Cigna Changed Diet Policy

It is now just 3 months instead of 6. EXCITING! Effective 5/15/2012.

 I agree!  I've got Cigna and that was my last hurdle to apply for approval!  All engines are go now

Hi guys - looks like you went through the surgery successfully using Cigna's coverage. I am just starting the process and curious about their 3 month weight management requirement. I am right around the 40BMI mark with no comorbid conditions. On this 3 month program are you required to lose weight or can you stay stable and still be approved? I'm sure I could get down 20lbs or so, but it would be the same 20 I've been losing and gaining for the last decade. I'm looking to make a permanent and major change. I'm worried 5lbs will be the difference between being approved and not. What were your experiences with Cigna's policy?

I did not lose any weight and was approved the first time. Be careful not to drop below their minimum BMI requirement w/o comorbidities.

Hi Lucy, Just wondering how you made out with Cigna. I also have Cigna and am at a 40 BMI, no comorbidities...also worried about losing weight on the 3 month diet. Afraid if I lose one pound that I will drop below the 40 BMI and not get approved. Hard to balance that weight, clothing can vary that weight by a pound or two. Ive been through this process once before about 6 yrs ago and dropped below 40 and was denied. At the time, the surgeon required a 10% weight loss, I know the criteria has gotten easier in the last few years and the surgeon Im considering now does not require it. Im nervous about going through the whole process again only to be denied. Just wondering how your process has gone with Cigna? 

My process with Cigna was SO smooth! I recently got approved and am having the surgery on March 18th. I went to my PCP for the 3 month weight management program. Luckily my PCP was very understanding of the irrational insurance requirements. So I first weighed in with my clothes on and for each month visit I was maybe a pound or two down. By the last one I was under 40BMI so we just tweaked the weight up a little bit so it wouldn't cause an insurance issue. Just make sure you have 4 visits - each at least 30 days apart. My weight was up and down during those visits, and that didn't matter. My PCP and I didn't talk much about eating and exercise since I had done it all before. She wrote down some things about reduced calories and increased activity on what she submitted to Cigna. Basically, just have a conversation with your PCP about exactly what your insurance requires and see if he/she is willing to work with you to make it work. I think this is pretty common. The doctors and my surgeon's office were also really familiar with it. The only requirement I had was that I couldn't gain more than 10 pounds from starting their program. But they were totally understanding about me not being able to lose any weight before getting approved by insurance.  My biggest recommendation is just to get a copy of Cigna's bariatric surgery coverage policy and bring it to all of your doctors to use as a checklist. If you have everything on the list, it won't be a problem at all. Hope that helps! Oh - also, Cigna approved me within a week of getting the paperwork, which was nice.

Thanks for the info. Congrats on your surgery date! My PCP suggested the surgery so I think he will be good to work with... I found the Cigna requirements online but I see they are due to update in May. Ugh! Well, good luck with your surgery! Thanks again for responding.