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New with lots of questions!


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#1 DonnaLou

DonnaLou

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  • LocationSt.Louis
  • Age:37
  • Surgeon:Dr. Ricks
  • Hospital:Des Peres Hospital
  • Height (ft-in):5-05
  • Start Weight:389
  • Current Weight:375
  • Goal Weight:180
  • Body Mass Index (BMI):62
  • Surgery Type:Vertical Sleeve

Posted 25 May 2013 - 01:03 PM

I have so many questions! My paper work was sent to Aetna on Thursday and I am totally freaking out! :eek:  I have been creeping on this site for quite some time. Everyone seems so knowledgeable and supportive and who doesn't need that in their lives?  :wub:   So here is a little bit about me, I am 37 whole 5’5” (almost 5’6”) and 375 lbs. I have sleep apnea, left ventricle hypertrophy and heart failure; all which is new to me with in the year.  So I guess my question is… Should I expect a denial from Aetna?  I am prepared for a NO and hoping for a YES. But like everything I have encountered in my life I am sure I will have to put up a fight even though I “qualify “by their (Aetna) terms.  So if anyone has had to deal with Aetna it would be nice if you could give me some insight on what is to be expected and is it possible that I will get an approval the first try? I thank anyone in advance for the comments or answers. :D



#2 mamaof4monkees

mamaof4monkees

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  • LocationSouthern California
  • Age:37
  • Surgeon:Dr. Scott Um
  • Hospital:Kaiser Permanente West Los Angeles
  • Height (ft-in):5-03
  • Start Weight:241
  • Current Weight:196
  • Goal Weight:125
  • Body Mass Index (BMI):34.8
  • Surgery Date:05/17/2013
  • Surgery Type:Vertical Sleeve

Posted 25 May 2013 - 02:36 PM

Hi and welcome!  I don't know about Aetna's policies but it would definitely be approved through Kaiser with BMI over 40 and even more so with co-morbidity Sleep Apnea etc...  I hope you get a  big YES soon!  And welcome from this newbie - it's amazing  here!


 
Post op diet started Jan 2013 with a High/241
Day of Surgery/211 * 1 week post op 207 * 2 weeks post op 201 * 3 weeks 196

#3 DianaS

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  • LocationDFW Area
  • Age:50
  • Surgeon:Dr. Hodges
  • Hospital:Forest Park
  • Height (ft-in):5-02
  • Start Weight:221
  • Current Weight:139
  • Goal Weight:135
  • Surgery Date:03/20/2013
  • Surgery Type:Gastric Bypass

Posted 25 May 2013 - 02:42 PM

Welcome!!! I also do not have Aetna, but I would think it would depend on the extent of the heart issues.  If you can get (or have gotten) past the cardiac clearance stage, you should be okay.



 
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#4 Elaine M

Elaine M

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  • LocationPortland, Oregon
  • Age:53
  • Surgeon:Dr. Emma Patterson
  • Surgery Date:05/13/2103
  • Surgery Type:Vertical Sleeve

Posted 25 May 2013 - 04:12 PM

Welcome to T-T. I think there is a sub-forum for insurance -- you might find some more info there.

 

Good luck with your insurance approval!


SW (2/8/2013): 325 --- DOS (5/13/2013): 299.8 --- CW: 193.6 -- Height: 5'8"


#5 DonnaLou

DonnaLou

    Newbie

  • Members
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  • 2 posts
  • LocationSt.Louis
  • Age:37
  • Surgeon:Dr. Ricks
  • Hospital:Des Peres Hospital
  • Height (ft-in):5-05
  • Start Weight:389
  • Current Weight:375
  • Goal Weight:180
  • Body Mass Index (BMI):62
  • Surgery Type:Vertical Sleeve

Posted 25 May 2013 - 04:16 PM

Hi all and thank you!! I am glad I decided to join instead of just creeping around LOL! I've look through some of the insurance section and plan to continue looking threw it for some answers.

#6 Grandmastoney

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  • LocationSeattle
  • Age:52
  • Surgeon:Dr ngyen
  • Hospital:Overlake
  • Height (ft-in):5-02
  • Start Weight:262
  • Current Weight:194
  • Goal Weight:120
  • Body Mass Index (BMI):41
  • Surgery Date:07/23/13
  • Surgery Type:Gastric Bypass

Posted 30 May 2013 - 04:23 AM

hi Donna and welcome, I also have aetna, I called them prior and asked them what was covered on my specific plan, iam 52 with lupus and a bmi of 41 they told me on my plan everything was covered 90%
i also have medicare part a &b and they are picking up the other 10%

call aetna and ask on your specific policy, its very relieving to know this information

#7 technogal63

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  • LocationOrland Hills, IL
  • Age:51
  • Surgeon:Dr. Brian Lahmann
  • Hospital:Silver Cross Hospital
  • Height (ft-in):5-09
  • Start Weight:284
  • Current Weight:146.5
  • Goal Weight:156
  • Body Mass Index (BMI):21.6
  • Surgery Date:06/25/2012
  • Surgery Type:Gastric Bypass

Posted 30 May 2013 - 05:22 AM

Welcome!  Sure hope you hear from Aetna soon....  :)


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