Surprise Surprise.....Cigna Denied me

Called Cigna they said that they did not have a documented 6 mnth Dr supervised weight-loss program. However I submitted a 6 month weigh****chers log to the Vandy clinic and to my PCP. Has anyone gotten approval with a weigh****chers log as the 6 month weight-loss attempt? Does anyone have any advise as to how to deal with this set back? Does anyone have a sample appeal letter that "worked"? I guess I am desperately asking, how can I get them to approve this surgery for me? Here is my story, I lost my job over a year ago. I have applied to nearly every job in my field in this area and several in remnote areas. Of all the interviews I have been to I have yet to get a job from those. I honestly do not believe it is because I am not qualified. I am beginning to think that it may be my physical appearance. I would like to think otherwise but I can't find another reason why I would be looked over for every job in the past year. Yeah yeah I know this sounds like a pity party but I do not intend for this to be that. Anyway any advise would be greatly appreciated. If anyone want to contact me directly I am at [email protected] Jeff

Jeff, Don't get discouraged. This is just a setback that you can overcome. If you know in your heart that you need this surgery, don't stop until you get it. I don't know about the W.W. log. I would think it would be acceptable. That is just my opinion. Others on here may know more about this than me. I do wish you the best of luck. Keep your chin up. Sara.

Jeff, I'm feeling your disappointment and would like to offer some words of encouragement. I found when I was going through what you are, OVERKILL is what worked for me. I asked my PCP for all my medical records, and ANYTHING that even closely resembled an attempt at weight loss, I highlighted with yellow marker and added to my "overkill" packet. My insurance company denied me the first time, and once I submitted my overkill packet, they approved me. They asked me for supervised diets, well, I included Weigh****chers, Jenny Craig, etc etc but they never asked me for proof that I had in fact been supervised on those diets. I think they must have a criteria that they follow, and all they really want is the paperwork to prove they are following the criteria. I hope that this helps in some small way. Since you know you need this surgery, don't let them take your resolve. Keep going as we all did, you WILL make this happen! Best wishes to you, Carol

Hi Jeff, I have Cigna too. I called them and they were adamate about having a physician directed weight loss program. I figured I cut out the middle man and go ahead and sign up for the program that they have at my surgeon's office. They told me that insurances like that program because it involves a nutritionist, exercise physiologist and a psychologist. We meet once a month. Even if I lost 2 lbs / week, I'll still be over my 40 BMI so I figured I'd bite the bullet so I would at least have this under my belt. See if you're surgeon has a program or if they know of such a program. I checked into other programs but they want to sell you weight loss meds like Phenteramine or Hoodia. Hang in there! I figure this is a process and I'll have to do it to get what I want in the end! Janie

Jeff I too have Cigna and was denied the first time for the same reason. You have to have the 6 months physician supervised diet. They will not except the WW diary. At least they didn't for me, I tried. My PCP went back and tweeked my record because I had been to his office at least once a month for the last 6 months and had weighed each time and we had discussed diet and excerise. We do this everytime I go no matter what I go for. When I sent this paper work in I was approved in 8 days. Hang in there. Don't give up. Just keep on submitting what they ask for and they will come around. Who is your surgeon? If you will work with Jennifer Gennings at Vandy, she can get you approved. She is very good at what she does. Also Brandy Powers did a lot for me. And I must mention Beth Goodrich. They are all wonderful so just ask. I email them all the time and they always answer as soon as they can. As for the appeal letter, just get your 6 months supervised diet and send it to Vandy and they will take it from there. They deal with this all the time. Good luck Jeff and hang in there!!!...........Terry

I have Cigna also, and they are sticklers about the 6 month doctor supervised diet....WW is not accepted......After I jumped through the hoops, 6 month diet, psych eval, nurtritionalist eval, letter of medical necessity, I got my approval in 3 days, but when I called to double check, was told I actually had been approved the day they received it....... I too, had tried to get by with my doctor's records, weight loss clinic records in the beginning, but it didn't fly.....Just start you six month diet, make sure your dr documents what you talk about, what you weigh, your exercise etc..... Hope this helps.