***Anxiously Waiting***

Hello, I am, I guess what you would call pre-op. My initial request for WLS was denied and an appeal was submitted for a Lap RNY on 6/29/06 to Aetna. I am anxiously waiting yet scared it may be another denial. I have Aetna Choice POS II plan. I am 5 ft 4 in and weigh in at 240 lbs. I do have hypertension which I have been living with since I was 25 yrs old and I have severe knee pain because of my weight. My fear is they will deny based on the fact that I am not "fat enough". Does anyone have any advice on this? I am new to OH, thanks.

Catina; Aetna can be one of the more difficult ones, but lots of people get approved by them after a 6-12 month supervised diet. Come check us out on the TX board. Someone there may have experience with your specific Aetna plan that they can share with you. Here's a link: http://www.obesityhelp.com/forums/TX Blessings, Jennifer 253 / 159 / 137

With your statistics, you are at a 41.something BMI. The "cutoff" is usually 40 or higher to get approved, unless your insurance has an exclusion. So, don't fear about that. Why were you denied before?

I have BCBS and had to appeal 3 times to get approval - just keep your hopes up. Most insurance companies require a BMI 35 w/comorb's or 40+ with no comorb's over a period of 5 years. What was the reason for denial? Sometimes they deny right off the bat hoping you will give up - as long as you have all your ducks in a row you should be successful!! Good Luck!

Hello, Thank you all for replying to my post. I am new to OH and have been reading the message boards and realize this is a great site for support and advice. Well Aetna denied me the first time stating they needed a 5 yr weight history, psych eval, diet history, surgical clearance, and supervised physcian diet. I also had to go thru Aetna's 90 day preparatory prgram. Well I have done everything they have requested and now I am just waiting for Aetna's response to the appeal.