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Answers ( 5 )

    0

    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.

    1

    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!

    Best answer
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      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.

    0

    I have Aetna HMO and they do not cover any bariatrics. I was cash pay. So it varies with your plan.

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      I have a PPO and they do cover bariatric surgery. They just have specific parameters if you have a low BMI

    1

    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!

      0

      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.

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        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!!

    0

    You need a BMI over 40 or comorbidity — sleep apnea, HBP, Diabetes to get approved.

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      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.

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