Question:
I AM STRESSED OUT AND LOOSING WEIGHT WHAT CAN I DO

IAM IN THE START OF A APPEAL I WAS DENIED BECAUSE CIGNA WANTED RECORDS OF A 26 WEEK DIET. OK MY WEIGHT DR FAXED IT TO MY SURGEON BUT THERE IS A PROBLEM I HAVE BEEN SEEING MY WEIGHT DR. FOR SEVERAL YEARS ACTUALLY SINCE 1996 BUT I HAVE A BREAK IN MY VISITS AND STARTED BACK IM MARCH WHICH LEAVES ME 1 OR 2 WEEKS SHORT OF THE 26 WEEKS REQUIRED FOR CIGNA AND ALSO ON MY LAST VISIT I LOST 4 MORE POUNDS I HAVE BEEN EATING LIKE A BAT OUT OF HELL . THE LOSS MUST BE FROM STRESS I AM SCARED .ALSO I WAS LAID OFF FROM MY JOB INSURANCE ENDS SEPT.30TH AND I WILL HAVE TO GET COBRA. WILL THIS HENDER MY JOURNEY . HELP I NEED ADVICE OR WORDS OF ENCOURAGEMENT....    — Nazarene D. (posted on August 20, 2003)


August 19, 2003
Losing 4 pounds does not mean you don't need WLS, unless of course that 4 lbs puts you below a 40 BMI. f not, don't sweat it! As far as the 2 weeks short I doubt they will deny for that as it will probably take them 2 weeks to decide in which case you have met the requirement! Relax a little and see how it goes. You may be getting upset for no reason at all. Wait till you have a denial in your hand and you know what it says then get tough and fight. In the meantime mellow out. It's for your body's sake!
   — zoedogcbr

August 19, 2003
Aetna required that I needed to be on a Dr. supervised diet for 6 months within a 2 year period. I was only on Xenical for about 3 months (while I was appealing). I thought this would hinder my approval, but it did not. Also, if you have already been to a Bariatric surgeon, I think they go by your initial visit. A doctor I interviewed with said he requires you to lose 15% of your weight before he would do surgery. That would have put me below the 40 BMI mark, and he said that would not deter the surgery or approval. It's the weight at the intial visit.
   — doubleh




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