Question:
DO YOU HAVE ANY AMMO TO HELP ME FIGHT MY INSURANCE COMPANY (CIGNA)

My insurance is giving me a hard time. It is my understanding that if my doctor says it is medically necessary (I have Cigna) that they really can't deny me. Does anyone know if this is true. I have 2 letters saying it is medically necessary and one where it is suggested. Do you have any tips or ammo for me to fight the insurance company?    — krissy F. (posted on July 31, 2001)

August 1, 2001
Have you looked for Cigna under insurers? I did and all Cigna PPO's but 1 had been approved after providing letters of medical necessity. But all were persistant in calling the insurer. Also, 1 had not been approved yet. Thats pretty good. Keep on them. I'd ask them exactly what further information to they need in order to prove that this surgery is a medical necessity?
   — K T.

August 1, 2001
I think the problem is, is that Cigna isn't taking anyones word for anything. They want all the medical records showing all the health problems that the weight is causing. That includes labwork,xrays,scans. Anything to prove the health conditions you claim the weight affects. They want 3 medically supervised diets, one in the last year. Not just a list but they want the actual clinic/doctor records of each date/weight/treatment,with weighins at least every month. Cigna wants documentated proof of you being morbidly overweight for at least 5 yrs or less if you have comorbidities. They aren't taking anyones word for anything so drown them with all the documentation you can gather up from your different doctors, all their records and lab results, xray results, scan results,hospital records,clinic records, diet club records, anything you can get your hands on. Once you can prove the health problems you have are caused by being overweight or worsened by being overweight, your 3 supervised diets(each lasting at least 12 weeks)with at least 1 in the last year and that you have had the weight problem for a certain time frame then they can't turn you down because you would have met their requirements. Good luck. After 13mo. I'm finally getting my surgery next week. I'm a Cigna survivor. -------Helen
   — Helen B.

August 5, 2001
I sent my 1st appeal letter in a while back but they did not get it till july 18. I have called many times to find out my status but, they tell me they have 30 days to respond. I got turned down the first time due to not having a supervised wt loss attempt for 12 weeks. What a joke!!. Good luck
   — Bev L.

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