CIGNA OF NH NIGHTMARE

OK SO FIRST CIGNA OF NH DENIES ME TO HAVE GASTRIC BYPASS SURGERY BECAUSE I HAVE NOT HAD ENOUGH SUPERVISED WEIGHT LOSS ATTEMPTS. SO I APPEAL TO NO AVAIL. SO I GO SEE MY PCP AND HE REFERS ME TO SEE A DIETICIAN TO START A WEIGHT LOSS PROGRAM AND CIGNA WILL NOT COVER IT. SO I GO BACK TO SEE MY PCP AND WE DISCUSS IT AND HE GIVES ME A PRESCRIPTION FOR MERIDIA. AND GUESS WHAT CIGNA WONT COVER THAT OR ANY OTHER WEIGHT LOSS MEDICATIONS EITHER. SO NOW THEY REQUIRE ME TO HAVE SUPERVISED WEIGHT LOSS ATTEMPTS BEFORE THEY WILL PAY FOR MY SURGERY BUT THEY WONT COVER ANY. SO NOW WHAT AM I SUPPOSED TO DO?

Unfortunately, you are going to have to shell out the $$$ for your diet programs...You must do everything required by CIGNA if you want them to approve your surgery, so just pay for what you have to pay for to get your surgery covered...Good luck!

Jennifer, first of all, you have to check out the yahoo group, cignasqueekywheels. Phenomenal group of women who have been fighting Cigna to get approved for WLS. Here's what we've figured out about the nasty diet business. Cigna will not accept any diet that includes a drug, like meridia, or weigh****chers, jenny craig, anything like that. They changed their criteria on October 1st. If you initially submitted your information prior to that, you should still be okay with Weigh****chers, but not Meridia. We found out for a fact that they wont accept any diets that are based around a drug. ( Unfortunately, they will also not help pay for the diet, outside of covering your Physician appointments for weigh in. Of course if you have a copay, that still applies. A diet could be something as simple as following a diabetic diet or an atkins type diet and having that noted in your medical chart, then weighing in once a month for the time that Cigna requires. I recommend that you try to find our cigna group... I wouldn't have had the sanity or drive to fight this company without the people at that board. Email me if you need anything, April