yet. She told me that it was APPROVED on Friday, a mere 4 days after receiving it. GOD BLESS Acordia and MetroHealth for allowing me this tool to get well. Suzza April 11, 2003 Yesterday I got the letter of confirmation of approval from the ins. co. I took it right away to the surgeons office and they put it together with my chart and I am to be scheduled for surgery. I don't think that Acordia stalled, but I feel like they insist that the charts be complete with the required information. I only called them 3 times and each time I got a different person. However, Tammy, Paula and Jeff were all polite and helpful and were not in the least irritated with me for asking any questions of them. I would recommend this ins. co. to others and have. June 18, 2003 My WLS didn't take place as planned on May 8th. While in surgery, it was found that I had a rather large (baseball) sized growth on my colon at the splenic flexure. One third of my colon was removed and pathology proved negative for cancer. But it was felt by the surgeon unwise to proceed with the RNY at that time because of infection issues. The insurance company has been notified of the change in situation and will cover the emergent surgery and the August RNY as planned. I cannot say enough good things about Acordia and about my employer, MetroHealth Medical Center. I am so blessed.
Source	Suzzanne D
Insurer Policy	Acordia (MEDICAL MUTUAL)
Insurer Status	Approved after first letter (01/15/03)
MD-supervised programs	4 (60 weeks)
Source	Char R
Insurer Policy	Acordia (EPO)
Insurer Status	Approved after first letter (06/04/2003)
Surgery Type	Open RNY
Weeks to approval	1
Comorbidities	Asthma, sore lower back and ankles, trouble sleeping through the night, easily out of breath and tir
Policy	Must be medically necessary
Comments	04/21/03: Called and was advised that if surgery was deemed medically necessary, it would be covered 100%. Stated that I needed a Dr to state why surgery was medically necessary, weight loss programs, medication. Said once above is recvd it would be approx 5 day turn around for decision. ****************************************** 06/03/03: Michell from CCBS let me know that all of my paper work has been sent to the insurance company. I will call the insurance company tomorrow to make sure that they have received all of the information they needed. **************************************** 06/04/03: I received my approval letter in the mail today. Should have a date scheduled in the next week!! ******************************************
Source	Kelli G
Insurer Policy	Acordia (ppo)
Insurer Status	Approved after appeal letter (05/20/04)
Surgery Type	Laparoscopic RNY
MD-supervised programs	2 (54 weeks)
Comorbidities	Arthritis, DJD of the knees and feet
Policy	Must be medically necessary
Comments	I don't think they stall any, except it did take a long time for them to mail my denial letter. Accordia sticks to the rules, so they want proof of everything. Finally, I am approved for the surgery, thanks be to God.
Source	S A
Insurer Policy	Acordia
Insurer Status	Approved after first letter (7/25/03)
Surgery Type	Laparoscopic RNY
Weeks to approval	3
Policy	Must be medically necessary
Comments	The insurance company was great. The problem is my dr's office wont call me back to schedule me!!! My insurance co did not stall at all.
Source	Cheryl D
Insurer Policy	Acordia
Insurer Status	Approved after appeal letter (June 2003)
Weeks to approval	12
Comorbidities	Hypertension, diabetes, sleep apnea
Policy	Must be medically necessary
Comments	I would do the surgery again but I would never want to deal with the insurance again. They were very slow with everything.
Source	Milissa P
Insurer Policy	Acordia (PPO)
Insurer Status	Approved after first letter (09/20/03)
Surgery Type	Open RNY
Weeks to approval	2
Pre-Op BMI	58.2
Comorbidities	SLEEP APNEA,ASTHMA
Policy	Must be medically necessary
Comments	WONDERFUL.APPROVED AFTER FIRST LETTER.VERY THOROUGH ALSO..
Source	Katrina G
Insurer Policy	Acordia
Insurer Status	Approved after first letter (11/03)
Surgery Type	Open RNY
Weeks to approval	2
Pre-Op BMI	48.2
Comorbidities	Hypertension, GERD, Diabetes
Policy	Must be medically necessary
Comments	I personally did not have to deal with the insurance company. The Bariatric Nurse Specialist dealt with Acordia National. I don't think there were many problems.
Source	T L M
Insurer Policy	Acordia (PPO)
Insurer Status	Denied after appeal letter (04/02/04)
Comorbidities	Severe sleep apnea, arthritis, lower back pain (pinch sciatic nerve), pain in knees, GERD, hypoglyce
Policy	Must be medically necessary
Comments	Acordia was difficult to deal with. I met all the criteria for surgery in my company's plan. Acordia had a 'secret' list of criteria and denied the surgery based on this list. I sent an appeal. Acordia then shared all my medical info with my company. I wasn't happy with that but it turned out very well for me because the folks that wrote the plan overrode Acordia's denial. My company said that I met all the criteria so Acordia has to approve me and after that they can issue an addendum to our policy with the additional requirements. My compnay sent me an official letter approving my surgery.
Source	Marianne K
Insurer Policy	Acordia
Insurer Status	First letter sent - still waiting (10/24/04)
Source	Jose R
Insurer Policy	Acordia
Insurer Status	Approved after first letter
Surgery Type	Laparoscopic RNY
Pre-Op BMI	54.2
Policy	Don't know
Source	Adriane W
Acordia -Medical Mutual
Insurer Policy	Acordia -Medical Mutual (EPO)
Insurer Status	Approved after first letter (03/21/2006)
Surgery Type	Laparoscopic RNY - distal
Weeks to approval	2
Pre-Op BMI	45.0
Comorbidities	Hypercholesterolemia, Stress incontinence, sleep apnea,
Policy	Must be medically necessary
Comments	I had very little to do with approval. St Vincent hospital has wonderful people whose sole mission is to get you approved, and they're good at it! You pay a fee of $250.00 to them for this service, and it includes a lot of other support, meetings, classes, loan closet, etc. It was well worth it.
Source	Kathy A
Acorida
Insurer Policy	Acorida
Insurer Status	Approved after first letter (10/28/05)
Surgery Type	Laparoscopic RNY - distal
Source	Aamber
Administrative Solutions
Insurer Policy	Administrative Solutions
Insurer Status	First letter sent - still waiting (01/20/05)
Source	Lisa F
Admistrative Service Consultants
Insurer Policy	Admistrative Service Consultants (ppo)
Insurer Status	Approved after first letter (11/12/02)
Surgery Type	Open RNY
Weeks to approval	4
MD-supervised programs	2 (24 weeks)
Comorbidities	HTN
Policy	Don't know
Comments	I didn't have any problems dealing with them. It took almost 2 months to get an answer. I called often to seek results. A board from Wisconsin made the decision, so I'm not sure that my calling often made a difference because my contacts were in Fidlay, OH. I was approved after the first letter, and I didn't have to do any additional testing for the insurance company.
Source	Tina L
Aenta
Insurer Policy	Aenta
Insurer Status	Approved after first letter
Surgery Type	Laparoscopic Duodenal Switch
Policy	Must be medically necessary
Source	Kathy P
Insurer Policy	Aenta (Choice POS II)
Insurer Status	Approved after first letter
Surgery Type	Laparoscopic RNY
Pre-Op BMI	41.4
Source	W M
Aetna
Insurer Policy	Aetna (PPO)
Insurer Status	Approved after first letter (March 1999)
Surgery Type	Open RNY - proximal
Weeks to approval	5
Pre-Op BMI	69.7
Comments	You can read Aetna's policy coverage bulletin on obesity surgery here: http://www.aetnaushc.com/cpb/data/CPBA0157.html Here is their policy coverage bulletin on abdominoplasty: http://www.aetnaushc.com/cpb/data/CPBA0211.htm
Source	Vicki U
Insurer Policy	Aetna (DANIEL EVANS)
Insurer Status	Approved
Source	Joni E
Insurer Policy	Aetna
Insurer Status	Approved after first letter
Surgery Type	Laparoscopic RNY
Comments	I had a little bit of trouble but they finally came through.
Source	Melanie S
Insurer Policy	Aetna (PPO)
Insurer Status	Approved after first letter (04/03/00)
Surgery Type	Open RNY
Pre-Op BMI	47.3
Source	Becky H
Insurer Policy	Aetna
Insurer Status	Approved after first letter (07/22/01)
Surgery Type	Open RNY
Weeks to approval	3
Comorbidities	DIABETES, ARTHRITIS, ASTHMA
Policy	Must be medically necessary
Source	Karin F
Insurer Policy	Aetna (PPO)
Insurer Status	Approved after first letter (12/15/99)
Surgery Type	Open RNY
Weeks to approval	2
Pre-Op BMI	45.7
Comorbidities	none, just family history of obesity
Policy	Must be medically necessary
Comments	I went to have pre-screening interveiw at BTC in Ann Arbor, MI. on Sept. 8,1999. I called them on Sept.14,1999 & they filed/sent information to my insurance company on Sept.13,1999. We recieved a letter approval on the 27th of Sept. BTC does their homework they had all the information set up right the first time to satisfy Aetna. I did call Aetna 3 times and faxed in the same report so they could not tell us they lost it. Seems to be the most problem with the insurance companies, so keep that in mind it helped me.
Source	Julie S
Insurer Policy	Aetna (PPO)
Insurer Status	Approved after first letter (04/25/00)
Surgery Type	Open RNY
Weeks to approval	3
Pre-Op BMI	43.9
Comorbidities	Gerd, arthritus,
Comments	They were very quick when the cleveland center for bariatric surgery sent in all the info and no diet history was necessary!
Source	Glenda M
Insurer Policy	Aetna (Federal)
Insurer Status	Approved after appeal letter (10/15/99)
Weeks to approval	12
Comorbidities	hypertension, edema, chronic back and knee pain
Policy	Must be medically necessary
Comments	My surgeon was familiar with most insurance companies and their policies to get coverage. I believe that helped to speed-up my approval. Once I got all the information together (including 18 mos medical records, psychological evaluation, referral, etc) it moved fairly quick. The insurance company denied receiving the request. We had to fax, then re-fax, and fax again the paperwork. They only came back requesting more info one time (5 yrs of medical history vs 18 mos). My recommendation with Aetna is to stay on them. Call WEEKLY! I honestly believe my pestering them helped. Everytime I called I remained very calm and professional, and always asked them if there was any additional info I could provide for them.
Source	Deanna B
Insurer Policy	Aetna (PPO)
Insurer Status	Approved after first letter (01/10/00)
Surgery Type	Open RNY - proximal
Weeks to approval	6
Pre-Op BMI	43.0
MD-supervised programs	2 (30 weeks)
Policy	Must be medically necessary
Comments	The Bariatric Tratment Center was great in dealing with Aetna. At first I was told they needed medical records showing I had been through a physician monitored weight loss program. BTC main office had called and spoken to them telling them it was impossible to get my records since the place I went closed. Then suprisingly I got an approval letter from Aetna. Thanks so much to BTC.
Source	Beth W
Insurer Policy	Aetna (HMO)
Insurer Status	Approved after first letter (04/11/2000)
Surgery Type	Open RNY - proximal
Weeks to approval	2
Pre-Op BMI	54.6
MD-supervised programs	2 (21 weeks)
Policy	Must be medically necessary
Comments	-----I called Aetna Insurance Company on 3-31-00 and found out that AETNA DOESN'T REQUIRE A LETTER FOR APPROVAL. ALL THE DOCTOR'S OFFICE NEEDS TO DO IS TO MAKE A PHONE CALL TO AETNA's PATIENT MANAGEMENT DEPT AT 1-800-933-4571 x7817 AND THE NURSES THERE CAN APPROVE OR DENY RIGHT OVER THE PHONE WITH JUST A FEW QUESTIONS FOR THE DOCTORS OFFICE TO ANSWER. Then the director will have to sign off on it with the nurse's recommendation. This is the procedure for any of the types of AETNA INSURANCES (HMO or PPO). -----When Sherry called me, to tell me we were both approved, I thought I was hearing things. LOL But I wasn't. YIPPY!!!!! --------AETNA HAS REALLY BEEN TERRIFIC-----
Source	Kathy W
Insurer Policy	Aetna
Insurer Status	Approved after first letter (12/03/99)
Surgery Type	Open RNY
Weeks to approval	2
Pre-Op BMI	55.8
MD-supervised programs	1 (12 weeks)
Policy	Must be medically necessary
Comments	dealing with aetna was good. i had no problems. they did not stall at all. people just need to do what the dr tells them to do. get all the test and document everything before you apply to the insurance co.
Source	Donald W
Insurer Policy	Aetna
Insurer Status	Approved after first letter (01/08/00)
Surgery Type	Open RNY
Weeks to approval	10
Pre-Op BMI	51.5
Comorbidities	GERD, Arthritis,SOB
Policy	Must be medically necessary
Comments	I have had a very good repore with my insurance company. They approved my surgery after the first try, granted the Bariatric Treatment Center that I used has a team of people that do nothing but get your insurance to approve this procedure. I don't think that they put me off at all. They were also very good about paying for everything in a timely manner. I only had to pay $85 for the inital consultation and after surgery I paid an additional $187 total, the insurance picked up the rest. I have been told that this procedure cost approx. $38,000 to $50,000 .
Source	Mindy C
Insurer Policy	Aetna (PPO)
Insurer Status	Approved after first letter (12/29/99)
Surgery Type	Open RNY
Comments	Things went tooo easy Had my consultation with Dr Spier on 12-29-99 His office did all the work with the ins company and on 1-3-00 I was approved I cant Believe it!!!! All of my Docotr and hospital bills are in and Aetna PPo covered everything except my week in the hospital, I am not complaining .I feel they did a wonderful job getting everything taken care of.
Source	Laura T
Insurer Policy	Aetna (US healthcare)
Insurer Status	Approved after first letter (03/05/01)
Surgery Type	Open RNY
Weeks to approval	3
Pre-Op BMI	40.4
Comorbidities	none
Policy	Must be medically necessary
Comments	Aetna is wonderfull! Only 3 weeks and I am approved! All I need is the letter sent to BTC. Need insurance???? Get Aetna!!! They are the best!
Source	Melissa G
Insurer Policy	Aetna
Insurer Status	Approved after first letter
Surgery Type	Open RNY - proximal
Weeks to approval	3
Pre-Op BMI	39.8
Comments	My policy is great. The doctor's office dealt with Aetna and as far as I know, there were no problems.
Source	Linda G
Insurer Policy	Aetna (PPO)
Insurer Status	Approved after first letter (01/24/00)
Surgery Type	Open RNY - proximal
Weeks to approval	14
Pre-Op BMI	46.3
Comorbidities	severe sleep apnea, hypertension
Comments	approval got held up because they needed proof of previous diet attempts, then the paperwork got lost on somebody's desk... after repeated phone calls they finally got their act together and approved the surgery.
Source	Richard U
Insurer Policy	Aetna (HMO)
Insurer Status	Approved after first letter (01/25/00)
Surgery Type	Open RNY
Pre-Op BMI	45.3
Policy	Don't know
Comments	Most important with my policy is the family doc referrals, as long as all referrals in place I had no problems! also, when in doubt about ANYTHING call Aetna directly they are very helpful!
Source	Mary Beth H

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