Question:
Has anyone had any problems with Aetna approving their surgery.
I dont have any co morbs and not alot of diet history even though I have tried everything out there. I dont have any thing to prove this except pill bottles and pamplets. Will I have a tough time getting approved. — Michelle Y. (posted on June 19, 2001)
June 19, 2001
Hello,
I have AETNA PPO. My BMI was 40.6 and I had no life threatning comorbidies.
Just pain in the joints and back, shortness of breath all of the common
pain associated with being overweight. The only Doctor suppervised diet
history I had was a one time visit to the doctor who prescribed me a weeks
dose of diet pills. I could not take the pills and never went back, plus it
had been 4 years since the visit. I wasn't even sure if they had my records
still. But, they did. But my Dr's office told me that if I had the pill
bottle or knew the pharmacy that it was filled at, that would be enough for
them. They could get the info from the pharmacy. The office sent in my
paperwork and 6 weeks later I was approved. I didn't have to do anything at
all. No phyc visit. It took so long becuz it was the beginning of the year.
My friend Marian also had surgery. She has AETNA HMO. Her BMI was higher
then mine and she had a comorb of Lupus. She was approved in 2 weeks.. Good
luck with your surgery and Know that if it was ment to happen it will! God
Bless you
— Katrina D.
June 19, 2001
I, too, have Aetna HMO. I, too, have a BMI of 40.2 (LOW). I was approved
by Aetna HMO within two days. They wanted NO PROOF! My doctor submitted
the claim and I was approved. I had no history of medically supervised
diets--only LA Weight Loss, Weight Watchers, Dexatrim, etc. I had one
doctor-supervised diet when I was 12, but that's it. Most people I've
talked to with Aetna were approved really quickly and with little hassle.
My surgery is on Thursday.
— PT LawMom
June 19, 2001
I wouldn't sweat it. I have Aetna HMO and they approved me within 2 days
before they had my psych eval or any doctor records. I think Aetna is one
of the easiest for obtaining approval for WLS.
— [Deactivated Member]
June 19, 2001
I too have Aetna and they approved me in a week and I did not have to have
a psyc. eval. I had tried before with Cigna and they would not approve me.
I think Aetna is great.
— Melisa D.
June 19, 2001
I have Aetna US Healthcare HMO. I was approved on the phone with the
doctor, in two hours, and then I got a letter of approval in
writing.........Aetna is one of the easiest to get a approvel for
WLS......If you go into Aetha USHeathcare
web-site, type in morbid obesity, it will state that they
cover WLS.
— Marie B.
June 19, 2001
Hi, I have Aetna HMO and they approved me in 3 days. They were so very
quick in responding. They simply wanted doctors recommendations and two
doctors names and address that I was under their care for weight loss (i.e.
Fen Phen, other diet drugs on the market) Even if your doctor noted putting
you on some type of low cal diet.
— Karen B.
June 19, 2001
Don't worry! I was approved within 24hrs- Aetna HMO. I'm sure you will be
fine.
— sgeisendorff
June 19, 2001
I have Aetna insurance and they approved me right away. I didn't even need
a referel. They didn't require a diet history or a psych eval.
— Terry H.
May 9, 2002
I was denied w/Aetna US Healthcare HMO. I met all their guidelines and
have back pain, high blood pressure and irregular periods, shortness of
breath and was told the medical director did not feel it was medically
neccessary. I am appealing...Wish me luck..
— Tracey M.
May 9, 2002
I was denied w/Aetna US Healthcare HMO. I met all their guidelines and
have back pain, high blood pressure and irregular periods, shortness of
breath and chest pains and was told the medical director did not feel it
was medically neccessary. I am appealing...Wish me luck..
— Tracey M.
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