Question:
what step should i take first?

my ins will come into effect this month ( cigna hmo) and i'm wondering should i call them first to see about getting the surgery covered? get with my PCP? or find and get with actual weight loss surgeon? what will help me in preventing getting denied from my ins company?    — brandy M. (posted on March 23, 2002)

March 23, 2002
First, check with your insurance company to see if the surgery is covered and they will tell you what you need to provide for approval. In my case, I had to provide a referral letter from my PCP and the surgeon. If you only need the surgeon, you can bypass the PCP. I also provided written proof of past medically-monitored diets and a referral letter from my chiropractor. I have Aetna and was approved within a week. Good luck!!
   — Katy B.

March 23, 2002
I, too, have CIGNA HMO. Unfortunately, at least in my policy, they have a written exclusion about weight loss surgery. (I had my surgery a year ago through a different provider.) You are probably going to have to FIGHT them on this one. My opinion: CIGNA tends to really rely on the advice from PCPs. I would definitely work through your PCP and see if he/she can write a letter of medical necessity for you. Be prepared - this will probably be a long, painful battle with them. They don't like to approve expensive stuff. One example: I almost died of appendicitis earlier this year because CIGNA didn't want to pay for an abdominal scan. It took them nearly 36 hours to approve this, and by then my appendicitis was BAD. Good luck to you--
   — Terissa R.

March 23, 2002
If you have a surgeon lined up call them for advice. They specialize in getting folks approved. Attend local support group meetings to find a surgen your comfy with.
   — bob-haller

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