For those of you with Cigna.....

A couple years ago I called our insurance company (Cigna) and asked about WLS.  I was told that our policy has  a strict EXCLUSION prohibiting coverage for ANY type of WLS.  I dropped the whole thing and tried dieting again.  I'm now at 356 and ready to try again to get the surgery - but this time, I am willing to try and fight the insurance company.   From what I've read here it seems like Cigna is always difficult to get approval from?  Where should I start?  Should I go to my PCP first and begin there?    I am 33 years old and I have lost 120 pounds on my own - twice - but each time I gained it back.  I am now at my heaviest weight ever.  I have been diagnosed with high blood pressure, depression, PCOS and weight related infertility.  I am having trouble with my knees, my feet, my legs, etc.....I suspect that I have sleep apnea but don't have a diagnosis for that yet.  My BMI is 54.   Is there any hope at all that I can get it covered? Any feedback, suggestions, hints & tips appreciated.  I have two small children now (adopted, ages 3 and 1) and I'm determined to live to see them grow up. Thanks for your help! Therese

I know someone who got approved by Cigna for the DS.  She had a heck of a time, but after several appeals, they approved her.  I'm not sure what WLS you are looking into.  Consider all of your options.  My dr. only suggests the DS for people with a bmi of 50 and over.  I don't know anyone that got approved for the rny with them, only because I am on the DS board mostly.  You could always post on the DS and rny boards and ask this question. 

Good luck!!

My policy excludes WLS. However if it is medically necessary they will pay for it. I am in the same boat as you are and I got my RNY approved after my six month diet. I am having it done the 12^th of December. Best of luck to you.

I got approval from Cigna for RNY in Oct. Now I’m in the appeal process for the Duodenal Switch. You just need to follow the guidelines set out by Cigna and you will be fine.  Unless you’re trying to get the DS, Then you will have to fight them for approval. I believe the DS is worth the fight.