Can someone please help me write my appeal letter?!! I have been denied because of my weight in 2011. I resubmitted new documents from my pediatricians office showing i was over 35BMI but they still are upholding their decision of denial. I am going for a second appeal now... SOMEONE PLEASE HELP ME !!! 

I have cigna...also been through 500 million diets.

I did have to got through three month consultation with a NUT. I was on the border like you. 

In this 3 month consultation period you learn a variety of techniques and issues regarding the surgery. For example, taking 30 minutes to eat (not 10 minutes for food and 20 minutes for fun/doing the dishes) concentrating on hunger and fullness, smaller sized plates, spoons and etc, learning to eat and take medications wihtout a beverage, and chewing the food to 'applesauce consistency."

Learning and practicing these techniques over the 3 month period permitted me to make these a habit and to prepare my home for my new way of eating (e.g. out with the gigantic plates/bowls, in with really small spoons (for feeding infants) and dip bowls to become my regular bowl).

I would have been overwhelmed if I had to do/learn this all at once. As a matter of fact, this time is the second time I have considered WLS. The first time I considered it...it required too much change, too fast, with minimial guidance. With the group I am with now, they seem to warn you that a change/new technique/test is needed at one appointment..tell you to actually do it at the second appointment...and see that you have followed up on the third appointment. I like it.  If you are like me and need some time to "wrap your head around things" and how they are going to be and impact your life....a warning that you have to do/learn/accomplish something is good. It allows someone like me to contemplate it, wonder how I am going to do it, research it, and give it a "few trial runs" BEFORE I have to do it with consistent perfection.

It is nice.

So now, at the second time around, I am not nervous or scared. I have executed all the techiques/ways of eating wiht success for two months beforehand. I have already got the supplements all purchased in the cupboard.

I feel confident, sure of myself and sure of the course.

And the three months have made all the difference.

I believe that Cigna switched their requirement from 6 months to 3 months in May of last year (or sometime close to May).  So that is probably why you're seeing all the 6 month info - its a relatively new change.  I also didn't have a PCP before this started.  I asked some coworkers and found one that was nice and set up the monthly appointments with her. She was also very understanding of my need to do the weight management program without losing any serious weight because of the BMI criteria. I don't know if your obgyn would work or not, but you could call Cigna and ask. My surgery program does require a letter from my PCP (its actually a form they have to fill out) recommending me for surgery and sending copies of any recent labs or tests.  I just keep asking and asking questions of everyone I interact with so that I don't miss something. I'd rather be the squeaky wheel now than get disapproved later!  Fingers crossed that works out!

Hi there - I'm a little further into the process now and can tell you what I've learned so far.  Cigna's requirement is the 3 month supervised diet.  You have to have four doctor's appointments, each at least 30 days apart. You don't have to lose weight while on it though - which is good if your BMI is close to 40 already. My best advice would be to first make sure that your individual Cigna plan covers the surgery.  Then take a look at Cigna's specific requirements for coverage, found on their site here: https://cignaforhcp.cigna.com/public/content/pdf/coveragePolicies/medical/mm_0051_coveragepositioncriteria_bariatric_surgery.pdf

If you meet these specific requirements, then they will approve you.  My surgery program takes care of the dietician, physician, psychologist and surgeon recommendations/clearance, so I'm having my PCP take care of the three month requirement and send a letter recommending that I have the surgery. Definetely the first step is go to a seminar at your surgery center. Chances are they have a pretty robust program like that also. If you go through their program and make sure you do the necessary extra steps that Cigna details out, you should have no problem! I haven't gotten approval yet, but I will submit after February 7th (my final weigh in of the 3 months).  After that I'll let you know how it goes!

I know this is an older question (im new to the boards) however, i have UHC choice plus and was told no diet and no history needed...just to inform prior to surgery. Can you please tell me how yours went in the end?