Cigna Insurance

LMF5012
on 3/26/09 10:41 am
Does anyone have Cigna insurance? I was just wondering b/c it is terrible!! Also, has anyone ever been denied by insurance?
Susan M.
on 3/27/09 12:05 pm - MA
Hi,

I have Cigna and got approved after the 1st letter.  I called them a week after the dr's office sent my paperwork and they said they didn't have it.  I had heard they are famous for losing paperwork.  So I just had the Dr ofifice refax it to them. After that I got my approval. 

Good Luck!
LMF5012
on 3/28/09 8:55 am
If this is too personal its ok if you dont answer... Did you have to pay out of pocket for any of the surgery? I have to pay 50% and it sucks. You are the first person who has said that you were approved. That makes me feel a little bit better. i also have pcos and am insulin resistant. it is almost impossible to lose weight. Thank you for replying to my post. :)
Kathy V.
on 3/28/09 4:21 am - MA
I had Cigna and got denied and I had EVERYTHING that they asked for.  My surgeons office said they are the hardest to deal with.  I was paying cobra at the time so I just cancelled it and got BCBS for the same price as cobra and was approved in 24hours.  Good Luck,.....

 

 .....kathy   

                         
                         

Susan M.
on 3/29/09 3:50 am - MA
LMF,
I didn't have to pay anything for the surgery or any of the preop appointments.  Is the hospital in-network? It may also be the plan/contract  your employer has with Cigna. 
I also have PCOS and insulin resistance...they approved it after the 1st letter.

Hope it all works out for you!
Sue
NeedhamGal
on 3/29/09 6:07 am - MA

You need to call CIGNA with your insurance number. Each plan is different. The plan I had covered NO BARIATRICs at all. End of Story.

Make the call monday.

Joan

Markrb
on 3/30/09 6:11 am - MA
I had Cigna when I first seriously looked into wls, that was in March 08.  I checked with Cigna and the did cover wls under my plan, however, they required a medically supervised 6 month weight loss program and was told that I could use the surgeons office since they provide mental health counseling, nutritionist, and medical supervision.

To make a long story short, the folks at the office really had some horror stories about Cigna dragging their feet and doing everything they could to deny the surgery. I also read some success stories on OH where folks were approved on the first letter.  Since my employer provides Harvard Pilgrim as well, and I was told by the surgeons office that they are very good to deal with I decided to wait until open enrollment and switched insurance on the first of this year.

Harvard Pilgrim approved me in 4 hours!  I received a lot of advice about dealing with Cigna, the biggest thing is keep on them, take names, keep  a log of who you talk to and what they say.

Best of luck!
-Mark
304/256/184/175
highest/surgery day/current/ goal



txbunny930
on 4/3/09 5:54 am - MA
I had Cigna and was denied twice and was finally approved at my last appeal.  This was over 2 years ago.

Cigna required you to do a 6 month supervised diet, which needs to be documented every month by going to your PCP each month and going over the progress of the weight loss you put into place. 

You can call Cigna and ask for a "Case Manager" to help you with this process.  This will help when talking to Cigna as to where the paperwork is and what is needed.  While Cigna denies, they also approve and are a great insurance company to have.  Their rules are in place for a reason, even if it frustrates the heck out of you, which it did me. 

My surgeon's office said I was the hardest case to get approved in the 25 years he has been doing this surgery.  Whatever you do, do not give up.  Fight!!!  It's well worth it.

***Bunny***
SW-267/CW-133/GW-145
 

LMF5012
on 4/3/09 7:54 am
If you don't mind me asking... why was it hard to be approved? I just went over my records with my PCP to make sure that I had everything in place. Did you have the same PCP throughout the whole 6 months or did you go to see one at the hospital where your surgery was taken place? I asked Cigna and they said its no problem to have 2 PCP's as long as you are documented. Did you have to pay anything out of pocket? My plan requires me to pay 50% of the cost, but I see it is an investment in my health. Thank you for replying to my message :)
txbunny930
on 4/7/09 5:49 am - MA
The 6 month documentation needed to be done by my PCP and I was told that my Surgeon and nutri could do the documentation.  That was incorrect.  My PCP tried to correct the error by sending a letter stating she was documenting my progress with the surgeon and nutri but that was not enough.  So I did the 6 month program all over again with scheduling my nutri and PCP visits for the same day.  You CANNOT miss a month and the notes need to state that you were "compliant" with the program for exercise and diet. 

Yes I had to pay 10% out of pocket for the surgery but 18 months of co-pays @ $30/surgeon, $30/nutri and $20/PCP per month plus $175 for each Psych evaluation (I had 2) made it costly.  This is an investment in your health and life.  I used the time to change my habits prior to surgery and it's paid off.  I do not look at food the way I once did.

Cigna just makes sure that every T is crossed and every I is dotted.  Sometimes they are looking to see just how committed you are to this.  Some give up and never go beyond the first denial.  Don't be one of them. 

***Bunny***
SW-267/CW-133/GW-145
 

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