Question:
I am waiting for insurance approval with Cigna PPO wondering if it would matter that

my PCP did not submit a letter to the insurance company due to the fact she is against the WLS. My surgeon still submited the predetermination letter without my PCP approval. I am worried this will hinder my approval. Does anyone have any thoughts on this worry of mine? It has been 6 weeks since my consult and I have heard nothing yet.    — blank first name B. (posted on February 28, 2002)

February 28, 2002
I have Cigna HMO, but I know they are particularly interested to know what your PCP thinks. In fact, in their HMO program, you wouldn't even be able to go see a surgeon unless your PCP wrote a referral. I don't know how the PPO differs, but regardless, I think it may be VERY important to get your PCP's support, even if you have to change PCPs. It will help in the approval process.
   — Terissa R.

February 28, 2002
I agree with Terissa. I have Cigna POS and it was one of the "must do's" before I could get approved, or even see my Surgeon. I had to get a referral from my PCP in order to get an authorization for my consultation.At first my PCP wasnt one of the doctors that agrees with WLS. But as time went on, I got a load of imformation from this website and made an appt to see her. I told her that this was something that I had been researching for a while and that this was something I intended to persue one way or another. It also helped that she was my treating physician and had being following my health decline for the past 3 yrs with Obesity and other co-mobilities. But with Cigna I am almost certain that you have to get approval from your PCP FIRST, in order for them to cover the surgery.
   — Maria L.

February 28, 2002
I have CIGNA PPO (in NC) and my lap RNY was approved within three weeks of the letter of medical necessity submitted by my surgeon. CIGNA did not require an accompanying letter from my PCP, nor did they require a psych consult or nutritional consult. Good luck!
   — Diana T.

February 28, 2002
I have secondary insurance with Cigna POS and I was approved within a week. My paperwork was submitted to Cigna from Weight For Life. I did not have to go to the PCP yet. If I want coordination of benefits I will have to do that but at this time I do not plan on going to the PCP because my primary insurance pays 100% as long as I go to in network doctors and hospital.
   — ChristineB

February 28, 2002
I have Cigna ppo and they approved my open rny within 2 weeks with no letter from pcp, just the hardship letter from the surgeon. Good luck!
   — jfoulk4663

March 1, 2002
Cigna really wants a letter from the surgeon saying you are a good candidate and yuor current weight. Based on those things they will make a decision. I was approved on the first try. Good Luck and God Bless.
   — ShayZ

November 19, 2002
My pcp did not approve of this surgery and i have been denied. I changed pcp and am still trying to appeal it isn't going well and I KNOW it's because my first pcp probably told them she did not recommend it.
   — anne T.