Jillfagg

Hi everyone. My name is Jill and I'm from orlando, Fl. I tried to get gastic bypass sergery over 2 years ago and was denied by my insurance company. I am in the process of trying again and would like to know if anyone has any suggestions for Aetna HMO when I speak with them.

I am 29 years old and have been @ 215 lbs. for more than 5 years. I was always heavy as a child and would just like to think about something other than my weight for the rest of my life!!!!

__________________
Jill
215

Goal: 120

Gatzby

You've managed to maintain weight for 5 years?

Thats pretty good. You might be one of the lucky few that could lose this weight with just a little bit of change to your lifestyle.

But I digress.

The best thing to do with your insurance company is make it personal. They can say no to a proceedure... it is hard to say no to a person.

__________________
-Rob
Not covered by insurance. How nice, they will pay for the symptoms...but not the cure for my disease.

cedesigns

Your weight/height ratio has a lot to do with qualifying as morbidly obese, as well as your body mass index. If you BMI is high then your ratio of fat to to body mass (muscle,bone) is high.

You should do some research on what morbidly obese is, how dangerous it is, what is a healthy BMI, and weight/height ratio. Also if you have co-morbities such as high blood pressure, diabetes, etc., that could be lowered by weight loss. Insuranc companies want to know if your weight is going to be life threatening to you. If you can prove a case to them, you might be able to win~ Good luck!

__________________
Carol
11mo post op/ laproscopic GBS
267/192/135

roser13

Jill I was denied for 3 years. I did everything they required of me but still denied. Finally I went to a girl that works over at my HR dept. and told her that I wanted to switch to a PPO plan. She was so helpfull and had me speak to the Co. Ins.broker. HE got in contact with my Ins.IPA and I'm finnaly approved. But I had to fight for this. My surgery date is for May 3rd 2005!!!!!!

roser13

Just paray on it!!

angieJ

Hi Jill,

I have Aetna HMO for my insurance provider. If they are the ones who denied you two years ago, you probably know their requirements, if they were not, go to the URL below for the latest policy bulletin on their requirements.

http://www.aetna.com/cpb/data/CPBA0157.html

Because it has been longer than two years since my last supervised weight loss program, they will not pay for mine at this time. Make sure that you have documentation of each of the requirements when you submit for approval. I wish you the best.

Angela

roser13

If they tell you that they need a 6month diet history then you know what do it! If you dont then they will use that excuse to deny you. Thats what happen to me and I was trying to fight them at first and it just prolonged everything. And now i'm finally waiting for my day. May 3rd is my day.

Roser

Blueyz

Hi Jill,

Welcome....it is so neat to see so many new friends here. You will find great support here.

__________________
Blueyz
Open 7/14/04 w/Dr. Callery 4 years out
239/103/125 below Goal fluctuating between 108-115
BMI 18.8~Dr. C is ok with my weight...yeah

Official Scale Whore # 27 (Recovered..I threw mine out!!)

tazbabygirl69

__________________
Tanya
Lap RNY 11/17/05 Dr. Fang
5'4"
Pre-op/Current/Goal
269 /170/130
46/32/22
http://www.myspace.com/tazbabygirl69

Quote:

Keep away from people who try to belittle your ambitions. Small people always do that, but the really great make you feel that you too, can become great. Mark Twain (1835 – 1910)

Jillfagg

My BMI is 42.5

I am 4"11 1/2 and 215 lbs.

__________________
Jill
215

Goal: 120