Question:
Anyone have experience dealing with Cigna HMO?

I have Cigna HMO and was wondering if anyone had any experience dealing with them, what they require, waiting time, etc. I sent in for approval about 1 week ago, and am anxiosly awaiting the results. Are they a good company to work with, or will I have problems getting approved? I definately qualify as far as obesity goes-- 5'10, 365 lbs, BMI 50.6 Also, will the fact the I am 22 hinder this? Thanks for all responses!    — Kylie E. (posted on January 27, 2003)

January 27, 2003
I had a very easy experience with Cigna HMO. I have had the same family physician for the past 15 years, so all my records were in one place. I wrote out what I needed his letter to Cigna to cover, and took it to his office. I picked up the letter within a couple of days, and took it to the surgeon's office. I was approved on the first try. I had Type II diabetes, high blood pressure, family history of heart disease, and diet attempts documented in my chart. Good luck.
   — Chris S.

January 27, 2003
I live in California and have Cigna HMO. I was approved after the second request. The first request was denied pending clearance from a cardiologist and pulmonologist. After both doctors cleared me, the surgeon sent in a second request and I was approved within a week. I had type II diabetes, high blood pressure, high cholesterol, and sleep apnea. It would have been hard for them to deny me with all of those co-morbidities. Since surgery my blood sugars are in normal range with just oral medication. I am off insulin all together. My blood pressure is normal, no more med. My cholesterol is normal for the first time in 10 or 15 years. My sleep apnea is gone. My referring doctor was also my family physician for the past 16 years. Good luck. Cigna was good to work with.
   — Sharon L.

January 27, 2003
I have Cigna EPP (which is a glorified HMO) in Virginia. It took me 5 months and one denial to get approved. I would suggest finding out Cigna's criteria in your area for approval and then making sure the records your surgeon submits for approval conforms to those criteria 100%. My denial was based upon the fact that I didn't have 12 weeks of physician supervised dieting in the last 12 months. Luckily, my surgeon's office informed me of this and I started it the same week as my consultation with the surgeon. I finished it the first week in April and we filed an appeal and I was approved as of the last week in May, but it took 5 months to get the approval. I had a LAP RNY on 8/15/2002.
   — Cathy S.

January 27, 2003
My answer to you is, think COSTS. With Cigna HMO, they have to see where allowing you to have the surgery will save them some money. If you have insurance and never use it...or you don't get sick....they will deny you all together. You have to utilize their insurance quite a bit to show that you are going to cost them more in the long run. They turned me down 4 times. I had to get my company union involved. They didn't come around until I started going to the doctor weekly and getting all of the ailments checked out and loads of tests done. My bills soared to an all time high of $15,000.00 in about a 6 month period. If Cigna don't think you are sick, they are not going to do anything for you. Whatever you do, hang in there...don't give up. If you need any help, please contact me. I'll be praying for you.
   — Lorna K.