Question:
Has anyone with Cigna PPO been approved lately?

I have Cigna PPO in Ohio and I am in the process of my first appeal. I was wondering if anyone got approved after their first appeal or were denied again and had to file a second level appeal? Thanks!!!    — Audrey W. (posted on May 17, 2003)

May 17, 2003
I have cigna hmo in california and i was never denied or had to go thru appeals. You really need to have medically supervised diet it one of there bigest ways of geting approved right away. Plus i had a hital hernia that needed to be repaired. But i joined weight watchers as soon as I statred hearing about the horror stories of people geting denied because of no medical supervised diets. Plus i called my old hospital (kasier) I had them copy all of my old medical records from the past 10 years and sent that in along with a letter from my PCP and one from my personal trainer friend from the fitnesss center i go to. Also i sent the insurance company a 12 page personal history, family history and diet history and all the medical history I could get a hold of. You really have to go over the top and be persistant. Fax all that stuff in sevral times and keep copy's of everything for your personal records.
   — sheri B.

May 17, 2003
I have had (3) dr. supervised diets within the last 6 years all over 26 weeks the last one within the past year. I have GERD,acute asthma,fibromyalgia, and irregular periods all from being obese, all documented for the last 8 years in my medical records. I had a letter from not only my surgeon but (2) PCP's the one I've seen for 5 years and the one I saw before him that stated in their professional opinion I am a perfect candidate for this surgery. My BMI has been over 40 for 2 years and had been over 35 for 7 years. I too wrote a 5 page letter explaining what it was like to live as a morbidly obese person day in and day out. I even gave them a copies of every test I have had done within the last 2 years for my comorbities that totaled $15,000. I was still denied even with all that. I guess I just can't believe I was with my record and history. I think Cigna PPO in Ohio is very hard to get approved with. I hope nobody else has to jump thru all the hoops that I have done. It just really steams my clams when someone really does qualify for WLS and they just don't want to front the money.
   — Audrey W.

May 17, 2003
I have Cigna PPO in WA state. I had no problem at all. Gave them all my diet attempts, and within 2 wks I was approved.
   — TLLessor

May 17, 2003
I, too, have Cigna PPO in Houston, TX. I have a BMI of 45.7, 269# on a 5'4" frame. I provided all my diet history (everything known to man), clearance letters from my PCP, all blood tests, psych eval, ultra sounds and I was denied. Now they want nutritional evaluation, internist clearance - I've supplied that plus a chiropractor's evaluation. Cigna is known to turn down on the first try so I was prepared for it. NeWeigh has their own Patient Advocate Group that fights for our rights with the insurance companies, thank goodness. Patience has never been one of my better virtues! I just found out yesterday it may be another 6 weeks before I hear of my appeal. I'm going to take this time to get stronger before surgery. I work out at Curves 4-5 times a week and powerwalk every other day. The stronger I go into surgery the better I will be. Hope this helps - good luck to you!
   — Sunie I.

May 18, 2003
I appreciate all your answers so much!!! Insurance just gets so frustrating!! It's great to be able to come here and get a personal answer from so many wise people.Thanks everyone!!!
   — Audrey W.

May 19, 2003
Hi! I have Cigna PPO in Illinois. The only problem I had with them was they kept saying they didn't receive my paperwork and then when they did, they didn't understand the code for Lap RNY. All I had to do was send a letter explaining that Lap was the same as open, but without the opening... lol. That may not be how I worded it, but it was the general message. Anyway, the most important thing I found was that they never communicated anything to me and the only way I found anything out was because I kept calling them. I was fortunate enough to get an "angel" at Cigna who took my case under their wing and helped to see it through to the end. I was approved in about a month and a half. Hang in there... with a little tenacity, you'll be fine. Good luck!
   — [Deactivated Member]