Does anyone in the states with a low BMI have Aetna insurance? If so what comorbidities did you have? I have PCOS, insulin resistance, high cholesterol, depression, anxiety and a past history of cancer. I’m afraid that won’t be enough for insurance approval. So, I’m trying to be proactive and look at all my options.
Answers ( 5 )
I would also consider whether or not you have arthritis, joint or back pain, or other orthopedic issues. They won’t want to cover a knee replacement if VSG (Vertical Sleeve Gastrectomy) could prevent that.
I have Aetna insurance, and my doctor submitted a great letter detailing back and knee pain (due to my weight), and an elevated cholesterol level… they accepted it. I have to say Aetna was very easy to deal with..no problems at all
High cholesterol is one for sure; if you have a proactive type PCP, he should be able to plead your case with the other things you have listed!
Thank you! That gives me a bit of hope. I’m going through a bariatric center so I’ll make sure I get my PCP to write a letter as well.
I have Aetna HMO and they do not cover any bariatrics. I was cash pay. So it varies with your plan.
I have a PPO and they do cover bariatric surgery. They just have specific parameters if you have a low BMI
My BMI is 35.5 and I have Aetna! I have high BP. That was my only comorbidity until I did a sleep study. Came to find out I also have sleep apnea. My doctor is certain that Aetna insurance will approve it!
Sleep apnea seems to be a guarantee that it’ll be approved! I haven’t gone and done the sleep study yet! So I guess we will see! I don’t know if my health issues are really what Aetna considers comorbidities.
Good luck! it’s kinda embarrassing to have sleep apnea, and I admit I was disappointed, but if it guarantees the surgery will be covered, I can live with it until it goes away!!
You need a BMI over 40 or comorbidity — sleep apnea, HBP, Diabetes to get approved.
Not with my insurance. With a BMI of 35-38, you can get approved if you have comorbidity or several issues. I’ve called them. Maybe it differs per plan.