Question:
Seeking Advice From Others With Cigna PPO
hello, i just got cigna ppo of ohio and im seriously thinking about getting the surgery done. im 38 years old,my bmi is between 36 and 37. my family has a history of heart attacks and diabetes, i have lower back pain, swelling in feet and ankles, acid reflux and have tried every diet you can imagine,but the only diets that have been documented are when i was on redux phen phen for a month then they took it off the market and then they put me on meridia and i was on that for a month,since then my doctor has passed away and im hoping that i can still get those records,also i have sleep apnea. my insurance says i dont have to have a referral from my family doctor, i have to have a letter of medical neccesity from the surgen....what do you think my chances are of approval????im nervous because some people say they have had NO problem with cigna and some people say they have nothing but problems....thanks — lisa A. (posted on June 22, 2003)
June 22, 2003
hello there,i am at the same point you are and so far this is what has
happened...my husband just resently got cigna ppo due to a job
change...they are very easy and very nice to deal with...i had to prove
medical nessesity..ususally threw your sergeon and they just recently put
in that they require 6 months of documnetation of supervised diet
...usually threw your pcp...there shouldn't be a problem with you getting
your records from your dr that passed on..also (A LITTLE HELP) if you saw
your dr at least once a month for 6 months and was weighed each time and
mentioned to your dr that you have been trying to watch your weight and
remained diagnosed with morbid obesity they will accept that...because,
dr's will document everytime you mention that you have been trying to loose
weight, when you are morbidly obese..dont get discouraged...cigna is a
wonderful insurance to be working...i would not change now for any other
insurance..they have even helped me get the info i needed faster than if i
left it up to the dr's...hang in there...and enjoy your journey!!!hope this
helps...god bless!!!
— denise C.
June 22, 2003
It's my opinion Cigna would rather see us die than part with their money! I
have a a 45 BMI, hypertension, bad knees, joints, fibromyalgia, family
history on both sides of obesity and heart failure. I've given them 5 yrs
of medical records, nutritionist evaluation, psych clearance, gallbladder
scan, veinous doppler scan, nuclear heart scan, cardiologist clearance,
blood work, my internist's clearance and like you have been on every
conceivable diet known to man but they do, as the other post said, require
WITHIN THE LAST YEAR a medically supervised diet with at least monthly
weigh-in. MY PCP started me on a low calorie diet last Nov. and I was so
excited until I realized I hadn't had monthly weigh-ins. Now I'm having to
start all over again in June - 6 friggin months!!! In Houston there are 38
of us fighting Cigna with NeWeigh - they are approving no one. I've got an
attorney involved and just received a letter from Cigna stating that if I
continued with the attorney on the appeal and they turned me down (again)
that I would have NO recourse for another appeal. My attorney is
investigating that statement now!!
I definitely hope you have better luck with Cigna that I have.
— Sunie I.
June 22, 2003
I have Cigna ppo in North Carolina. I had no problems with getting
approved for surgery. I have had problems in the past (I have had them for
15 years). I think the reason I got approved so easy is the way my surgeon
and my primary care physican handled them. Check to see if your surgeon's
office has experience with them. If so they know what you need to be
approved. Don't be afraid to call Cigna and ask them. Make sure to make
notes everytime you call. List who you spoke to and what day and time it
is.
— june22
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