NEW REQUIREMENTS FOR CIGNA ~ EFFECTIVE 4/29/03

I just received a letter from my doctor that I have been waiting to see, and apparently Cigna has revised their rules governing the approval process for this surgery. I have POS service, but the letter was a form letter to all Cigna patients. They are making it MUCH more difficult to get approved. I dont have the letter in front of me now, but some of the things that were listed were a BMI over 40 for at least a year, (if less than 40 for a year, severe co-morbids had to be present) *I have sleep apnea and high cholesterol and neither of those were listed* . Also required were at least 2 medically supervised diets (One of which had to be a very recent attempt). I can update this and offer better info when I have the letter in front of me. ALSO, I called Cigna just to ask a rep there thinking that maybe I could get a better idea of what's going on and the rep who I spoke to was not very nice~She basically said "You are going to have to go to your PCP and ask THEM what is required by Cigna". I thought with them having a prompt that says "FOR INFORMATION ON YOUR BENEFITS" that I might get some help, but she acted like she did not want to tell me. Hmmmm..... Anyways, I hope this helps you all in your quest, I would advise to check with your surgeon, PCP or Cigna directly to see if there are any unexpected changes!! Good luck all!

Hi Judith, Cigna reps are awful, everyone tells you something different and none of them appear to know what they are talking about. I have had those same issues and i started requestiong to speak to a supervisor when i call. It is awful that it is our well being that we are talking about and they won't discuss anyting with us. I am one of those who caught the rath of the new policy i am stuck at this six month diet thing.

I am just starting my journey and called Cigna today for more information on what I needed and what were the requirements - and the rep there was useless. She wouldn't tell me what I needed to qualify and that it was up to my doctor. Which I know isn't true because so many others where I work have had issues with Cigna approving them. I'm worried that they won't approve me although I have had a BMI over 40 for at least 5 years. She did tell me that if I was accepted my entire copay was $100. Plus I just had a baby and had gestational diabetes that never went away, I'm hoping that will work in my favor with them. I hope you can get it figured out! Good luck on your appeal!

Hello, I have CIGNA PPO and am now aware of their insistance with having 6 mos. of supervised dieting and weigh-ins. It's true that you get different answers from all of them. The last person I spoke with told me to go ahead with my 2nd appeal (a teleconference) without the 6 mos. of dieting. She felt that if I pleaded my case I could win. So on June 10th I will put it to the test. She states that I still have 1 more appeal if I am denied after a second appeal?

Hey everyone~Here I am again, posting without that letter, but I just wanted to say thanks for the response, and PLEASE let me know how appeals go for you as Im sure that I will be on that road at some point in the future. One thing that I think I am going to look into is the website www.obesitylawyers.com ~ They specialize in getting approval beforehand and on appeals and if you start EARLY before denials and such, it can be easier to be approved (I think.) Again, I have not talked to them as of yet, because my hubby may be switching jobs so insurance may totally change... sigh... Anyways, I will keep you all updated on my journey. Even if I started a diet through my PCP now, I would not make the 26 week requirement and I already did Medifast for OVER a year awhile back and can document the 90 pound weight loss and over 100 lb REGAIN.... This is such a frustrating cycle!! Good luck to all of you on your journey, and all you Cigna people that are working on approval since May and June, let us know how it was for you and if you met the requirements, thanks!!!