Weigh****chers & Cigna HMO

I have just started doing Weigh****chers as part of my PRE-OP stuff, in order to get approved when surgery time comes. Does anyone know if i must go Once a week? OR Can i go Twice a month? I have Cigna HMO. I just want to make sure i go about this the right way. My insurance company does not give me much information. And the surgeon i am on the waiting list for is playing phone tag with my PCP, who has never done this before, so has NO idea what to do. Can someone help? Thanks, Danette

Please make sure that this is what your insurance company will accept as a doctor supervised diet. It was explained to me that a person should make an appointment with their PCP for "weight loss". It is then documented in your file. Then you would schedule an appointment each month with your doctor and the appointment would be specifically for weight loss. In other words, it would not be included with another problem. The appointment must be for the weight loss follow up. The doctor would document everything in your file. Your doctor may recomment Weigh****chers for you and that would be fine, but you would still go to your PCP on a monthly basis for weight loss. I know that everyone hears different things from different doctors so you need to follow what you have been told. Just did not want you to do the 6 month diet only to find out that the waiting was in vein. Check with the person who handles the insurance at your bariatric surgeon's office. Hope this works. I have Unithed Health Care and we have an exclusion. I hope things go better for you. Terry

Please make sure CIGNA will actually accept the weigh****chers. I have CIGNA and it was a real ***** to get approved. My friend (who is still trying to jump through all their hoops) was told weigh****chers would be OK. by the phone answering girl at CIGNA, but the review nurse who was dealing with my case said when it goes through review they do not accept weigh****chers because it is not "physican supervised" Cigna will also not pay for any doctors apts. that are for weight loss. The only way I got approved is that I had been seeing an endocrinologist for diabetes and she had me on a diet for the diabetes. I only got weighed every other month and I really was not seeing her for weight loss even though she did want me to loose weight. I was also told by the review nurse that weigh ins need to be weekly but they did approve me because I had 4 years with the endocrinologist. I would definately get weighed in at weigh****chers weekly to cover your ass if you are going that route. I would hate to have you do the 26 week diet thing and them not accept it because they say you didn't try hard enough by not weighing weekly! Good Luck! - Diane

Danette, HI! I am going thru the same thing with Cigna HMO. I received a letter from my surgeon's office stating Cigna's guidelines as of 4/29/03. They are: 1. A BMI greater than 40 for at least one year or greater than 35 with at least one significant co-morbid that has not responded to non-surgical treatment. Examples of co-morbidities are life threatening cardiopulmonary problems, unmanageable diabetes, hypertension, coronary artery disease, or obesity related pulmonary hypertension. 2. History and documentation of at least 2 different professionally supervised weight loss programs for a minimum of 26 weeks each, with at least one of the programs in the last 12 months. This should include monthly consecutive weigh-ins that are documented. Examples of professionally supervised diets are Weigh****chers, Jenny Craig, a nutritionist or a primary care physician's office. Programs that do not count are Slim Fast, Richard Simmons, or any prescription drugs. 3. Also, documentation from a physician that the co-morbidities have been attempted to be managed. It goes on to say that "documentation" means office notes that were written up while you were in an office visit with the physician. It should include weight, what you have been doing to try to lose weight and what the plan is for you to continue to try. Letters written by your physician that state that you have been trying to lose weight are not acceptable. Even tho it SAYS that you only have to weigh in monthly, I have been going to BOTH my PCP and WW every stinkin' week to get weighed in. I am not going to let Cigna change their "monthly" requirements and not be prepared for it! So... sounds like you are on the right track with WW, provided that you have a documented history of at least one other 26-week diet prior to this one. Good luck! email me anytime to chat about it. If you're interested in coming to support group meetings email me as well. We have a GREAT one that meets in Aurora twice a month! Later, Susan