Question:
PLEASE HELP ME!!!

I need help with my appeal letter to Cigna HMO. I was told I was denied because I do not have 2 26 week supervised diets, which I do not have. Can someone please help me??    — Kylie E. (posted on February 24, 2003)

February 24, 2003
My insurance required 5 YEARS of doctor supervised diets. I hardly had any such thing. I wrote down everything I have ever tried and approximate dates and gave it to my doctor. She wrote up the necessary info, submitted it, and I was approved.
   — Deborah R.

February 24, 2003
Oh boy. This is a new one. Two 26-week diets now. Where do they get this stuff? LOL Kylie, do not panic. You're in for it with Cigna HMO, but you can win. Read my profile and feel free to write me directly. Send in everything that you can and while you're waiting, go see your PCP and have him put you on a "diet" while you're going through this. Blessings!!
   — Kim D.

February 24, 2003
Must be a new requirement. When I got approved last year, I had to have 3 12-week physician supervised diets, one of which had to be in the last year. Cigna wouldn't budge an inch on it I was told. Luckily when I went for my consult last January the surgeon warned me about it and told me to get to my regular doctor and start a diet that week. I got denied at first, but once I finished the 12 weeks, I was approved. I had my surgery 8/15/2002 and am down 116 lbs. If I were you, I'd get to my doctor and start this week. I lost 41 pounds between January and when I was approved in May, so all was not lost with the time spent. My appeal letter consisted of a discussion of all my co-morbidities and how they were affecting the quality of my life. I described the pain I was in every day and ended with an appeal for help! I also followed up with Cigna weekly until I got an approval. I climbed the "ladder" and even spoke with a district manager for Virginia.
   — Cathy S.

February 24, 2003
Last year Cigna told me that I had to have 1 12week supervised diet in the past 12 months. They WILL NOT bend on their rules about supervised diets. Join Weight Watchers and ask your doctor to start you on a low cal diet NOW. Make sure you go EVERY week and have it noted in your chart. Cigna didnt accept my docs records because I didnt weigh at their office every week but every 3 months. Hang in there. You WILL win it just may take some time to get there. Keep the faith! Sidney Open RNY 10-23-02 down 70 pounds.
   — Siddy I.

February 25, 2003
I have cigna PPO and I was denied at first and it said I needed a supervised diet which I did not have. I called and Cigna said I was Approved.
   — wesley B.