DENIED

Just got a call from the nurse at my doctor's office to advise that CIGNA denied me because I didn't have the full 6 months of MD supervised weight loss....PLEASE! 

I have been trying UNSUCESSFULLY since age 10 to lose weight. Considering WLS was not easy for me or a decision that is easy!

I filed a complaint with the Georgia Ins. Commissioner, and my doctor is scheduled to do a "peer to peer" with one of CIGNA's doctors.

Is there anyone out there who has been denied intially and then approved?

I believe that's a Cigna standard. There is no way around it. We ALL had to do the 6 mos diet.  Most insurance companies require 3-6 months. The time it would take you to write a letter, appeal, etc, you coulda just did the diet.




Sorry, I know it's not what you want to hear BUT do the diet and resubmit. 


I am surprised your surgeon didn't let you knwo you would need to do the diet upfront. They usually tell you all that before your consult??

Hey, thank you for the feedback....I had the same thought too..."I shoulda started seeing the MD right away for the supervised weight loss just in case".....I am going to go thru the appeal process and while I wait, I am going to re-start the MD supervised weight loss program. Heck, it can't hurt!

Another thing to consider is whether your insurance plan is self funded or not. If it is, the insurance commissioner won't have much authority to override them.

Also, Cigna requires 6 mos of support meetings on some plans. 


Have you called Cigna to see what the pre-op requirements are for your plan?  Where do you work? Maybe someone else on the board can guide you through ght process  if we can figure out which Cigna you have.

Thanks for your feedback...I have Cigna PPO.....I have made an appt. for the 22nd at Weight Loss MD to start my supervised weight loss program (again). Did last year, but for only 4 months. I think Cigna could make an acception in my case, and as such, I did file a complaint with the insurance commissioner, and my doctor is appealing their decision on Monday.

I know it's frustrating to get push-backs from your insurance company but your weight problem didn't arrive over night and a solution probably won't either. Most of us had many obstacles thrown at us by our insurance companies and just kept jumping over, under and around them instead of trying to fight them. In the end, they have the checkbook.

Taking 6 months to follow a doctor supervised diet is not that long when you think about having to measure portions and eat healthy foods for the rest of your life. WLS is certainly not the magic bullet I had hoped it would be. It is simply one part of a much bigger solution-- making healthy eating choices, measuring portions, drinking enough water, taking a multi-vitamin each day, increasing my activity (exercise) as the weight comes off and so on. The surgery doesn't change what kinds of foods I want to eat, order healthy off a menu, do my grocery shopping or make me go exercise. The surgery did make me feel satisfied with smaller portions. That was a miracle. But, if I kept eating the same foods, just smaller portions, I would not have been very successful.

Whatever happens, I wish you much success on your journey.

Thanks Mick for responding to my vent! I agree that 6 months is a "drop in the bucket" in terms of time and my weight issues ( which have been with me since the beginning of my time!)....I am going to give the MD a call today and re-start the supervised weight loss program. At least it's a step in the "right" direction.....and this time,  I will work closely with the nutrionist to develop healthy eating patterns and not just smaller portions of the junk I eat now.