Cigna GA SHBP starting my journey, Just Wondering...
Conrats on taking the 1st step. You have a long journey ahead of you.
I have Cigna SHBP. If you follow all the guidelines and your surgeon is quick with paperwork then YES you can get your surgery in 6 months. I would allow another month or 2 because you have to consider the surgeron and pcp will have to write your letters and fax and you will have to wait for an open surgrey slot. So plan for the worst (8 months) and expect the best (6 months).
When my surgeon faxed my papoers to Cigna I received an approval in less than 3 hours...
Open enrollment starts next month. You need to choose Cigna or UHC HRA or HIgh Deductible insurance. None of the others cover wls.
Be sure to stick to the Cigna guidelines. Don't miss a support group or diet visit. Take the health assesment, etc. Call them often at least a couple of times each month to see if there are any changes to the requirements. Also call and ask to be assigned a case manager right away. They can be a godsend for inside info and can help get your stuff rushed through asap.
You should also be your own secretery and document everything, phone calls to insurance reps, Dr. visit dates, testing dates, etc. Invest in an inexpensive binder and dividers and start saving everything. Also keep copies of all the test results and get a copy of each diet visit report from your pcp. This way if your surgeon loses it (yes they lose stuff) or you switch surgeons (like me), you wil lhave your own copies of everything at hand, and can fax them wherever needed in a pinch. My last couple of months into this, I took my folder everywhere!
I know it seems loony, but I can't count the number of times I was at work, I had to run out to the car and fax something to the surgeon's office. If you ever had to buy a house, it's kinda the same way... having to get stuff turned in at that last hour.
As for me my bmi was 53, I had co-morbids, and I had my DS at Centennial Medical Center in Nashville TN.
If you have a high bmi and you are not having DS try to lose as much as possible without going under the Cigna bmi limit. You need to be as healthy as possible for this surgery. Start walking and watch your diet.
Get involved with a good support group asap. Emory charges for their group, but there are plenty in town that are free. You will need 6 mos of support group visits for insurance approval. I think you need more than that for knowledge, support, and peace of mind. You may have supportive family and friends, but nothing compares to calling up your wls buddies who've been through this already. I am blessed to have a lot of wls friends and I would have been blind and crazy these past few months without them. Izzy called me 3x a day when I was battling dehydration to fuss at me and make me eat. Atlanta Laura physically picked up my cup of tea and MADE me drink to keep hydrated. GInger and Laura took me out for my last supper and laughed and cried with me over my last piece of cake.
My wls buddies have given me phone calls, and clothes and hugs, and protein, and vitamins, and a kick in the ass when I needed it!
You can PM me anytime you have a question. If you need my ph# pm me and I will send it. There will be times these next 6 months you will cry, and scream, and want to roll over and play dead because it can be a very frustrating process. I am here anytime you need me.
A lot of shbp people have gotten surgery this year and disapeared on us. We cried, prayed, and faught the system together, and they got their surgries and ran from OH.
I promise not to do that. I am commited to being here to support you and everybody else through this process like people did for me.
~ Best Wishes on Your Journey
LaShelle
I have Cigna SHBP. If you follow all the guidelines and your surgeon is quick with paperwork then YES you can get your surgery in 6 months. I would allow another month or 2 because you have to consider the surgeron and pcp will have to write your letters and fax and you will have to wait for an open surgrey slot. So plan for the worst (8 months) and expect the best (6 months).
When my surgeon faxed my papoers to Cigna I received an approval in less than 3 hours...
Open enrollment starts next month. You need to choose Cigna or UHC HRA or HIgh Deductible insurance. None of the others cover wls.
Be sure to stick to the Cigna guidelines. Don't miss a support group or diet visit. Take the health assesment, etc. Call them often at least a couple of times each month to see if there are any changes to the requirements. Also call and ask to be assigned a case manager right away. They can be a godsend for inside info and can help get your stuff rushed through asap.
You should also be your own secretery and document everything, phone calls to insurance reps, Dr. visit dates, testing dates, etc. Invest in an inexpensive binder and dividers and start saving everything. Also keep copies of all the test results and get a copy of each diet visit report from your pcp. This way if your surgeon loses it (yes they lose stuff) or you switch surgeons (like me), you wil lhave your own copies of everything at hand, and can fax them wherever needed in a pinch. My last couple of months into this, I took my folder everywhere!
I know it seems loony, but I can't count the number of times I was at work, I had to run out to the car and fax something to the surgeon's office. If you ever had to buy a house, it's kinda the same way... having to get stuff turned in at that last hour.
As for me my bmi was 53, I had co-morbids, and I had my DS at Centennial Medical Center in Nashville TN.
If you have a high bmi and you are not having DS try to lose as much as possible without going under the Cigna bmi limit. You need to be as healthy as possible for this surgery. Start walking and watch your diet.
Get involved with a good support group asap. Emory charges for their group, but there are plenty in town that are free. You will need 6 mos of support group visits for insurance approval. I think you need more than that for knowledge, support, and peace of mind. You may have supportive family and friends, but nothing compares to calling up your wls buddies who've been through this already. I am blessed to have a lot of wls friends and I would have been blind and crazy these past few months without them. Izzy called me 3x a day when I was battling dehydration to fuss at me and make me eat. Atlanta Laura physically picked up my cup of tea and MADE me drink to keep hydrated. GInger and Laura took me out for my last supper and laughed and cried with me over my last piece of cake.
My wls buddies have given me phone calls, and clothes and hugs, and protein, and vitamins, and a kick in the ass when I needed it!
You can PM me anytime you have a question. If you need my ph# pm me and I will send it. There will be times these next 6 months you will cry, and scream, and want to roll over and play dead because it can be a very frustrating process. I am here anytime you need me.
A lot of shbp people have gotten surgery this year and disapeared on us. We cried, prayed, and faught the system together, and they got their surgries and ran from OH.
I promise not to do that. I am commited to being here to support you and everybody else through this process like people did for me.
~ Best Wishes on Your Journey
LaShelle
I am also a state employee and will be switching t oCigna HRA. I was told that we had to have 6 months in a physical fitness program or some sort of exercise program. Do you know what counts for this? I made an appt. with my PCP for next week to get on a diet progrma for the six months so when my insurance changes over, I will have had three months done.
I didn't have to do an exercise program? Where did you get that info? SHBP Cigna is different from other Cigna plans, so be sure it is a shbp requirement.
I would make sure to get the requiremetns in writing January1, 2010 and make Cigna honor them. They tried to add requirements to us midstream, but we fought them and won.
I would make sure to get the requiremetns in writing January1, 2010 and make Cigna honor them. They tried to add requirements to us midstream, but we fought them and won.
I can't remember if I read it in the Bariatric info from Cigna or if the customer service person told me. At open enrollment, during the health fairs, wouldn't they need to give us something in writing regarding the process for 2010? What does the psych eval. entail? Is it filling out a questionnaire or seeing a pschologist? What are they trying to figure out?
Well, I guess they've changed it AGAIN. My advice would be just to do whatever they ask. 6 months of doing anything is worth having a lifetime of not being obese.
I would just make sure to log everythign you do. Ask them how they want you to keep track of it and verify it.
I only lost 7 pounds on my 6 mos supervised diet, since my bmi was 52-3 and I didn't want it to fall below 50 for the DS. You don't actually have any certain amt that you have to lose for them to approve you. I did really work hard after I got my approval to eat better and exercise though.
I don't think they will have the requirements available at open enrolllment. You may have to call and have them mailed or get them off the website.
Keep us posted on everything you do w/ Cigna please.
I would just make sure to log everythign you do. Ask them how they want you to keep track of it and verify it.
I only lost 7 pounds on my 6 mos supervised diet, since my bmi was 52-3 and I didn't want it to fall below 50 for the DS. You don't actually have any certain amt that you have to lose for them to approve you. I did really work hard after I got my approval to eat better and exercise though.
I don't think they will have the requirements available at open enrolllment. You may have to call and have them mailed or get them off the website.
Keep us posted on everything you do w/ Cigna please.
What she said!
I to have Cigna HRA. I have a bmi of 44 with Co-morbidities. It took me a little longer to get my stuff together as far as clearances. I thought I could get by without having some of the test run. The Pulmonary function test and at first I couldn't get a cardiac clearance. But all was well with the ticker and the cardiologist cleared me. Once I had everything together, I faxed it in to Dr. Hobson's office. I called to check to make sure they had everything and she (Colleen I think) told me that they were running about 3 weeks behind cause they had just moved their office. But she called me on the day that she faxed it to the insurance co. The very next day, she called me back to tell me I was approved by Cigna. I was doing the happy dance big time.
My surgery is October 5th. Its been a long journey, but I think it will be worth it in the long run.
Pray and most any questions you have, someone one OH can answer it or help you find the answers. Really great people on here.
Pray
Until
Something
Happens
I to have Cigna HRA. I have a bmi of 44 with Co-morbidities. It took me a little longer to get my stuff together as far as clearances. I thought I could get by without having some of the test run. The Pulmonary function test and at first I couldn't get a cardiac clearance. But all was well with the ticker and the cardiologist cleared me. Once I had everything together, I faxed it in to Dr. Hobson's office. I called to check to make sure they had everything and she (Colleen I think) told me that they were running about 3 weeks behind cause they had just moved their office. But she called me on the day that she faxed it to the insurance co. The very next day, she called me back to tell me I was approved by Cigna. I was doing the happy dance big time.
My surgery is October 5th. Its been a long journey, but I think it will be worth it in the long run.
Pray and most any questions you have, someone one OH can answer it or help you find the answers. Really great people on here.
Pray
Until
Something
Happens
Wow, replies, I never got a reply on soul cysters on the WLS forum
I am new to OH and you girls rock! God sure does work in odd ways, just when you think you are alone and then he whispers in your ear...
I talked with my coach Pam, she stressed to follow the check list...Our first Nutrientist visit is Oct. 1, my husband is doing this with me!
I found this about the exercise---
The weight-management program must include monthly documentation of ALL of the following components:
� weight
� current dietary program
� physical activity (e.g., exercise program)
In my documents this will include walking the track at the park when my son is playing, walking dogs and walking neighborhood. If you want you could always join Curves. I think they just want us to get up and move.
I have been fat since 3rd grade, 6 months is March, April is my birthday & Easter. I hope The Easter Bunny brings my surgery ok. I told my health coach that and she said it is possible. God is with me, he led me here and the meeting at the bank...It will happen.
I hope you are all doing well. Anyone know of an opening for a great receptionist???
Thanks for the whispers!
Shalom
I am new to OH and you girls rock! God sure does work in odd ways, just when you think you are alone and then he whispers in your ear...
I talked with my coach Pam, she stressed to follow the check list...Our first Nutrientist visit is Oct. 1, my husband is doing this with me!
I found this about the exercise---
The weight-management program must include monthly documentation of ALL of the following components:
� weight
� current dietary program
� physical activity (e.g., exercise program)
In my documents this will include walking the track at the park when my son is playing, walking dogs and walking neighborhood. If you want you could always join Curves. I think they just want us to get up and move.
I have been fat since 3rd grade, 6 months is March, April is my birthday & Easter. I hope The Easter Bunny brings my surgery ok. I told my health coach that and she said it is possible. God is with me, he led me here and the meeting at the bank...It will happen.
I hope you are all doing well. Anyone know of an opening for a great receptionist???
Thanks for the whispers!
Shalom
OKAY!!! That's not a change! You guys had me worried for a minute that Cigna was acting foolish again.
All that means is that when your pcp sends inyour diet letter, they need to include that you did some type of exercise. Mine wrote something to the effect of " patient has been walking for exercise, but is unable to do much because of impaired mobility" (I actually wrote my own pcp letter and had her sign off on it by the way)
So, you don't have to join a gym or log anything or even exercise for that matter. Just have yor pcp write down that you did...
All that means is that when your pcp sends inyour diet letter, they need to include that you did some type of exercise. Mine wrote something to the effect of " patient has been walking for exercise, but is unable to do much because of impaired mobility" (I actually wrote my own pcp letter and had her sign off on it by the way)
So, you don't have to join a gym or log anything or even exercise for that matter. Just have yor pcp write down that you did...
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