On my last leg - hoping for approval

Larimer_Tom
on 9/24/06 1:47 pm - Fort Collins, CO
I'm on my last leg hoping for approval. My wife has more confidence than I do. I have a BMI of 74, 463lbs, high blood pressure, astham/bronchitis, severe knee & hip pain, & severe obstructive sleep apnea ( Doc says he's amazed I'm still alive). Still I'm denied becaues of no medically necissity. I'm pre-paring for an external appeal but I have no idea how many co-morbidities it takes before they tell Cigna it is medically necessary. I am depressed and I am on meds but this has just about taken the last breath out of me. I don't know how many more prayers will help, as much as we all hope we are in control I know I've got to let God help with this. I'm tired of not being able to hardly move and not being able to breath. If anyone has any ideas on how I can help my lawyer with this please let me know.
Angela W.
on 9/24/06 1:50 pm - New Orleans, LA
Tom:  I've written you before, so won't repeat all that, but you will want to obviously list any medical condition that you've been diagnosed with , especially those that might be secondary to obesity.  You may also want to sit down and kind of mentally go through a day in your life and make some notes about how many things you cannot do or cannot do adequately in your daily life due to obesity. I wish you all the best luck in the world!
Angela
Kym B.
on 9/24/06 8:07 pm - Lawrenceburg, TN
Tom, I've never in my life heard of anyone needing this surgery like you do but being denied for having no necessity...that is ridiculous.  I don't know what to tell you that would help, but I felt the need to let you know that I have begun praying for you by name and in earnest right now.  Keep faith that the Lord will provide...perhaps just not in the way you may be thinking of.  God bless !
PFTingos
on 9/27/06 12:14 am - Chester, NH
Hi Tom, I wanted to tell you to fight it! Before anything, ask God for guidance, ask Him to lead the way and start on your grievance. First level of appeal, second, external review, whatever it takes. We don't need to accept their decisions, we can fight it. Let me tell you something. My insurance has a full exclusion and I am now, as a matter of fact today, on my second level of appeal. I have contacted all of my legislators and sent e-mails and letters to everyone and guess what? Senator Jack Barnes, from NH is has volunteered to represent me at the board meeting TODAY. They are trying to change the wording on their policy so it would exclude wls UNLESS MEDICALLY NECESSARY. I have Severe OSA, Asthma/ Bronchitis, High Blood pressure and my BMI is 53 and I was certified as medically necessary. Ask for letters from your PCP, Nutritionist, Surgeon and anyone else you can think of. Good luck and keep us posted. Let me know if I can help you in any way Take care
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