Cigna "Duration of more than 5 years"???

beck720
on 9/8/10 12:53 am - Granby, MA
Ugh!  I've been denied TWICE from Cigna.  "The obesity problem must have a duration of more
 
than five years.  The documentation submitted indicates that while your current BMI is greater
 
than 40, it has ranged between 30 and 40 over the past 5 years.  Therefore this request cannot
 
be approved, as the documentation does not support that you have been consistently obese

over the time period required by your benefit plan."

Ummm............ I thought having a BMI of 30 or greater IS obese?!  It has fluctuated because I have been trying on my OWN to lose the weight before turning to the Band. 

Has anybody been through this?  Any suggestions?  I'm about ready to give up.  I asked for their requirements many times and NOWHERE does it say the mentioned above, only in their letters to me.

Any help or suggestions would be greatly appreciated.

Thank you.
Becky
WASaBubbleButt
on 9/21/10 3:43 am - Mexico
This one is hard, an appeal could go either way. Have you tried a peer to peer review?

Yes, 30 is obese but most ins co's don't pay until you are morbidly obese.

Previously Midwesterngirl

The band got me to goal, the sleeve will keep me there.

See  my blog for newbies: 
http://wasabubblebutt.blogspot.com/
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