Guest guest Posted May 29, 2000 Report Share Posted May 29, 2000 Hi I to have Aetna us healthcare. Please pray for me as well my PCP appointment is Tuesday and she stated that she will support me. I have completed the on-line form and the appointment form I help I'm not moving to fast please email me if I should be during something else. bka MJRN of land Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 29, 2000 Report Share Posted May 29, 2000 Hi I to have Aetna us healthcare. Please pray for me as well my PCP appointment is Tuesday and she stated that she will support me. I have completed the on-line form and the appointment form I help I'm not moving to fast please email me if I should be during something else. bka MJRN of land Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 8, 2001 Report Share Posted April 8, 2001 .....I was wondering if you could find the info about this surgery on insurance sites....I tried to look on Highmark BC/BS and couldn't find any info about it....if anyone else has found the info on BCBS site could you let me know?? Thanks Bobbi-jo 4-30-01 ( if approved) Dr. Elariny Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 8, 2001 Report Share Posted April 8, 2001 .....I was wondering if you could find the info about this surgery on insurance sites....I tried to look on Highmark BC/BS and couldn't find any info about it....if anyone else has found the info on BCBS site could you let me know?? Thanks Bobbi-jo 4-30-01 ( if approved) Dr. Elariny Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 8, 2001 Report Share Posted April 8, 2001 .....I was wondering if you could find the info about this surgery on insurance sites....I tried to look on Highmark BC/BS and couldn't find any info about it....if anyone else has found the info on BCBS site could you let me know?? Thanks Bobbi-jo 4-30-01 ( if approved) Dr. Elariny Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 8, 2001 Report Share Posted April 8, 2001 Yes , I went to the Aetna site and also found that they are saying they dont approve DS or BPD surgery. Oh no now what? OK Question: Can a RNY be converted into a DS or BPD/DS surgery? If some of us have to go that way , the way of the RNY by forcing it on us then can we later convert it into what we wanted in the beginning? Also, Is there any MEXICO DRs that do the DS surgery? Does anybody know? Thanks so much, Lee H. In a message dated 4/8/01 8:42:32 PM Eastern Daylight Time, W@... writes: << Hi All, I have Aetna HMO and am hoping to have a lap DS from Dr. Elariny in VA in late May. I was just reading the Aetna website this weekend, though, and noticed in the fine print it said it did not pay for DS since it was a " new " procedure. I'm wondering if anyone out there has Aetna HMO and had any problems getting DS versus RNY. Pre-Op BMI 40 >> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 8, 2001 Report Share Posted April 8, 2001 Yes , I went to the Aetna site and also found that they are saying they dont approve DS or BPD surgery. Oh no now what? OK Question: Can a RNY be converted into a DS or BPD/DS surgery? If some of us have to go that way , the way of the RNY by forcing it on us then can we later convert it into what we wanted in the beginning? Also, Is there any MEXICO DRs that do the DS surgery? Does anybody know? Thanks so much, Lee H. In a message dated 4/8/01 8:42:32 PM Eastern Daylight Time, W@... writes: << Hi All, I have Aetna HMO and am hoping to have a lap DS from Dr. Elariny in VA in late May. I was just reading the Aetna website this weekend, though, and noticed in the fine print it said it did not pay for DS since it was a " new " procedure. I'm wondering if anyone out there has Aetna HMO and had any problems getting DS versus RNY. Pre-Op BMI 40 >> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 9, 2001 Report Share Posted April 9, 2001 I dont think you can convert a RNY because the whole point of the DS is to save that one part and when you have the RNY it changes your anatomy. I could be wrong but I think its doubtful. Mexico I'm unfamiliar with. There is one in Spain that does it for around 11,000 US dollars. I know one gal that had the adjustable gastric band done and she loves it. I know for me that would never work. AJ duodenalswitch wrote: > > Yes , I went to the Aetna site and also found that they are saying they dont > approve DS or BPD surgery. Oh no now what? > > OK Question: Can a RNY be converted into a DS or BPD/DS surgery? > If some of us have to go that way , the way of the RNY by forcing it on us > then can we later convert it into what we wanted in the beginning? > > Also, Is there any MEXICO DRs that do the DS surgery? Does anybody know? > > Thanks so much, > Lee H. > > > > In a message dated 4/8/01 8:42:32 PM Eastern Daylight Time, > W@... writes: > > << Hi All, I have Aetna HMO and am hoping to have a lap DS from Dr. Elariny in > Â VA in late May. Â I was just reading the Aetna website this weekend, though, > Â and noticed in the fine print it said it did not pay for DS since it was a > Â " new " procedure. Â I'm wondering if anyone out there has Aetna HMO and had > Â any problems getting DS versus RNY. > Â > Â > Â Pre-Op > Â BMI 40 >> > > ---------------------------------------------------------------------- > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 9, 2001 Report Share Posted April 9, 2001 I dont think you can convert a RNY because the whole point of the DS is to save that one part and when you have the RNY it changes your anatomy. I could be wrong but I think its doubtful. Mexico I'm unfamiliar with. There is one in Spain that does it for around 11,000 US dollars. I know one gal that had the adjustable gastric band done and she loves it. I know for me that would never work. AJ duodenalswitch wrote: > > Yes , I went to the Aetna site and also found that they are saying they dont > approve DS or BPD surgery. Oh no now what? > > OK Question: Can a RNY be converted into a DS or BPD/DS surgery? > If some of us have to go that way , the way of the RNY by forcing it on us > then can we later convert it into what we wanted in the beginning? > > Also, Is there any MEXICO DRs that do the DS surgery? Does anybody know? > > Thanks so much, > Lee H. > > > > In a message dated 4/8/01 8:42:32 PM Eastern Daylight Time, > W@... writes: > > << Hi All, I have Aetna HMO and am hoping to have a lap DS from Dr. Elariny in > Â VA in late May. Â I was just reading the Aetna website this weekend, though, > Â and noticed in the fine print it said it did not pay for DS since it was a > Â " new " procedure. Â I'm wondering if anyone out there has Aetna HMO and had > Â any problems getting DS versus RNY. > Â > Â > Â Pre-Op > Â BMI 40 >> > > ---------------------------------------------------------------------- > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 9, 2001 Report Share Posted April 9, 2001 I dont think you can convert a RNY because the whole point of the DS is to save that one part and when you have the RNY it changes your anatomy. I could be wrong but I think its doubtful. Mexico I'm unfamiliar with. There is one in Spain that does it for around 11,000 US dollars. I know one gal that had the adjustable gastric band done and she loves it. I know for me that would never work. AJ duodenalswitch wrote: > > Yes , I went to the Aetna site and also found that they are saying they dont > approve DS or BPD surgery. Oh no now what? > > OK Question: Can a RNY be converted into a DS or BPD/DS surgery? > If some of us have to go that way , the way of the RNY by forcing it on us > then can we later convert it into what we wanted in the beginning? > > Also, Is there any MEXICO DRs that do the DS surgery? Does anybody know? > > Thanks so much, > Lee H. > > > > In a message dated 4/8/01 8:42:32 PM Eastern Daylight Time, > W@... writes: > > << Hi All, I have Aetna HMO and am hoping to have a lap DS from Dr. Elariny in > Â VA in late May. Â I was just reading the Aetna website this weekend, though, > Â and noticed in the fine print it said it did not pay for DS since it was a > Â " new " procedure. Â I'm wondering if anyone out there has Aetna HMO and had > Â any problems getting DS versus RNY. > Â > Â > Â Pre-Op > Â BMI 40 >> > > ---------------------------------------------------------------------- > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 9, 2001 Report Share Posted April 9, 2001 Thank you AJ for responding. I dont really know what approach to use in finding the answer here. I have looked high and low and come up with nothing every time. I was hoping someone had gone before me and found the answers somewhere. I cant beleive that Aetna is turning down 5 or 6 of the WLS. I just cant beleive all of the prejudice against Fat People. We are conintually put down and downright ignored. This is a sin and has got to stop. I see a huge stream of people continuing to demand WLS for them and one fo these days they all will see that this is not going away...it is for real. Sincerely, Lee H. << I dont think you can convert a RNY because the whole point of the DS is to save that one part and when you have the RNY it changes your anatomy. I could be wrong but I think its doubtful. Mexico I'm unfamiliar with. There is one in Spain that does it for around 11,000 US dollars. I know one gal that had the adjustable gastric band done and she loves it. I know for me that would never work. AJ duodenalswitch wrote: > > Yes , I went to the Aetna site and also found that they are saying they dont > approve DS or BPD surgery. Oh no now what? > > OK Question: Can a RNY be converted into a DS or BPD/DS surgery? > If some of us have to go that way , the way of the RNY by forcing it on us > then can we later convert it into what we wanted in the beginning? > > Also, Is there any MEXICO DRs that do the DS surgery? Does anybody know? > > Thanks so much, > Lee H. > > > >> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 9, 2001 Report Share Posted April 9, 2001 Thank you AJ for responding. I dont really know what approach to use in finding the answer here. I have looked high and low and come up with nothing every time. I was hoping someone had gone before me and found the answers somewhere. I cant beleive that Aetna is turning down 5 or 6 of the WLS. I just cant beleive all of the prejudice against Fat People. We are conintually put down and downright ignored. This is a sin and has got to stop. I see a huge stream of people continuing to demand WLS for them and one fo these days they all will see that this is not going away...it is for real. Sincerely, Lee H. << I dont think you can convert a RNY because the whole point of the DS is to save that one part and when you have the RNY it changes your anatomy. I could be wrong but I think its doubtful. Mexico I'm unfamiliar with. There is one in Spain that does it for around 11,000 US dollars. I know one gal that had the adjustable gastric band done and she loves it. I know for me that would never work. AJ duodenalswitch wrote: > > Yes , I went to the Aetna site and also found that they are saying they dont > approve DS or BPD surgery. Oh no now what? > > OK Question: Can a RNY be converted into a DS or BPD/DS surgery? > If some of us have to go that way , the way of the RNY by forcing it on us > then can we later convert it into what we wanted in the beginning? > > Also, Is there any MEXICO DRs that do the DS surgery? Does anybody know? > > Thanks so much, > Lee H. > > > >> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 9, 2001 Report Share Posted April 9, 2001 Thank you AJ for responding. I dont really know what approach to use in finding the answer here. I have looked high and low and come up with nothing every time. I was hoping someone had gone before me and found the answers somewhere. I cant beleive that Aetna is turning down 5 or 6 of the WLS. I just cant beleive all of the prejudice against Fat People. We are conintually put down and downright ignored. This is a sin and has got to stop. I see a huge stream of people continuing to demand WLS for them and one fo these days they all will see that this is not going away...it is for real. Sincerely, Lee H. << I dont think you can convert a RNY because the whole point of the DS is to save that one part and when you have the RNY it changes your anatomy. I could be wrong but I think its doubtful. Mexico I'm unfamiliar with. There is one in Spain that does it for around 11,000 US dollars. I know one gal that had the adjustable gastric band done and she loves it. I know for me that would never work. AJ duodenalswitch wrote: > > Yes , I went to the Aetna site and also found that they are saying they dont > approve DS or BPD surgery. Oh no now what? > > OK Question: Can a RNY be converted into a DS or BPD/DS surgery? > If some of us have to go that way , the way of the RNY by forcing it on us > then can we later convert it into what we wanted in the beginning? > > Also, Is there any MEXICO DRs that do the DS surgery? Does anybody know? > > Thanks so much, > Lee H. > > > >> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 9, 2001 Report Share Posted April 9, 2001 Lee, I think I am in a pretty good position to respond to this one. I too have Aetna (PPO). Most everyone here knows that I have been working with them for about 10 months too get this surgery approved for myself. I started by sending my case worker at Aetna ALL the research information I had collected for months. Then I also gave ger sites on the web to look up the information herself. 's site was a big help. I knew ahead of time that Aetna does not cover this procedure. They state that and have stuck to it. HOWEVER, After sending the information to my worker and asking her to look at the information (Informally), she said she would. I was months away from asking formally for the proceedure. She looked it over and liked what she saw. She passed it on to her doctor (boss) and asked him to look at it (informally). He did and liked it as well. To make a long story short, My rep called me one day and said that I was unoffically denied. Two days later she called back and told me she could not believe it. She recieved a note from corporate stating that this surgery was is not approved in the policy BUT, they would approve it for me. And, look into the DS as to changing their policy to include it in the future. I know that many have been turned down and those in the denial process are still being denied. But everyone I have talked to that has Aetna, and have asked for this since I started has been approved. Ask Jodie. She just has the DS and Aetna approved her. She applied after I went through the course. Now I am not saying that everyone will be approved. I can't. But I do know that a lot more have been and that they are looking at changing their policy. I have yet to have my DS as I set my own date to fitmy schedule. I am scheduled for May 10th, 2001. And I have been approved by Aetna for months now. Hope your journey goes well. I know Becki is interested as well as others. All I can say is don't give up. It is not a fight just a plan of action. If I can be of any help, --- surfdog1156@... wrote: > Thank you AJ for responding. I dont really know what > approach to use in > finding the answer here. I have looked high and low > and come up with nothing > every time. I was hoping someone had gone before me > and found the answers > somewhere. > I cant beleive that Aetna is turning down 5 or 6 of > the WLS. I just cant > beleive all of the prejudice against Fat People. We > are conintually put down > and downright ignored. > This is a sin and has got to stop. > I see a huge stream of people continuing to demand > WLS for them and one fo > these days they all will see that this is not going > away...it is for real. > Sincerely, > Lee H. > > << > I dont think you can convert a RNY because the > whole point of the DS is to > save that one part and when you have the RNY it > changes your anatomy. I > could be wrong but I think its doubtful. > > Mexico I'm unfamiliar with. There is one in Spain > that does it for around > 11,000 US dollars. I know one gal that had the > adjustable gastric band done > and she loves it. I know for me that would never > work. > > AJ > > duodenalswitch wrote: > > > > Yes , I went to the Aetna site and also found > that they are saying they > dont > > approve DS or BPD surgery. Oh no now what? > > > > OK Question: Can a RNY be converted into a DS or > BPD/DS surgery? > > If some of us have to go that way , the way of > the RNY by forcing it on us > > then can we later convert it into what we wanted > in the beginning? > > > > Also, Is there any MEXICO DRs that do the DS > surgery? Does anybody know? > > > > Thanks so much, > > Lee H. > > > > > > >> > > ---------------------------------------------------------------------- > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 9, 2001 Report Share Posted April 9, 2001 Lee, I think I am in a pretty good position to respond to this one. I too have Aetna (PPO). Most everyone here knows that I have been working with them for about 10 months too get this surgery approved for myself. I started by sending my case worker at Aetna ALL the research information I had collected for months. Then I also gave ger sites on the web to look up the information herself. 's site was a big help. I knew ahead of time that Aetna does not cover this procedure. They state that and have stuck to it. HOWEVER, After sending the information to my worker and asking her to look at the information (Informally), she said she would. I was months away from asking formally for the proceedure. She looked it over and liked what she saw. She passed it on to her doctor (boss) and asked him to look at it (informally). He did and liked it as well. To make a long story short, My rep called me one day and said that I was unoffically denied. Two days later she called back and told me she could not believe it. She recieved a note from corporate stating that this surgery was is not approved in the policy BUT, they would approve it for me. And, look into the DS as to changing their policy to include it in the future. I know that many have been turned down and those in the denial process are still being denied. But everyone I have talked to that has Aetna, and have asked for this since I started has been approved. Ask Jodie. She just has the DS and Aetna approved her. She applied after I went through the course. Now I am not saying that everyone will be approved. I can't. But I do know that a lot more have been and that they are looking at changing their policy. I have yet to have my DS as I set my own date to fitmy schedule. I am scheduled for May 10th, 2001. And I have been approved by Aetna for months now. Hope your journey goes well. I know Becki is interested as well as others. All I can say is don't give up. It is not a fight just a plan of action. If I can be of any help, --- surfdog1156@... wrote: > Thank you AJ for responding. I dont really know what > approach to use in > finding the answer here. I have looked high and low > and come up with nothing > every time. I was hoping someone had gone before me > and found the answers > somewhere. > I cant beleive that Aetna is turning down 5 or 6 of > the WLS. I just cant > beleive all of the prejudice against Fat People. We > are conintually put down > and downright ignored. > This is a sin and has got to stop. > I see a huge stream of people continuing to demand > WLS for them and one fo > these days they all will see that this is not going > away...it is for real. > Sincerely, > Lee H. > > << > I dont think you can convert a RNY because the > whole point of the DS is to > save that one part and when you have the RNY it > changes your anatomy. I > could be wrong but I think its doubtful. > > Mexico I'm unfamiliar with. There is one in Spain > that does it for around > 11,000 US dollars. I know one gal that had the > adjustable gastric band done > and she loves it. I know for me that would never > work. > > AJ > > duodenalswitch wrote: > > > > Yes , I went to the Aetna site and also found > that they are saying they > dont > > approve DS or BPD surgery. Oh no now what? > > > > OK Question: Can a RNY be converted into a DS or > BPD/DS surgery? > > If some of us have to go that way , the way of > the RNY by forcing it on us > > then can we later convert it into what we wanted > in the beginning? > > > > Also, Is there any MEXICO DRs that do the DS > surgery? Does anybody know? > > > > Thanks so much, > > Lee H. > > > > > > >> > > ---------------------------------------------------------------------- > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 10, 2001 Report Share Posted April 10, 2001 , I, too, have Aetna Ushealthcare Managed Choice for my primary insurance..I checked with them as soon as I decided that the BPD/DS was for me--they told me that they do approve it based on medical necessity. The policy my company has does not have a WLS exclusion, but I guess they could attempt to dictate which surgery a person could have, but I dont think they are doing that at this point, the burden of medical necessity appears to fall within the realm of the surgeons & doctors. You are correct in saying it is not a fight but plan of action. take good care. ogretta pre-op & ready may 11, 2001 dr inabnet - In duodenalswitch@y..., Murdock wrote: > Lee, > > I think I am in a pretty good position to respond to > this one. I too have Aetna (PPO). Most everyone here > knows that I have been working with them for about 10 > months too get this surgery approved for myself. I > started by sending my case worker at Aetna ALL the > research information I had collected for months. Then > I also gave ger sites on the web to look up the > information herself. 's site was a big help. > > I knew ahead of time that Aetna does not cover this > procedure. They state that and have stuck to it. > HOWEVER, After sending the information to my worker > and asking her to look at the information > (Informally), she said she would. I was months away > from asking formally for the proceedure. She looked it > over and liked what she saw. > > She passed it on to her doctor (boss) and asked him to > look at it (informally). He did and liked it as > well. To make a long story short, My rep called me one > day and said that I was unoffically denied. Two days > later she called back and told me she could not > believe it. She recieved a note from corporate stating > that this surgery was is not approved in the policy > BUT, they would approve it for me. And, look into the > DS as to changing their policy to include it in the > future. > > I know that many have been turned down and those in > the denial process are still being denied. But > everyone I have talked to that has Aetna, and have > asked for this since I started has been approved. Ask > Jodie. She just has the DS and Aetna approved her. She > applied after I went through the course. > > Now I am not saying that everyone will be approved. I > can't. But I do know that a lot more have been and > that they are looking at changing their policy. I have > yet to have my DS as I set my own date to fitmy > schedule. I am scheduled for May 10th, 2001. And I > have been approved by Aetna for months now. > > Hope your journey goes well. I know Becki is > interested as well as others. All I can say is don't > give up. It is not a fight just a plan of action. > > If I can be of any help, > > > > > > > > --- surfdog1156@c... wrote: > > Thank you AJ for responding. I dont really know what > > approach to use in > > finding the answer here. I have looked high and low > > and come up with nothing > > every time. I was hoping someone had gone before me > > and found the answers > > somewhere. > > I cant beleive that Aetna is turning down 5 or 6 of > > the WLS. I just cant > > beleive all of the prejudice against Fat People. We > > are conintually put down > > and downright ignored. > > This is a sin and has got to stop. > > I see a huge stream of people continuing to demand > > WLS for them and one fo > > these days they all will see that this is not going > > away...it is for real. > > Sincerely, > > Lee H. > > > > << > > I dont think you can convert a RNY because the > > whole point of the DS is to > > save that one part and when you have the RNY it > > changes your anatomy. I > > could be wrong but I think its doubtful. > > > > Mexico I'm unfamiliar with. There is one in Spain > > that does it for around > > 11,000 US dollars. I know one gal that had the > > adjustable gastric band done > > and she loves it. I know for me that would never > > work. > > > > AJ > > > > duodenalswitch@y... wrote: > > > > > > Yes , I went to the Aetna site and also found > > that they are saying they > > dont > > > approve DS or BPD surgery. Oh no now what? > > > > > > OK Question: Can a RNY be converted into a DS or > > BPD/DS surgery? > > > If some of us have to go that way , the way of > > the RNY by forcing it on us > > > then can we later convert it into what we wanted > > in the beginning? > > > > > > Also, Is there any MEXICO DRs that do the DS > > surgery? Does anybody know? > > > > > > Thanks so much, > > > Lee H. > > > > > > > > > >> > > > > > -------------------------------------------------------------------- -- > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 10, 2001 Report Share Posted April 10, 2001 , I, too, have Aetna Ushealthcare Managed Choice for my primary insurance..I checked with them as soon as I decided that the BPD/DS was for me--they told me that they do approve it based on medical necessity. The policy my company has does not have a WLS exclusion, but I guess they could attempt to dictate which surgery a person could have, but I dont think they are doing that at this point, the burden of medical necessity appears to fall within the realm of the surgeons & doctors. You are correct in saying it is not a fight but plan of action. take good care. ogretta pre-op & ready may 11, 2001 dr inabnet - In duodenalswitch@y..., Murdock wrote: > Lee, > > I think I am in a pretty good position to respond to > this one. I too have Aetna (PPO). Most everyone here > knows that I have been working with them for about 10 > months too get this surgery approved for myself. I > started by sending my case worker at Aetna ALL the > research information I had collected for months. Then > I also gave ger sites on the web to look up the > information herself. 's site was a big help. > > I knew ahead of time that Aetna does not cover this > procedure. They state that and have stuck to it. > HOWEVER, After sending the information to my worker > and asking her to look at the information > (Informally), she said she would. I was months away > from asking formally for the proceedure. She looked it > over and liked what she saw. > > She passed it on to her doctor (boss) and asked him to > look at it (informally). He did and liked it as > well. To make a long story short, My rep called me one > day and said that I was unoffically denied. Two days > later she called back and told me she could not > believe it. She recieved a note from corporate stating > that this surgery was is not approved in the policy > BUT, they would approve it for me. And, look into the > DS as to changing their policy to include it in the > future. > > I know that many have been turned down and those in > the denial process are still being denied. But > everyone I have talked to that has Aetna, and have > asked for this since I started has been approved. Ask > Jodie. She just has the DS and Aetna approved her. She > applied after I went through the course. > > Now I am not saying that everyone will be approved. I > can't. But I do know that a lot more have been and > that they are looking at changing their policy. I have > yet to have my DS as I set my own date to fitmy > schedule. I am scheduled for May 10th, 2001. And I > have been approved by Aetna for months now. > > Hope your journey goes well. I know Becki is > interested as well as others. All I can say is don't > give up. It is not a fight just a plan of action. > > If I can be of any help, > > > > > > > > --- surfdog1156@c... wrote: > > Thank you AJ for responding. I dont really know what > > approach to use in > > finding the answer here. I have looked high and low > > and come up with nothing > > every time. I was hoping someone had gone before me > > and found the answers > > somewhere. > > I cant beleive that Aetna is turning down 5 or 6 of > > the WLS. I just cant > > beleive all of the prejudice against Fat People. We > > are conintually put down > > and downright ignored. > > This is a sin and has got to stop. > > I see a huge stream of people continuing to demand > > WLS for them and one fo > > these days they all will see that this is not going > > away...it is for real. > > Sincerely, > > Lee H. > > > > << > > I dont think you can convert a RNY because the > > whole point of the DS is to > > save that one part and when you have the RNY it > > changes your anatomy. I > > could be wrong but I think its doubtful. > > > > Mexico I'm unfamiliar with. There is one in Spain > > that does it for around > > 11,000 US dollars. I know one gal that had the > > adjustable gastric band done > > and she loves it. I know for me that would never > > work. > > > > AJ > > > > duodenalswitch@y... wrote: > > > > > > Yes , I went to the Aetna site and also found > > that they are saying they > > dont > > > approve DS or BPD surgery. Oh no now what? > > > > > > OK Question: Can a RNY be converted into a DS or > > BPD/DS surgery? > > > If some of us have to go that way , the way of > > the RNY by forcing it on us > > > then can we later convert it into what we wanted > > in the beginning? > > > > > > Also, Is there any MEXICO DRs that do the DS > > surgery? Does anybody know? > > > > > > Thanks so much, > > > Lee H. > > > > > > > > > >> > > > > > -------------------------------------------------------------------- -- > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 10, 2001 Report Share Posted April 10, 2001 , I, too, have Aetna Ushealthcare Managed Choice for my primary insurance..I checked with them as soon as I decided that the BPD/DS was for me--they told me that they do approve it based on medical necessity. The policy my company has does not have a WLS exclusion, but I guess they could attempt to dictate which surgery a person could have, but I dont think they are doing that at this point, the burden of medical necessity appears to fall within the realm of the surgeons & doctors. You are correct in saying it is not a fight but plan of action. take good care. ogretta pre-op & ready may 11, 2001 dr inabnet - In duodenalswitch@y..., Murdock wrote: > Lee, > > I think I am in a pretty good position to respond to > this one. I too have Aetna (PPO). Most everyone here > knows that I have been working with them for about 10 > months too get this surgery approved for myself. I > started by sending my case worker at Aetna ALL the > research information I had collected for months. Then > I also gave ger sites on the web to look up the > information herself. 's site was a big help. > > I knew ahead of time that Aetna does not cover this > procedure. They state that and have stuck to it. > HOWEVER, After sending the information to my worker > and asking her to look at the information > (Informally), she said she would. I was months away > from asking formally for the proceedure. She looked it > over and liked what she saw. > > She passed it on to her doctor (boss) and asked him to > look at it (informally). He did and liked it as > well. To make a long story short, My rep called me one > day and said that I was unoffically denied. Two days > later she called back and told me she could not > believe it. She recieved a note from corporate stating > that this surgery was is not approved in the policy > BUT, they would approve it for me. And, look into the > DS as to changing their policy to include it in the > future. > > I know that many have been turned down and those in > the denial process are still being denied. But > everyone I have talked to that has Aetna, and have > asked for this since I started has been approved. Ask > Jodie. She just has the DS and Aetna approved her. She > applied after I went through the course. > > Now I am not saying that everyone will be approved. I > can't. But I do know that a lot more have been and > that they are looking at changing their policy. I have > yet to have my DS as I set my own date to fitmy > schedule. I am scheduled for May 10th, 2001. And I > have been approved by Aetna for months now. > > Hope your journey goes well. I know Becki is > interested as well as others. All I can say is don't > give up. It is not a fight just a plan of action. > > If I can be of any help, > > > > > > > > --- surfdog1156@c... wrote: > > Thank you AJ for responding. I dont really know what > > approach to use in > > finding the answer here. I have looked high and low > > and come up with nothing > > every time. I was hoping someone had gone before me > > and found the answers > > somewhere. > > I cant beleive that Aetna is turning down 5 or 6 of > > the WLS. I just cant > > beleive all of the prejudice against Fat People. We > > are conintually put down > > and downright ignored. > > This is a sin and has got to stop. > > I see a huge stream of people continuing to demand > > WLS for them and one fo > > these days they all will see that this is not going > > away...it is for real. > > Sincerely, > > Lee H. > > > > << > > I dont think you can convert a RNY because the > > whole point of the DS is to > > save that one part and when you have the RNY it > > changes your anatomy. I > > could be wrong but I think its doubtful. > > > > Mexico I'm unfamiliar with. There is one in Spain > > that does it for around > > 11,000 US dollars. I know one gal that had the > > adjustable gastric band done > > and she loves it. I know for me that would never > > work. > > > > AJ > > > > duodenalswitch@y... wrote: > > > > > > Yes , I went to the Aetna site and also found > > that they are saying they > > dont > > > approve DS or BPD surgery. Oh no now what? > > > > > > OK Question: Can a RNY be converted into a DS or > > BPD/DS surgery? > > > If some of us have to go that way , the way of > > the RNY by forcing it on us > > > then can we later convert it into what we wanted > > in the beginning? > > > > > > Also, Is there any MEXICO DRs that do the DS > > surgery? Does anybody know? > > > > > > Thanks so much, > > > Lee H. > > > > > > > > > >> > > > > > -------------------------------------------------------------------- -- > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 10, 2001 Report Share Posted April 10, 2001 ogretta, You are correct. I do not think any insurance has an exclusion for WLS. I may not be right here but I think they have to cover a WLS. Aetna has covered WLS before. But, they only covered the RNY, and only based on medical nesessity. It has not been till recently that they have knowingly covered the DS. Some have had it approved earlier, but Aetna will be the first to tell you that it is because it slipped by somehow. As said earlier in their policy, they do not cover the DS because it is either dangerous or investigational. It looks like they are still investigating but are now approving it based on their findings. They polciy is not yet changed so everyone is not yet being approved. That will come in time. That is why it is improtant to have a good Aetna rep., one who is willing to dig a little to see who in Aetna is approving the DS and working with them. Hopefully it will not be an issue in the near future. --- om55@... wrote: > , I, too, have Aetna Ushealthcare Managed Choice > for my primary > insurance..I checked with them as soon as I decided > that the BPD/DS > was for me--they told me that they do approve it > based on medical > necessity. The policy my company has does not have > a WLS exclusion, > but I guess they could attempt to dictate which > surgery a person > could have, but I dont think they are doing that at > this point, the > burden of medical necessity appears to fall within > the realm of the > surgeons & doctors. You are correct in saying it is > not a fight but > plan of action. take good care. > > ogretta > pre-op & ready > may 11, 2001 > dr inabnet > > > > > - In duodenalswitch@y..., Murdock > wrote: > > Lee, > > > > I think I am in a pretty good position to respond > to > > this one. I too have Aetna (PPO). Most everyone > here > > knows that I have been working with them for about > 10 > > months too get this surgery approved for myself. I > > started by sending my case worker at Aetna ALL the > > research information I had collected for months. > Then > > I also gave ger sites on the web to look up the > > information herself. 's site was a big > help. > > > > I knew ahead of time that Aetna does not cover > this > > procedure. They state that and have stuck to it. > > HOWEVER, After sending the information to my > worker > > and asking her to look at the information > > (Informally), she said she would. I was months > away > > from asking formally for the proceedure. She > looked it > > over and liked what she saw. > > > > She passed it on to her doctor (boss) and asked > him to > > look at it (informally). He did and liked it as > > well. To make a long story short, My rep called me > one > > day and said that I was unoffically denied. Two > days > > later she called back and told me she could not > > believe it. She recieved a note from corporate > stating > > that this surgery was is not approved in the > policy > > BUT, they would approve it for me. And, look into > the > > DS as to changing their policy to include it in > the > > future. > > > > I know that many have been turned down and those > in > > the denial process are still being denied. But > > everyone I have talked to that has Aetna, and have > > asked for this since I started has been approved. > Ask > > Jodie. She just has the DS and Aetna approved her. > She > > applied after I went through the course. > > > > Now I am not saying that everyone will be > approved. I > > can't. But I do know that a lot more have been and > > that they are looking at changing their policy. I > have > > yet to have my DS as I set my own date to fitmy > > schedule. I am scheduled for May 10th, 2001. And I > > have been approved by Aetna for months now. > > > > Hope your journey goes well. I know Becki is > > interested as well as others. All I can say is > don't > > give up. It is not a fight just a plan of action. > > > > If I can be of any help, > > > > > > > > > > > > > > > > --- surfdog1156@c... wrote: > > > Thank you AJ for responding. I dont really know > what > > > approach to use in > > > finding the answer here. I have looked high and > low > > > and come up with nothing > > > every time. I was hoping someone had gone before > me > > > and found the answers > > > somewhere. > > > I cant beleive that Aetna is turning down 5 or 6 > of > > > the WLS. I just cant > > > beleive all of the prejudice against Fat People. > We > > > are conintually put down > > > and downright ignored. > > > This is a sin and has got to stop. > > > I see a huge stream of people continuing to > demand > > > WLS for them and one fo > > > these days they all will see that this is not > going > > > away...it is for real. > > > Sincerely, > > > Lee H. > > > > > > << > > > I dont think you can convert a RNY because the > > > whole point of the DS is to > > > save that one part and when you have the RNY it > > > changes your anatomy. I > > > could be wrong but I think its doubtful. > > > > > > Mexico I'm unfamiliar with. There is one in > Spain > > > that does it for around > > > 11,000 US dollars. I know one gal that had the > > > adjustable gastric band done > > > and she loves it. I know for me that would > never > > > work. > > > > > > AJ > > > > > > duodenalswitch@y... wrote: > > > > > > > > Yes , I went to the Aetna site and also found > > > that they are saying they > > > dont > > > > approve DS or BPD surgery. Oh no now what? > > > > > > > > OK Question: Can a RNY be converted into a DS > or > > > BPD/DS surgery? > > > > If some of us have to go that way , the way > of > > > the RNY by forcing it on us > > > > then can we later convert it into what we > wanted > > > in the beginning? > > > > > > > > Also, Is there any MEXICO DRs that do the DS > > > surgery? Does anybody know? > > > > > > > > Thanks so much, > > > > Lee H. > > > > > > > > > > > > >> > > > > > > > > > -------------------------------------------------------------------- > -- > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 10, 2001 Report Share Posted April 10, 2001 ogretta, You are correct. I do not think any insurance has an exclusion for WLS. I may not be right here but I think they have to cover a WLS. Aetna has covered WLS before. But, they only covered the RNY, and only based on medical nesessity. It has not been till recently that they have knowingly covered the DS. Some have had it approved earlier, but Aetna will be the first to tell you that it is because it slipped by somehow. As said earlier in their policy, they do not cover the DS because it is either dangerous or investigational. It looks like they are still investigating but are now approving it based on their findings. They polciy is not yet changed so everyone is not yet being approved. That will come in time. That is why it is improtant to have a good Aetna rep., one who is willing to dig a little to see who in Aetna is approving the DS and working with them. Hopefully it will not be an issue in the near future. --- om55@... wrote: > , I, too, have Aetna Ushealthcare Managed Choice > for my primary > insurance..I checked with them as soon as I decided > that the BPD/DS > was for me--they told me that they do approve it > based on medical > necessity. The policy my company has does not have > a WLS exclusion, > but I guess they could attempt to dictate which > surgery a person > could have, but I dont think they are doing that at > this point, the > burden of medical necessity appears to fall within > the realm of the > surgeons & doctors. You are correct in saying it is > not a fight but > plan of action. take good care. > > ogretta > pre-op & ready > may 11, 2001 > dr inabnet > > > > > - In duodenalswitch@y..., Murdock > wrote: > > Lee, > > > > I think I am in a pretty good position to respond > to > > this one. I too have Aetna (PPO). Most everyone > here > > knows that I have been working with them for about > 10 > > months too get this surgery approved for myself. I > > started by sending my case worker at Aetna ALL the > > research information I had collected for months. > Then > > I also gave ger sites on the web to look up the > > information herself. 's site was a big > help. > > > > I knew ahead of time that Aetna does not cover > this > > procedure. They state that and have stuck to it. > > HOWEVER, After sending the information to my > worker > > and asking her to look at the information > > (Informally), she said she would. I was months > away > > from asking formally for the proceedure. She > looked it > > over and liked what she saw. > > > > She passed it on to her doctor (boss) and asked > him to > > look at it (informally). He did and liked it as > > well. To make a long story short, My rep called me > one > > day and said that I was unoffically denied. Two > days > > later she called back and told me she could not > > believe it. She recieved a note from corporate > stating > > that this surgery was is not approved in the > policy > > BUT, they would approve it for me. And, look into > the > > DS as to changing their policy to include it in > the > > future. > > > > I know that many have been turned down and those > in > > the denial process are still being denied. But > > everyone I have talked to that has Aetna, and have > > asked for this since I started has been approved. > Ask > > Jodie. She just has the DS and Aetna approved her. > She > > applied after I went through the course. > > > > Now I am not saying that everyone will be > approved. I > > can't. But I do know that a lot more have been and > > that they are looking at changing their policy. I > have > > yet to have my DS as I set my own date to fitmy > > schedule. I am scheduled for May 10th, 2001. And I > > have been approved by Aetna for months now. > > > > Hope your journey goes well. I know Becki is > > interested as well as others. All I can say is > don't > > give up. It is not a fight just a plan of action. > > > > If I can be of any help, > > > > > > > > > > > > > > > > --- surfdog1156@c... wrote: > > > Thank you AJ for responding. I dont really know > what > > > approach to use in > > > finding the answer here. I have looked high and > low > > > and come up with nothing > > > every time. I was hoping someone had gone before > me > > > and found the answers > > > somewhere. > > > I cant beleive that Aetna is turning down 5 or 6 > of > > > the WLS. I just cant > > > beleive all of the prejudice against Fat People. > We > > > are conintually put down > > > and downright ignored. > > > This is a sin and has got to stop. > > > I see a huge stream of people continuing to > demand > > > WLS for them and one fo > > > these days they all will see that this is not > going > > > away...it is for real. > > > Sincerely, > > > Lee H. > > > > > > << > > > I dont think you can convert a RNY because the > > > whole point of the DS is to > > > save that one part and when you have the RNY it > > > changes your anatomy. I > > > could be wrong but I think its doubtful. > > > > > > Mexico I'm unfamiliar with. There is one in > Spain > > > that does it for around > > > 11,000 US dollars. I know one gal that had the > > > adjustable gastric band done > > > and she loves it. I know for me that would > never > > > work. > > > > > > AJ > > > > > > duodenalswitch@y... wrote: > > > > > > > > Yes , I went to the Aetna site and also found > > > that they are saying they > > > dont > > > > approve DS or BPD surgery. Oh no now what? > > > > > > > > OK Question: Can a RNY be converted into a DS > or > > > BPD/DS surgery? > > > > If some of us have to go that way , the way > of > > > the RNY by forcing it on us > > > > then can we later convert it into what we > wanted > > > in the beginning? > > > > > > > > Also, Is there any MEXICO DRs that do the DS > > > surgery? Does anybody know? > > > > > > > > Thanks so much, > > > > Lee H. > > > > > > > > > > > > >> > > > > > > > > > -------------------------------------------------------------------- > -- > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 10, 2001 Report Share Posted April 10, 2001 ogretta, You are correct. I do not think any insurance has an exclusion for WLS. I may not be right here but I think they have to cover a WLS. Aetna has covered WLS before. But, they only covered the RNY, and only based on medical nesessity. It has not been till recently that they have knowingly covered the DS. Some have had it approved earlier, but Aetna will be the first to tell you that it is because it slipped by somehow. As said earlier in their policy, they do not cover the DS because it is either dangerous or investigational. It looks like they are still investigating but are now approving it based on their findings. They polciy is not yet changed so everyone is not yet being approved. That will come in time. That is why it is improtant to have a good Aetna rep., one who is willing to dig a little to see who in Aetna is approving the DS and working with them. Hopefully it will not be an issue in the near future. --- om55@... wrote: > , I, too, have Aetna Ushealthcare Managed Choice > for my primary > insurance..I checked with them as soon as I decided > that the BPD/DS > was for me--they told me that they do approve it > based on medical > necessity. The policy my company has does not have > a WLS exclusion, > but I guess they could attempt to dictate which > surgery a person > could have, but I dont think they are doing that at > this point, the > burden of medical necessity appears to fall within > the realm of the > surgeons & doctors. You are correct in saying it is > not a fight but > plan of action. take good care. > > ogretta > pre-op & ready > may 11, 2001 > dr inabnet > > > > > - In duodenalswitch@y..., Murdock > wrote: > > Lee, > > > > I think I am in a pretty good position to respond > to > > this one. I too have Aetna (PPO). Most everyone > here > > knows that I have been working with them for about > 10 > > months too get this surgery approved for myself. I > > started by sending my case worker at Aetna ALL the > > research information I had collected for months. > Then > > I also gave ger sites on the web to look up the > > information herself. 's site was a big > help. > > > > I knew ahead of time that Aetna does not cover > this > > procedure. They state that and have stuck to it. > > HOWEVER, After sending the information to my > worker > > and asking her to look at the information > > (Informally), she said she would. I was months > away > > from asking formally for the proceedure. She > looked it > > over and liked what she saw. > > > > She passed it on to her doctor (boss) and asked > him to > > look at it (informally). He did and liked it as > > well. To make a long story short, My rep called me > one > > day and said that I was unoffically denied. Two > days > > later she called back and told me she could not > > believe it. She recieved a note from corporate > stating > > that this surgery was is not approved in the > policy > > BUT, they would approve it for me. And, look into > the > > DS as to changing their policy to include it in > the > > future. > > > > I know that many have been turned down and those > in > > the denial process are still being denied. But > > everyone I have talked to that has Aetna, and have > > asked for this since I started has been approved. > Ask > > Jodie. She just has the DS and Aetna approved her. > She > > applied after I went through the course. > > > > Now I am not saying that everyone will be > approved. I > > can't. But I do know that a lot more have been and > > that they are looking at changing their policy. I > have > > yet to have my DS as I set my own date to fitmy > > schedule. I am scheduled for May 10th, 2001. And I > > have been approved by Aetna for months now. > > > > Hope your journey goes well. I know Becki is > > interested as well as others. All I can say is > don't > > give up. It is not a fight just a plan of action. > > > > If I can be of any help, > > > > > > > > > > > > > > > > --- surfdog1156@c... wrote: > > > Thank you AJ for responding. I dont really know > what > > > approach to use in > > > finding the answer here. I have looked high and > low > > > and come up with nothing > > > every time. I was hoping someone had gone before > me > > > and found the answers > > > somewhere. > > > I cant beleive that Aetna is turning down 5 or 6 > of > > > the WLS. I just cant > > > beleive all of the prejudice against Fat People. > We > > > are conintually put down > > > and downright ignored. > > > This is a sin and has got to stop. > > > I see a huge stream of people continuing to > demand > > > WLS for them and one fo > > > these days they all will see that this is not > going > > > away...it is for real. > > > Sincerely, > > > Lee H. > > > > > > << > > > I dont think you can convert a RNY because the > > > whole point of the DS is to > > > save that one part and when you have the RNY it > > > changes your anatomy. I > > > could be wrong but I think its doubtful. > > > > > > Mexico I'm unfamiliar with. There is one in > Spain > > > that does it for around > > > 11,000 US dollars. I know one gal that had the > > > adjustable gastric band done > > > and she loves it. I know for me that would > never > > > work. > > > > > > AJ > > > > > > duodenalswitch@y... wrote: > > > > > > > > Yes , I went to the Aetna site and also found > > > that they are saying they > > > dont > > > > approve DS or BPD surgery. Oh no now what? > > > > > > > > OK Question: Can a RNY be converted into a DS > or > > > BPD/DS surgery? > > > > If some of us have to go that way , the way > of > > > the RNY by forcing it on us > > > > then can we later convert it into what we > wanted > > > in the beginning? > > > > > > > > Also, Is there any MEXICO DRs that do the DS > > > surgery? Does anybody know? > > > > > > > > Thanks so much, > > > > Lee H. > > > > > > > > > > > > >> > > > > > > > > > -------------------------------------------------------------------- > -- > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 10, 2001 Report Share Posted April 10, 2001 Well , it seems like you have a lot of sense. informing instead of pushing truly would be very helpful. I do not like the automatic discrimination against these surgeries. I know that they look at it as cosmetic surgery, and of course it is not. It is both a healthful surgery and necessary surgery. Thanks for responding. Lee H. duodenalswitch wrote: > > Lee, > > I think I am in a pretty good position to respond to > this one. I too have Aetna (PPO). Most everyone here > knows that I have been working with them for about 10 > months too get this surgery approved for myself. I > started by sending my case worker at Aetna ALL the > research information I had collected for months. Then > I also gave ger sites on the web to look up the > information herself. 's site was a big help. > > I knew ahead of time that Aetna does not cover this > procedure. They state that and have stuck to it. > HOWEVER, After sending the information to my worker > and asking her to look at the information > (Informally), she said she would. I was months away > from asking formally for the proceedure. She looked it > over and liked what she saw. > > She passed it on to her doctor (boss) and asked him to > look at it (informally). He did and liked it as > well. To make a long story short, My rep called me one > day and said that I was unoffically denied. Two days > later she called back and told me she could not > believe it. She recieved a note from corporate stating > that this surgery was is not approved in the policy > BUT, they would approve it for me. And, look into the > DS as to changing their policy to include it in the > future. > > I know that many have been turned down and those in > the denial process are still being denied. But > everyone I have talked to that has Aetna, and have > asked for this since I started has been approved. Ask > Jodie. She just has the DS and Aetna approved her. She > applied after I went through the course. > > Now I am not saying that everyone will be approved. I > can't. But I do know that a lot more have been and > that they are looking at changing their policy. I have > yet to have my DS as I set my own date to fitmy > schedule. I am scheduled for May 10th, 2001. And I > have been approved by Aetna for months now. > > Hope your journey goes well. I know Becki is > interested as well as others. All I can say is don't > give up. It is not a fight just a plan of action. > > If I can be of any help, > > > > > > > > --- surfdog1156@... wrote: > > Thank you AJ for responding. I dont really know what > > approach to use in > > finding the answer here. I have looked high and low > > and come up with nothing > > every time. I was hoping someone had gone before me > > and found the answers > > somewhere. > > I cant beleive that Aetna is turning down 5 or 6 of > > the WLS. I just cant > > beleive all of the prejudice against Fat People. We > > are conintually put down > > and downright ignored. > > This is a sin and has got to stop. > > I see a huge stream of people continuing to demand > > WLS for them and one fo > > these days they all will see that this is not going > > away...it is for real. > > Sincerely, > > Lee H. > > > > << > > Â I dont think you can convert a RNY because the > > whole point of the DS is to > > save that one part and when you have the RNY it > > changes your anatomy. Â I > > could be wrong but I think its doubtful. > > Â > > Â Mexico I'm unfamiliar with. Â There is one in Spain > > that does it for around > > 11,000 US dollars. Â I know one gal that had the > > adjustable gastric band done > > and she loves it. Â I know for me that would never > > work. Â > > Â > > Â AJ > > Â > > Â duodenalswitch wrote: > > Â > > > Â > Yes , I went to the Aetna site and also found > > that they are saying they > > dont > > Â > approve DS or BPD surgery. Oh no now what? > > Â > > > Â > OK Question: Can a RNY be converted into a DS or > > BPD/DS surgery? > > Â > If some of us have to go that way , the way of > > the RNY by forcing it on us > > Â > then can we later convert it into what we wanted > > in the beginning? > > Â > > > Â > Also, Is there any MEXICO DRs that do the DS > > surgery? Does anybody know? > > Â > > > Â > Thanks so much, > > Â > Lee H. > > Â > > > Â > > > Â > >> > > > > > ---------------------------------------------------------------------- > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 10, 2001 Report Share Posted April 10, 2001 Well , it seems like you have a lot of sense. informing instead of pushing truly would be very helpful. I do not like the automatic discrimination against these surgeries. I know that they look at it as cosmetic surgery, and of course it is not. It is both a healthful surgery and necessary surgery. Thanks for responding. Lee H. duodenalswitch wrote: > > Lee, > > I think I am in a pretty good position to respond to > this one. I too have Aetna (PPO). Most everyone here > knows that I have been working with them for about 10 > months too get this surgery approved for myself. I > started by sending my case worker at Aetna ALL the > research information I had collected for months. Then > I also gave ger sites on the web to look up the > information herself. 's site was a big help. > > I knew ahead of time that Aetna does not cover this > procedure. They state that and have stuck to it. > HOWEVER, After sending the information to my worker > and asking her to look at the information > (Informally), she said she would. I was months away > from asking formally for the proceedure. She looked it > over and liked what she saw. > > She passed it on to her doctor (boss) and asked him to > look at it (informally). He did and liked it as > well. To make a long story short, My rep called me one > day and said that I was unoffically denied. Two days > later she called back and told me she could not > believe it. She recieved a note from corporate stating > that this surgery was is not approved in the policy > BUT, they would approve it for me. And, look into the > DS as to changing their policy to include it in the > future. > > I know that many have been turned down and those in > the denial process are still being denied. But > everyone I have talked to that has Aetna, and have > asked for this since I started has been approved. Ask > Jodie. She just has the DS and Aetna approved her. She > applied after I went through the course. > > Now I am not saying that everyone will be approved. I > can't. But I do know that a lot more have been and > that they are looking at changing their policy. I have > yet to have my DS as I set my own date to fitmy > schedule. I am scheduled for May 10th, 2001. And I > have been approved by Aetna for months now. > > Hope your journey goes well. I know Becki is > interested as well as others. All I can say is don't > give up. It is not a fight just a plan of action. > > If I can be of any help, > > > > > > > > --- surfdog1156@... wrote: > > Thank you AJ for responding. I dont really know what > > approach to use in > > finding the answer here. I have looked high and low > > and come up with nothing > > every time. I was hoping someone had gone before me > > and found the answers > > somewhere. > > I cant beleive that Aetna is turning down 5 or 6 of > > the WLS. I just cant > > beleive all of the prejudice against Fat People. We > > are conintually put down > > and downright ignored. > > This is a sin and has got to stop. > > I see a huge stream of people continuing to demand > > WLS for them and one fo > > these days they all will see that this is not going > > away...it is for real. > > Sincerely, > > Lee H. > > > > << > > Â I dont think you can convert a RNY because the > > whole point of the DS is to > > save that one part and when you have the RNY it > > changes your anatomy. Â I > > could be wrong but I think its doubtful. > > Â > > Â Mexico I'm unfamiliar with. Â There is one in Spain > > that does it for around > > 11,000 US dollars. Â I know one gal that had the > > adjustable gastric band done > > and she loves it. Â I know for me that would never > > work. Â > > Â > > Â AJ > > Â > > Â duodenalswitch wrote: > > Â > > > Â > Yes , I went to the Aetna site and also found > > that they are saying they > > dont > > Â > approve DS or BPD surgery. Oh no now what? > > Â > > > Â > OK Question: Can a RNY be converted into a DS or > > BPD/DS surgery? > > Â > If some of us have to go that way , the way of > > the RNY by forcing it on us > > Â > then can we later convert it into what we wanted > > in the beginning? > > Â > > > Â > Also, Is there any MEXICO DRs that do the DS > > surgery? Does anybody know? > > Â > > > Â > Thanks so much, > > Â > Lee H. > > Â > > > Â > > > Â > >> > > > > > ---------------------------------------------------------------------- > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 10, 2001 Report Share Posted April 10, 2001 Well , it seems like you have a lot of sense. informing instead of pushing truly would be very helpful. I do not like the automatic discrimination against these surgeries. I know that they look at it as cosmetic surgery, and of course it is not. It is both a healthful surgery and necessary surgery. Thanks for responding. Lee H. duodenalswitch wrote: > > Lee, > > I think I am in a pretty good position to respond to > this one. I too have Aetna (PPO). Most everyone here > knows that I have been working with them for about 10 > months too get this surgery approved for myself. I > started by sending my case worker at Aetna ALL the > research information I had collected for months. Then > I also gave ger sites on the web to look up the > information herself. 's site was a big help. > > I knew ahead of time that Aetna does not cover this > procedure. They state that and have stuck to it. > HOWEVER, After sending the information to my worker > and asking her to look at the information > (Informally), she said she would. I was months away > from asking formally for the proceedure. She looked it > over and liked what she saw. > > She passed it on to her doctor (boss) and asked him to > look at it (informally). He did and liked it as > well. To make a long story short, My rep called me one > day and said that I was unoffically denied. Two days > later she called back and told me she could not > believe it. She recieved a note from corporate stating > that this surgery was is not approved in the policy > BUT, they would approve it for me. And, look into the > DS as to changing their policy to include it in the > future. > > I know that many have been turned down and those in > the denial process are still being denied. But > everyone I have talked to that has Aetna, and have > asked for this since I started has been approved. Ask > Jodie. She just has the DS and Aetna approved her. She > applied after I went through the course. > > Now I am not saying that everyone will be approved. I > can't. But I do know that a lot more have been and > that they are looking at changing their policy. I have > yet to have my DS as I set my own date to fitmy > schedule. I am scheduled for May 10th, 2001. And I > have been approved by Aetna for months now. > > Hope your journey goes well. I know Becki is > interested as well as others. All I can say is don't > give up. It is not a fight just a plan of action. > > If I can be of any help, > > > > > > > > --- surfdog1156@... wrote: > > Thank you AJ for responding. I dont really know what > > approach to use in > > finding the answer here. I have looked high and low > > and come up with nothing > > every time. I was hoping someone had gone before me > > and found the answers > > somewhere. > > I cant beleive that Aetna is turning down 5 or 6 of > > the WLS. I just cant > > beleive all of the prejudice against Fat People. We > > are conintually put down > > and downright ignored. > > This is a sin and has got to stop. > > I see a huge stream of people continuing to demand > > WLS for them and one fo > > these days they all will see that this is not going > > away...it is for real. > > Sincerely, > > Lee H. > > > > << > > Â I dont think you can convert a RNY because the > > whole point of the DS is to > > save that one part and when you have the RNY it > > changes your anatomy. Â I > > could be wrong but I think its doubtful. > > Â > > Â Mexico I'm unfamiliar with. Â There is one in Spain > > that does it for around > > 11,000 US dollars. Â I know one gal that had the > > adjustable gastric band done > > and she loves it. Â I know for me that would never > > work. Â > > Â > > Â AJ > > Â > > Â duodenalswitch wrote: > > Â > > > Â > Yes , I went to the Aetna site and also found > > that they are saying they > > dont > > Â > approve DS or BPD surgery. Oh no now what? > > Â > > > Â > OK Question: Can a RNY be converted into a DS or > > BPD/DS surgery? > > Â > If some of us have to go that way , the way of > > the RNY by forcing it on us > > Â > then can we later convert it into what we wanted > > in the beginning? > > Â > > > Â > Also, Is there any MEXICO DRs that do the DS > > surgery? Does anybody know? > > Â > > > Â > Thanks so much, > > Â > Lee H. > > Â > > > Â > > > Â > >> > > > > > ---------------------------------------------------------------------- > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 10, 2001 Report Share Posted April 10, 2001 GREAT MICHELLE!!! Let us know how it all went in a week or so. I also see that you are not living in NY. How does Aetna handle out of state surgeries? It sounds risky just by way of being a non state resident. I hope I am wrong. Good Luck Lee H. In a message dated 4/10/01 9:42:57 PM Eastern Daylight Time, mibrica@... writes: << Understand however, that Dr. Pomp's office has not yet applied for my surgery. We are waiting until they get the results of my endoscopy, which I am having in two days. Until then I remain cautiously optimistic - based on their confidence - with all appendages triple crossed. But there is no denying that with these other approvals, a presidence is being set. from Philly >> Quote Link to comment Share on other sites More sharing options...
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