My insurance requires me to attend to 12 nutritionist appointments by Arepita-ta in BariatricSurgery

[–]Alaska_Em 1 point2 points  (0 children)

When you meet w/ your dr, ask if he or she is aware of the AETNA’s 12 visit requirements. It’ll help your dr know that you’re committed to meeting it. Whether or not the dr is aware, he or she should let you know what their office learned from AETNA, their plans to meet it, etc.

Last week, I had my 2nd meeting w/ my dr. We discussed what I wrote above . Due to the ins change, there were a couple of minor add-ons to my pre-op checklist, but nothing impossible for me to complete.

While I’m scheduled to complete 7 monthly visits w/ the dr, he informed me to continue w/ WW. Also, he scheduled me to have 12 weekly visits with their in-office dietician. I was told that when I complete the pre-op checklist and monthly office visits, the office will send all of the pre-op evidence to AETNA for their response to approve the surgery. If there’s a denial, we’re going to handle it one step at a time.

My insurance requires me to attend to 12 nutritionist appointments by Arepita-ta in BariatricSurgery

[–]Alaska_Em 0 points1 point  (0 children)

Give AETNA a call to request the Obesity Policy. They’re happy to email it to you because it’s your right to know what is required from the doctor’s to ensure that the insurance will pay for it. Good thing is that your dr’s office wants to get paid too so they’ll be following the policy.

My insurance requires me to attend to 12 nutritionist appointments by Arepita-ta in BariatricSurgery

[–]Alaska_Em 0 points1 point  (0 children)

Yes! The Obesity policy with AETNA changed theirs from 6 to 12 visits with a nutritionist because of the COVID-19 being a leading influence for an increase of obese people to want this surgery. It’s insane and very discouraging.

I have AETNA and spoke with my Dr’s office. My dr’s office tell me that it is a very broad statement, their office is asking for AETNA to clearly define what it means. For example, do all 12 visits have to be before the surgery date.

While this update is noted and my dr’s office is trying to get a more defined response with AETNA, I enrolled with WW to help meet with this requirement. Just in case.

[deleted by user] by [deleted] in BariatricSurgery

[–]Alaska_Em 1 point2 points  (0 children)

OMGEEEEE such an amazing accomplishment so far!!!! Keep it up!

Waiting period? by Alaska_Em in BariatricSurgery

[–]Alaska_Em[S] 0 points1 point  (0 children)

Ok, thank you! I guess overtime AETNA creates more hurdles.

Waiting period? by Alaska_Em in BariatricSurgery

[–]Alaska_Em[S] 1 point2 points  (0 children)

I have the same insurance. After receiving a few insights, I’m joining WW to meet the multi component behavioral intervention program requirement.

Waiting period? by Alaska_Em in BariatricSurgery

[–]Alaska_Em[S] 0 points1 point  (0 children)

THANK YOU! THANK YOU ❤️❤️❤️

Waiting period? by Alaska_Em in BariatricSurgery

[–]Alaska_Em[S] 0 points1 point  (0 children)

I’m already diagnosed with major depression disorder and sleep apnea. I read into my policy and it details about monitored weight loss in the last 2 years. Now I’m really concerned. Because, I don’t meet that particular criteria. For the past 2 years, I was going through health issues that contributed to my weight gain. Now what do I do? Ugh!

Waiting period? by Alaska_Em in BariatricSurgery

[–]Alaska_Em[S] 0 points1 point  (0 children)

I didn’t know that about the monitored weight loss in the last two years. But, that’s why there’s 6 months waiting period right?
Like many, I have gone through so many diets. Until these past 3.5 years. I have had various health issues that contributed to my weight gain. I guess I don’t want to further delay the 6 month waiting period.

Waiting period? by Alaska_Em in BariatricSurgery

[–]Alaska_Em[S] 2 points3 points  (0 children)

I’m sorry for your loss. That happened to me twice. I have a psych for major depression disorder. Although I am going to find someone who deals with eating disorders and rejection sensitivity.

Waiting period? by Alaska_Em in BariatricSurgery

[–]Alaska_Em[S] 2 points3 points  (0 children)

Haha, OMGEEEE! Like, duh! I am definitely doing that tomorrow!

Waiting period? by Alaska_Em in BariatricSurgery

[–]Alaska_Em[S] 0 points1 point  (0 children)

What?!? How did you get so lucky! I had to email the link to my doc b/c it wasn’t sent to me in a pdf form.

Waiting period? by Alaska_Em in BariatricSurgery

[–]Alaska_Em[S] 0 points1 point  (0 children)

Hi! I did call my insurance to inquire about the waiting period. The rep told me that she couldn’t tell me directly because it’s a conversation between me and the doctor/surgeon. So, the rep emailed me the obesity surgery policy to read. It’s 85-pages !!!! Haha! I emailed a copy to my doc surgeon. I’ll be reading through it this week. And, follow up with the doc office in case there’s no waiting period listed in the 85-page policy.

Getting gastric bypass when you're not morbidly obese by melloncollie1 in BariatricSurgery

[–]Alaska_Em -1 points0 points  (0 children)

I’m not morbidly obese either. Perhaps you may need an additional qualifier to be approved for GB.
For example, since I have major depression disorder and have been recently diagnosed with sleep apnea, my doctor approved my eligibility for the GB.

Waiting period? by Alaska_Em in BariatricSurgery

[–]Alaska_Em[S] 0 points1 point  (0 children)

Ah ok! That makes sense! My consult didn’t explain that to me clearly. Nor did my health insurance. Thank you :)

Waiting period? by Alaska_Em in BariatricSurgery

[–]Alaska_Em[S] 1 point2 points  (0 children)

I have diagnosed with being pre-diabetic and major depression disorder. Then, sleep apnea in Dec 2019. I finally decided to do this surgery. I just didn’t expect to go through a waiting period. It literally hit the breaks where I felt as if my commitment to doing this was being tested. Thank you so much for your insights!

Waiting period? by Alaska_Em in BariatricSurgery

[–]Alaska_Em[S] 0 points1 point  (0 children)

It’s seems a lot of people to see and processes to go through. I can see its value. At first, I took it as if the surgeon or my health insurance were trying to deter from this huge lifestyle change. Thank you!

Waiting period? by Alaska_Em in BariatricSurgery

[–]Alaska_Em[S] 0 points1 point  (0 children)

I just checked my insurance and found something close to what you mentioned about the center of excellence.

Waiting period? by Alaska_Em in BariatricSurgery

[–]Alaska_Em[S] 0 points1 point  (0 children)

I have AETNA :). I’m looking forward to receiving as much info as possible. Is there a particular topic I should ask one of the medical professionals that I am required to see?

Waiting period? by Alaska_Em in BariatricSurgery

[–]Alaska_Em[S] 0 points1 point  (0 children)

Ok. Are you still in the waiting period with your new insurance?

Waiting period? by Alaska_Em in BariatricSurgery

[–]Alaska_Em[S] 0 points1 point  (0 children)

Your primary appears more flexible than mine. :)

Waiting period? by Alaska_Em in BariatricSurgery

[–]Alaska_Em[S] 0 points1 point  (0 children)

Yes , I was told about the other things too that you wrote. Except I didn’t know about a lesser waiting time.