Cigna Health C

Has anyone had problems with Cigna? I did all of the pre-op garbage they asked of me with the six months of dieting. (what a waste of time after twenty years of being fat) and the nutritionist, and the mental health testing ($400.00) later. They denied me after the first letter claiming I am not medically necessary. I weight 350 pounds on a five foot two frame with diabetes, hypertension, GERD, back pain and sleep apnea, but I don't have any medical problems according to Cigna. Help!

Have you filed for an appeal yet? That sounds odd that they would deny you with all those problems. I hope everything works out. Keke PS If I come across an appeal letter I will forward it to you!

I have already faxed them my appeal letter. I am going to ask for expedited appeal process which is supposed to give an answer in 72 hours. I have also heard of Obesity Law.com which says they will advocate for me. It is very expensive, but if I have to, I will do it!

Terry, I have Cigna and was denied on the first try. See if you plan has a peer to peer review. That is when your PCP calls the insurance company doctor and talks about your health. I think that this went a long way in getting me approved. Did your PCP document your 6 months of weight lose? Even thought I had been seeing my doctor for 10 years and had been overweight all 10 of those years because it wasn't documented officially as a visit to dicuss weight lose it didn't count and I had to do the 6 months doctor supervised diet. If you've already done that then the peer to peer review will help get you some answers. Good luck! Don't give up, Rhonda -154

Dear Rhonda, My PCP is personally against the surgery and wrote that in his letter, but still documented the six month weight loss thing. In August, he wrote a letter documenting my weight loss failure and I still weighed in September, October, November and December.

I would suggest getting a new PCP! Why go to someone who isn't supportive of your weight lose options when you have so many co-morbidities. I believe that the PCP needs to support you in order to be approved. Rhonda

I have hear Cigna is not covering WLS after January 1, 2006. True or not I don't know? Maybe they are trying to push you out of the time frame. Good Luck. Carol

You might consider an appeal advocate instead of an attorney. I used one - the cost was what I considered to be reasonable. She gave me quite a few references & all were glowing. I add my reference too - Cigna PPO approved my appeal about 48 hours after receiving it. Let me know if you'd like her contact information - you can drop me an email. P~ "Life is too short to wear sensible shoes!" "WWCHD?"

First off Terry - why isn't your WL surgeon's insurance coordinator taking care of this - you shouldn't be the one submitting to the insurance. My dr's office took care of everything - all I did was go have my blood work, cardi work-up and the psych and nutritionist testing done. Look into this - they should have someone available in the office. Barbi