Question:
Has anyone been approved by CIGNA HMO since June 2003?

I have CIGNA HMO and have heard nothing but horror stories about getting approval for WLS. They keep changing their criteria, it seems like they want to get out of paying. Anyhow, has anyone been approved by CIGNA HMO since June 2003. They added a new criteria of 2 26 week medically supervised diets. I have read in some cases that this change was made back in November 2002 and in other cases April 2003. Thanks in advance for your feedback Anniee    — Anniee M. (posted on August 8, 2003)

August 9, 2003
I have been denied recently because of the requirement of 2 26 week diets. I don't have the answer to your question but there is a group called [email protected] and we are a bunch of people that share out tips and triumphs with each other. We all have Cigna and are trying to get approved. Good luck to you. Sherri
   — Sherri M.

August 9, 2003
I was approved on 7-24-03. I was denied on 7-9. My surgeon did a "peer to peer revue", which accomplished nothing. The 2 26 weeks are required, with one in last 12 months prior to surgery. I had just completed 18 months of WW and was still denied, but appealed and was approved. I have heard they are denying everyone the first time. Keep fighting. This your health and life they are playing games with. Good luck and stay focused. My surgery if 8-19-03. Karen
   — Karen T.

August 9, 2003
I was approved on the first request on 7/7/03. It took four months and my doctors office was told that I would be denied due to the 2-26 week diet thing. I called them and convinced them that the past 4 years supervised by my endocrinologigt should count even though I didn't loose weight. She had me on a diabetic diet with bi-monthly check ups and weigh ins. Luckily the right person reviewed it for me and I was approved 1 week after that phone call. I did hear though by the people at my doctors office that CIGNA is being so strict about this supervized diet thing because they know most people do not have this documentation and they want to discourage or put you off. They are trying to make WLS a total exclusion and by the time you do a 26 wee supervized diet they may allready have the exclusion in place. The lady that deals with insurance at my bariatric surgeons office said they are trying to get the exclusion in place sometime in 2004. Good Luck - Work fast and appeal so you can get in before the dead line whenever that will be! I feel blessed that I got in by defult with the endocrinologist thing because I really wasn't on a diet to loose weight as much as a diet to help the diabetes! Best wishes to you.
   — dianekoch

August 9, 2003
Yes I have I got approved in eight (8) days but the number one thing is making sure you were anal with all your documentation and that you can show one (1) year of attempting weight loss. I just got my approval on 7/25/03 and it took them seven days to give me my approval. I wish you all the best!! = )
   — Ms. Aldo B.

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