Cigna Denied My Surgery..Very depressed...

Hi all, well I havent posted in a while because I have been very upset. My surgery was scheduled for the 28th of this month and I just got a denial letter from Cigna. To wrap it up in a nutshell, they are saying I need 6 months of dietary therapy including and not limited to...at least monthly visits, weigh ins, diet guidance, exercise and behavior modification..Cigna requires documentation of a minimum of at least 6-month weight loss program that is directed by a physician. I have 10 YRS OF DIET HISTORY!! But my dr had a flood and all his records were destroyed. Weigh****chers, nutra-system, etc doesnt count either. So they are saying that they have determined that wls does not meet the definition of medical necessity for me. I am so mad and hurt. But after I calmed myself down I realized that I just have to go through another 6 months, do what they are asking and then I can have my surgery. everything happens for a reason right? Well, thanks for letting me get that off my chest. Any words of encouragement of experience would be appreciated. Peace and love to all of you.....

Hi Susan, I have Aetna. I was denied 2 times, and it took a complaint to get approved. Aetna have a requirement for the 6 months diet -OR- a multi-disciplinary surgical preparatory program. The prep program is only 3 months duration in the case of Aetna, and my surgeon began the clock counting from my first visit with him. You might want to see if Cigna have something similar. The large insurance companies often have their policies and guidelines available online. Whether you get it on the net or ask over the phone, make sure you have it in writing. Good luck. It's very hard to endure the disappointment. Having taken 2.5 years, 2 surgeon referrals, and my surgeon changing his practice, I had a bit longer journey than most, so I can really understand the disappointment. Hang in there through the awful time, good things come to those who wait. irene

Thanks Irene, after I read your reply I went and read your profile. I give you alot of credit for hanging in there. I will use your story to inspire me when it gets tough. Thanks again and I will hang in there. It WILL happen eventually. Not in MY time but in GODS time. There is a reason for everything. Susan

Hi Susan, I also had Cigna and had the same thing happen to me. I also was denied. Fortunately, for me my job changed insurances and my new insurance was Aetna. I heard they were just as bad. It turned out that with Aetna I was able to use my surgeon for the 6 months of diets. My Pcp would not do that even though I was going there for that he said he did not have the notes for weight loss. All I can say is that your are right everything happens for a reason. I was suppose to have surgery on March 30th and four months later here I am. I go in next week and belive me I have gone through so many emotions going for this operation. I don't think I have missed anyone. So hang in there and before you know it you will be writing me saying your going in the hospital next week too. My prayers are with you God Bless and keep faith

Susan I believe things happen for a reason. Do what they ask you to do. Try having your doctor write another letter. I had no problems with my insurance company and I feel my doctor knew how to write the letter. Keep your chin up and before you know it you will be on the lossing side. Take care and please try to see that there is an end at the tunnel. Kathy

My lawyer has experience with Cigna, you may want to contact him. Also you should go on the Yahoo website for people who have been denied by Cigna. www.cignassqueakywheels.com Here is the lawyers info. Gary Viscio, Esq. THE OBESITY LAW CENTER "OBESITY LAW AND ACTIVISTS NATIONWIDE" Resnikoff & Viscio, PC 145 Willis Avenue Mineola, New York 11501 (516) 742-5300 fax (516) 742-8130 1-877 LAW 4 ALL [email protected] www.Obesitylawyers.com