Question:
What are my chances with AETNA PPO OPEN CHOICE,having very little

dr superivised diets??    — [Anonymous] (posted on September 15, 2001)


September 15, 2001
I thnk it all would depend on your BMI and comorbids. I also have AEtna, and have been told that it is one of the easier ones to approve. I know they approve with a BMI of 35 with severe comorbids (sleep apnea, type 2 diabetes etc.) or with a BMI of 40 with no comorbids. I am in the approval process and dont really have a documented history of supervised diets. My OB/GYN put me on Pentermine for a very short time, and years ago I did try Jenny Craig. That is all I have for "supervised". My surgeons office seems very confident that I will be approved. If I were you, I would really concentrate in my comorbids. Document everything!! Complain about everything...ie..joint pain, shortness of breath, back problems etc...etc... (I think you get my point) You can visit the AEtna website at www.AEtna.com for a list of requirements. Please feel free to email me with any questions. Good luck!!
   — skymaxjr

September 15, 2001
I was also approved under Aetna. The only Dr. supervised diet that I had was fen/phen and diet pills in 4th grade. No "proof" was required. The surgeon's office had me list all the weight loss attempts, which (of course) included just about everything you could think of except maybe Jenny Craig. Just how they used this in requesting approval I'm not sure, but I was approved with a BMI of 40+ and few co-morbidities.
   — Gina E.

September 15, 2001
I have Aetna US Healthcare Open Choice PPO. I was just denied because I couldn't produce medical records from at least six months of failed physician-supervised weight loss attempts. I know other people who have the same coverage through Aetna who have been approved without this documentation, so I can't figure out what their game is. In case you have the same plan, here is the website for their coverage policy bulletin regarding weight loss surgery: http://www.aetnaushc.com/cpb/data/CPBA0157.html. I hope you have better luck than I did!
   — Benita W.




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