Question:
I have AETNA PPO

I have AETNA PPO..it goes into effect on Oct 1..whichis the same day I see my surgeon, I am scared because I dont have the medically supervised diets. I have been to a weight loss center in 97 I have those records. I have been to see a dr this past january,,,I only saw him once he have me pills that I thought were gonna kill me, but I know I can get those records..I am 410lbs.. I am hurting all the time, and just recently my feet and hands are swelling up big time, my feet are swelling to the point I have to take my shoes off. I am so scred to go to the dr because I am afraid, my insurance would consider it pre exisitng..do I have enough for the insurance? Also I dont even have a P.C.P..My surgeon has one that he will send me to. WHat do I need to do?    — [Anonymous] (posted on August 26, 2001)

August 26, 2001
Check w/ your Atena rep./HR person. I also have Aetna that will kick in in Oct. I have choosen the HMO plan because I will only have to pay $ 240.00 out of my pocket. I checked w/ my Atena rep. who said they don't have any Pre- ex. clause w/ my plan. Also, the meds you took will count as" med. supervised," because they were gien to you by a doc! cheer up I think you'll be fine. good luck
   — Cindee A.

August 26, 2001
Aetna PPO covered me without documented doctor diet and I weighted 263, BMI 41. Your PPO coverage may go through....good luck!
   — [Anonymous]

August 26, 2001
I also have Aetna (US Healthcare, Open Choice) PPO and they did not require proof of medically supervised weight lose attempts. I am 330#'s, BMI 54.5. With your weight and I am assuming at least one serious co-morbidities or highly at risk of obtaining some, you shouldn't have any trouble getting approved. Good luck!
   — Susan M.

August 26, 2001
I think it might depend on which plan you are on and who you get working your case. I have Aetna PPO and was denied due to not enough "medically supervised" diet history. I sent them in a sheet showing my diet history since I was 13 years old, but these were mainly diets like Weight Watchers, etc. I even sent them receipts and weekly weigh in sheets. I am planning on appealing this. Hopefully you will have a better plan than me. Best of luck to you!
   — Sasha A.

August 26, 2001
I also had Aetna - US Access. No proof of medically supervised diets were required. I did give the surgeon a diet history. How, exactly, he used that in applying for surgery approval, I don't know. I'm not even sure he did. But, the point being that you may not have to have "proof" of medically supervised diets.
   — Gina E.

August 27, 2001
I also have Aetna. I was denied by Aetna because I did not send them records of medically supervised diets. Once I sent them the records I was approved within two weeks. I know of others who have been approved without sending in records for weight loss. I guess it just depends on the plan. If you saw a Dr. who gave you pills to lose weight that would be considered a medically supervised weight loss. I would gather records from all doctors I went to and that may be enough to get approved. Good luck.
   — blank first name B.

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