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10-11-2009, 11:10 PM
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#1 (permalink)
| | Big Loser
Join Date: Jun 2009 Location: Ohio
Posts: 187
Weight Statistics Aug 6th 2009 Start Date:
Feb 25, 2010 Surgery Date:
5' 8"
Height:
294 lb Start Weight:
177 lb Current Weight:
160 lb Goal Weight:
117 lb Weight Loss:
17 lb Lb Left to Lose:
39.7959183673 % % Lost:
2011 Goal Date:
Body Mass Index44.6976643599 BMI Start:
26.9098183391 BMI Current:
24.3252595156 BMI Goal:
 |  Aetna 3 month requirement
I am curious if anyone who did the 3 month requirement, did lose any weight or even gain and get approved?
I am was not put on any real diet or eating plan. Non calorie drinks, make smart choices. Work out 3 times a week. I did not lose any weight. Sometimes I actually gained. I have not clue how, I gave up all my favorites ... pizza, chips, cookies, coke and fried food. I went in for my last weigh in and I was up 2 lbs. Two weeks ago at my PCD, I was down 5 lbs. (I know all scales are different) Also I wonder, I always go to the surgeon's office the first week of the month. Not the best time of the month if you know what I mean?
I wonder if this will affect my approval from Aetna?
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10-25-2009, 12:00 PM
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#2 (permalink)
| | Newbie
Join Date: Sep 2009 Location: Texas
Posts: 6
Weight Statistics 07/21/2009 Start Date:
12/15/2009 Surgery Date:
5' 3"
Height:
237 lb Start Weight:
211 lb Current Weight:
125 lb Goal Weight:
26 lb Weight Loss:
86 lb Lb Left to Lose:
10.970464135 % % Lost:
10/2010 Goal Date:
Body Mass Index41.9780801209 BMI Start:
37.3728898967 BMI Current:
22.1403376165 BMI Goal:
Weight Loss MethodAdjustable Gastric Band
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I am in the same situation. I went for my last nutritionist appt and I was up 2 pounds. I'm just waiting to here from Aetna.
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10-25-2009, 01:00 PM
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#3 (permalink)
| | Seasoned Veteran
Join Date: Mar 2007 Location: Floyd County Virginia
Posts: 9,445
Weight Statistics September 19th 2007 Start Date:
September 19th 2007 June 18,2012 Surgery Date:
5' 10"
Height:
363 lb Start Weight:
226 lb Current Weight:
170 lb Goal Weight:
137 lb Weight Loss:
56 lb Lb Left to Lose:
37.741046832 % % Lost:
When I get there again Goal Date:
Body Mass Index52.0793877551 BMI Start:
32.4240816327 BMI Current:
24.3897959184 BMI Goal:
Weight Loss MethodRoux en Y Gastric Bypass
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I dont know what that clause in your policy acutally states. I would think the Dr that told you this and what you had to do would have told ya? Good luck on this.
__________________ Remember Tough times never last Tough people do... This Ribbon is for our Lady Lisa and all the women that fight this ugly disease. RIP Jerry my friend
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10-25-2009, 01:12 PM
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#4 (permalink)
| | Guru In Training
Join Date: Oct 2009 Location: Southern Oregon
Posts: 206
Weight Statistics April 30, 2010 Surgery Date:
5' 6"
Height:
274 lb Start Weight:
165 lb Current Weight:
145 lb Goal Weight:
109 lb Weight Loss:
20 lb Lb Left to Lose:
39.7810218978 % % Lost:
5/2011 Goal Date:
Body Mass Index44.2199265381 BMI Start:
26.6287878788 BMI Current:
23.4010560147 BMI Goal:
Weight Loss MethodRoux en Y Gastric Bypass
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I am on a 6 month similar program though BCBS, and this is what my Surgeons office told me. She told me that if I had a small weight gain, they could definitely show that there was a reason, ie time of the month, gained muscle, holding water, etc. They will weigh me on a special scale that measures all those things, and then she makes it her job to explain away. The truth is we shouldn't be gaining any, but things happen. She did say that the insurance company would deny if it was ever a large gain or if they were consistent gains every month. Talk to your surgeons office and ask what it is that they submit to the insurance company. At my office, the main person Kathleen, does all that for me. She is very experienced in getting approval, so she will make it happen (as long as I don't completely fail and gain over 10 pounds at a weigh in). I hope you have a person like this at your surgeons office. Good Luck!
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10-25-2009, 01:27 PM
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#5 (permalink)
| | Seasoned Veteran
Join Date: Jul 2009 Location: North
Posts: 2,180
Weight Statistics August 20, 2009 Surgery Date:
5' "
Height:
210 lb Start Weight:
102 lb Current Weight:
110 lb Goal Weight:
108 lb Weight Loss:
-8 lb Lb Left to Lose:
51.4285714286 % % Lost:
August 2010 Goal Date:
Body Mass Index41.0083333333 BMI Start:
19.9183333333 BMI Current:
21.4805555556 BMI Goal:
Weight Loss MethodRoux en Y Gastric Bypass
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Depending on the policy Aetna can be tricky to work with or to get approval from. Have you decreased your caloric intake or at least upped your excercise? If not you may simply be maintaining your current weight. Do you keep a journal of everything that goes into your mouth to see what your intake is? One of the things Aetna looks for before approving is to see if the applicant has the willpower to make and stick with lifestyle changes. Kind of like testing you to see if you can cut the mustard.
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10-25-2009, 07:40 PM
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#6 (permalink)
| | Big Loser
Join Date: Jun 2009 Location: Ohio
Posts: 187
Weight Statistics Aug 6th 2009 Start Date:
Feb 25, 2010 Surgery Date:
5' 8"
Height:
294 lb Start Weight:
177 lb Current Weight:
160 lb Goal Weight:
117 lb Weight Loss:
17 lb Lb Left to Lose:
39.7959183673 % % Lost:
2011 Goal Date:
Body Mass Index44.6976643599 BMI Start:
26.9098183391 BMI Current:
24.3252595156 BMI Goal:
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Thanks everyone for the replies.
I am waiting on old weight records to come in the mail .... no clue what's taking so long.
Anyways, the doctor told me not to worry about it when I asked her. She told me they just want to see that you are trying. I did do everything I was told to do. I was not put on a certain caloric intake. I was just told to cut things out and workout 3 times a week. I did.
BigMomma, let me know how things go for you?
Thanks
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04-18-2011, 01:20 PM
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#7 (permalink)
| | Newbie
Join Date: Mar 2011 Location: Northern VA
Posts: 6
Weight Statistics Jan. 7, 2011 Start Date:
July 28, 2011 Surgery Date:
5' 4"
Height:
320 lb Start Weight:
311 lb Current Weight:
145 lb Goal Weight:
9 lb Weight Loss:
166 lb Lb Left to Lose:
2.8125 % % Lost:
Feb. 14, 2012 Goal Date:
Body Mass Index54.921875 BMI Start:
53.3771972656 BMI Current:
24.8864746094 BMI Goal:
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I know this is an old thread, but I had the same questions.
I'm going to my 3rd and last nutrition class next week. I haven't lost any weight, so I'm really nervous. Last month I gained 2 lbs.
I've been more active but I haven't really been exercising. I have back and knee issues so trying to actually work out usually ends with a day off from work(when i'm trying to save leave for surgery) or round the clock pain meds. I even gave up sweets for Lent and that hasn't helped. I am drinking alot of water and I am definitely eating healthier.
Does anyone have any experience with Aetna ?
P.S. My DH is eating the same diet as me and he's walks around the block at lunch....he's lost 50 lbs.
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04-18-2011, 08:50 PM
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#8 (permalink)
| | Big Loser
Join Date: Mar 2011 Location: Richmond, va
Posts: 138
Weight Statistics 03/04/2011 Start Date:
03/21/2011 Surgery Date:
5' 9"
Height:
396 lb Start Weight:
224 lb Current Weight:
180 lb Goal Weight:
172 lb Weight Loss:
44 lb Lb Left to Lose:
43.4343434343 % % Lost:
aug 2012 Goal Date:
Body Mass Index58.4725897921 BMI Start:
33.0754043268 BMI Current:
26.5784499055 BMI Goal:
Weight Loss MethodRoux en Y Gastric Bypass
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i just had surgery last month and i am with aetna i had gained weight before sergury but my Sergent put me on a liver shrinking diet 3 weeks before and i lost 32 lbs but there are different policies with aetna so it can differ
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396 at heaviest
364 day of surgery
224 as of Jan.19,2012    | |
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04-18-2011, 09:06 PM
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#9 (permalink)
| | Guru In Training
Join Date: Mar 2011 Location: Hudson Valley, NY
Posts: 311
Weight Statistics Too many to list Start Date:
August 17, 2011 (yay!) Surgery Date:
5' 10"
Height:
293 lb Start Weight:
229 lb Current Weight:
150 lb Goal Weight:
64 lb Weight Loss:
79 lb Lb Left to Lose:
21.843003413 % % Lost:
no rush, just want to be healthy Goal Date:
Body Mass Index42.0365306122 BMI Start:
32.8544897959 BMI Current:
21.5204081633 BMI Goal:
Weight Loss MethodRoux en Y Gastric Bypass
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I have Aetna too, my first pre-op surgeon's appointment is tomorrow. I am curious, as well.
__________________ Bertie  Let go of the past and go for the future. Go confidently in the direction of your dreams. Live the life you imagined. - Henry David Thoreau  | |
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05-14-2011, 08:33 AM
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#10 (permalink)
| | Whipper Snapper
Join Date: Mar 2011 Location: Southcentral Lower Michigan
Posts: 21
Weight Statistics 02.2008 (after my dad passed away) Start Date:
10.06.2009 Surgery Date:
5' "
Height:
336 lb Start Weight:
231 lb Current Weight:
150 lb Goal Weight:
105 lb Weight Loss:
81 lb Lb Left to Lose:
31.25 % % Lost:
06.2012 Goal Date:
Body Mass Index65.6133333333 BMI Start:
45.1091666667 BMI Current:
29.2916666667 BMI Goal:
Weight Loss MethodRoux en Y Gastric Bypass
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I had Aetna - six month supervised weight loss. I had to go through this TWICE because we changed insurances! Ugh!
However, I had my last PCP appt on Sept. 15 2009 and got a phone call from my WLS office on Sept. 19 with a date (Oct. 6, 2009)!
Since I had my "out-of-pocket" met they paid 100% of EVERYTHING! God is AWESOME! 
__________________ Theresa Anxiously Awaiting ONEderland!   | |
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