Question:
HAS ANYONE HAD CIGNA PPO FOR INSURANCE?

I was wondering if anyone has had cigna ppo for health insurance and how was it. I am getting ready to send all my paperwork in for approval and am wondering about denials and what else i am going to have to go through. I have al ready gotten the six month journey done that they requested. Any advice?    — missyheffelfinger (posted on January 2, 2007)

January 2, 2007
Hello Missy, I hope you meant that your bariatric surgeon is getting ready to send in you paperwork for approval. Because if you are sending it in without the psyche eval and two other tests; you the individual will be turned down. I have CIGNA PPO and had no problems getting approved. Your surgeon is the one that is suppose to submit the paper work for the surgery. Also your PCP has to submit a Letter of Clearance along with the medical documents submitted by your surgeon. So you might want to back track prior to sending it the paperwork. I was approved the first time around. My surgery date is January the 18th and I have my pre-op class on Friday morning. I did the 6 months with my PCP and not with my bariatric surgeon.
   — the7thdean

January 2, 2007
I just went through the process with Cigna. My husband used to administrate a private insurance company so he was a big help. Do all the paperwork thoroughly and have the doctor's office help. I do recommend keeping in touch often as I waited for my answer only to call and find out they had lost all my paperwork. They need to be watched which you can do on their web site.
   — Sandyhammer

January 2, 2007
I have CIGNA PPO as well. I had no problems getting approved for a GB or Lapband. Make sure that you have ALL of your paperwork. Psych eval, letter for PCP, and supporting documents from other doctors, 6 months of weight loss work.
   — [Deactivated Member]

January 3, 2007
I was denied three times by Cigna PPO before I was finally approved, it was devistating! Make sure you have all of the paperwork they require before sending it in, do not rely on the doctor's office to do it for you. I had the hardest time with the 6 month evaluation because they felt my dr.'s notes for the 6 months did not have all the information they wanted. Just be as through as you can and the most important thing, promise me, DON'T GIVE UP!! I felt like doing that everytime there was a denial but I think that is what they are hoping for. It was the best thing I have ever done for myself, I had my surgery in August and I am down 80 pounds, feeling great! Good luck on your journey!!!! If you need any more info please contact me, more than happy to chat!
   — tatybrown68

January 3, 2007
cigna was great about covering my rny last april... at least they were once the guidelines were met! just make sure that you know what they require, and follow their rules! good luck, it is all worth it!
   — earthangel

January 3, 2007
Hi, I have Cigna PPO. I had my appt with my surgeon 5/31/06. I had my first appt with PCP for diet/exercise plan on 6/1/06. I went to the doctor every month on or around the 1st (on the 5th in July due to holiday) , got all labwork, psyc eval, nutritionist appt and finished my last diet/exercise appt on 12/1/06. My surgeons office submitted to insurance on 12/4/06. They called me on 12/6/06 and told me I was approved and had to have surgery by end of year. I had pre op testing on 12/7/06 and surgery on 12/8/06. No problems at all because I called Cigna about every month to confirm their requirements. As long as I met their requirements (which they sent to me), I would be approved. I followed the appts to the letter, never missed one--if you miss a month, you have to start over. Many people at my job had WLS so I knew Cigna would approve it but I just had to do everything they required. I paid ZERO out of pocket, just had to pay my co pay each month to my dr and I paid 1 co pay to my surgeon of 20.00 back in May. I also paid my 20.00 co pay for the psyc eval. When I went to the doctor (he was an internal med dr), I was told to eat low fat, low carb, lean protein diet and cut out fried food, sweets and soda and exercise daily. I was not required to lose any weight during the 6 month but he didnt want to see any gains. My experience with Cigna was seamless with no problems at all. Good luck to you. Angela
   — A Q.

January 3, 2007
Missy, 2 things i forgot to add: Make sure YOU call Cigna to confirm your coverage and their requirements for approval for bariatric surgery. They are required to release that information to you. secondly, you have to attend 7 appts with your PCP which would represent 6 months of supervised diet. The appts must be 30 days apart (1 per month) again with no gaps. I have Cigna's coverage position saved on my system. If you want me to email it, send me your address and I will but of course , you have to make sure your employer has not excluded it from coverage. Good luck to you, make sure your surgeons office submits EVERYTHING to Cigna and they will approve it. I agree too with checking up on insurance company even though I didnt have to do that, mine went way too quick.
   — A Q.

January 9, 2007
I had Cigna PPO, I was denied the first time. I had all the correct paperwork and the weight loss history they wanted, but they insisted that I go on a 6 mo. supervised diet by my Dr. for one last try, so I did. Once my 6 mo. was up the surgeons office resubmitted my paperwork and within a week I was approved. The whole process took me 1 yr and 1 month for approval. It was worth the wait though. I will be 3 yr post op in May. I lost 135 lbs. and really happy! I am still wanting to lose 20-25 lbs to make it to my orginal goal, so this year I am starting fresh. Hang in there, it is soooo worth it!
   — teedegee