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I did not lose any weight and was approved the first time. Be careful not to drop below their minimum BMI requirement w/o comorbidities.
Hi guys - looks like you went through the surgery successfully using Cigna's coverage. I am just starting the process and curious about their 3 month weight management requirement. I am right around the 40BMI mark with no comorbid conditions. On this 3 month program are you required to lose weight or can you stay stable and still be approved? I'm sure I could get down 20lbs or so, but it would be the same 20 I've been losing and gaining for the last decade. I'm looking to make a permanent and major change. I'm worried 5lbs will be the difference between being approved and not. What were your experiences with Cigna's policy?
I dont know I hear from 24 hours to 30 days lol but im still waiting for my papers to be sent to the insurance company!!!
May I ask why the revision? Good Luck
Not many doctors or insurance do DS anymore not sure why but sleeve and rny are the most popular. I would liet the center go ahead and file an appeal, mainly because its more likely to get denied. Just let them appeal it and get an answer before doing work to find DS revisions. That can be a lot of work for nothing, unless your going to self pay.
WOW 3 years??? Thats along time. I would try and get a case worker from the insurance to see exactly what would a 3 year supervised diet look like, cause I have heard of 3,6, and 12 month but 3 years sounds off...
I 'm planning to have revision surgery (BOB)it may be an overnight stay but maybe not if there are adhesions.Has anyone accessed their AFLAC Hospitalization coverage ?
I don't remember exactly, but it was less than 2 weeks. I think it was more like 7 working days, etc.
Good luck!!
HW: 274 | SW: 232 | CW: 137 | Goal: 145 (ticker includes a 42 pound loss pre-op) | Height: 5'4"
M1: -24 (205) | M2: -14 (191) | M3: -11 (180) | M4: -7 (173) | M5: -7 (166) | M6: -8 (158) | M7: -11 (147) | M8: -2 (145) | M9: -3 (142) | M10: -2 (140) | M11: -4 (136) | M12: -2 (134) | M13: -0 (134) | M14: -3 (131) | M15: +4 (135) | M16: +2 (137)
Thanks Rose
I have no personal experience with Cigna, so I can't help there. But ...
Aetna has the same requirement. I did the 3-month multidisciplinary program. It is imperative that you go for no less than 90 days - 89 days and you will be screwed. I did something like 105 days just to make sure.
Regarding losing weight and going under BMI, talk to your surgeon's office. My surgeon's office submitted final approval to insurance based on my consultation weight - not the weight after I did the 3-month program. So, even though I lost 40 pounds on the program and my BMI was 39.8 at the time of surgery, I was approved because the weight I was submitted on was 272.
3 months is a long time to "fake" a program - meaning, following the plan, meeting with dieticians/doctors/nurses/trainers, and not lose weight. Aetna just implemented a requirement that the patient must not gain weight during the program. Apparently, you don't have to lose weight, you just can't gain weight.
So, long story short (too late), call you surgeon's office and ask the insurance coordinator.
HW: 274 | SW: 232 | CW: 137 | Goal: 145 (ticker includes a 42 pound loss pre-op) | Height: 5'4"
M1: -24 (205) | M2: -14 (191) | M3: -11 (180) | M4: -7 (173) | M5: -7 (166) | M6: -8 (158) | M7: -11 (147) | M8: -2 (145) | M9: -3 (142) | M10: -2 (140) | M11: -4 (136) | M12: -2 (134) | M13: -0 (134) | M14: -3 (131) | M15: +4 (135) | M16: +2 (137)
Hockeymom87 · 0 replies · 711 views
