[Michelle]

I have all of the criteria Aetna says is required to the surgery, but my Dr's office submitted it and it was denied. Part of their criteria is that I need to have been morbidly obese for 5 years (or BMI of 40). I appealed the denial, but I am nervous because my BMI has fluctuated up and down for 10 years. Has anyone had any similar situations?

Thanks,

Michelle

[jbarfield]

I have Aetna and my surgeons' coordinator told me to get a copy of one page from the doctors file showing my weight for 5 years. In other words, 5 doctor's pages. My weight fluctuates also, but I was able to find a time during the year that show that I was overweight. Do you have any co-morbidities as well. I do and in that case your BMI does not have to be 40 or more.