Question:
Has anyone has WLS through Aetna PPO, who well over met the BMI criteria, but ...

I have Aetna PPO. My BMI is 49, but I haven't quite met the "documented attempts and failures of dieting through a physician". I'm a little worried about this. I'll find out if I'm approved for surgery in 4-6 weeks. I also forgot to give the doc's office my letter to Aetna. I'm also wondering how long approval from Aetna takes. Any and all info would be greatly appreciated! Thanks.:)    — camiam (posted on June 21, 2001)

June 21, 2001
Camille - I have Aetna PPO as my secondary insurance. They do cover the surgery and did not require any physican-monitored diet history from me. My doctor sent a letter stating my BMI, co-mobidities and family history of other health problems. They did approve the surgery, but it took FOREVER! They will keep telling you six weeks, but start a log and call a couple of times a week. Once you find a customer service rep who is willing to help, keep asking for them each time. Tell them the situation and educate them a little on the surgery. Be friendly (and sometimes that is hard when they put you off). They just like to drag it out and make you wait forever, but persistance does pay off. Good Luck!
   — gina P.

June 21, 2001
I had a BMI of 40+ and was approved through Aetna in about three weeks. Prior to the consultation, the surgeon had me fill out a diet history. This included EVERY weight loss attempt and/or diet. The ONLY "supervised" diet that I had was phen/fen. I did not have to submit any documentation verifying the diet attempts. I was approved with no problem. Aetna, from what I hear, is one of the best in approving this surgery.
   — Gina E.

June 21, 2001
Camille, I have Aetna and I was approved in 1 day. I didn't need a referell or a documented diet history. The surgeons office just asked me what diets I have been on and wrote that down. I never even had to contact Aetna. They called me the same day I was approved. Good Luck
   — Terry H.

July 20, 2001
Camille, I have Aetna PPO and it took around 3 weeks for my approval. My BMI is over 40 and I went through WFL, so they sent in all of my info for me. Whenever I called to check on the approval, which was every week, they were very nice and helpful about it. They stressed the BMI being a factor more than the diet history and told me I didn't have to worry if it was over 40 and that I have a co-morbidity. They also told me that they aren't allowed to take longer than 4 weeks to approve. If you haven't already checked it out, under the bulletins section in the Aetna web site, it describes what they need to approve for obesity surgery. Hope this helps, good luck!
   — Kathy P.

August 18, 2001
I have Aetna PPO and they didnt require a note from my physican reagarding the suervised diet. Dr. Wittgroves office typed up a 3 page letter based on my co morbities, and they approved it immediately. I wish everyone had this quick no hassle response from thier insurance.
   — Sandi K.

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