Question:
Has anyone gotten Cigna to waive the 6 month Dr. supervised diet b4 approval?
Any Cigna PPO info is greatly appreciated. Thanks. — Lawanna B. (posted on December 4, 2004)
December 4, 2004
I have cigna also. I just had my surgery on the 29th. I had a to fight
cigna with an appeal. I had seven months of dr supervised diets, saw a
nutritionist, a physciatrist. all their requirements. I also had food
journals for 7 months. my surgeon sent all papers in. 67 pages! every
month of weigh ins , discussions with dr. vitals. I was denied. I had to
hire someone to appeal for me. it was then approved. I was told by many ,
many people I would be denied no matter what. how true. go to yahoo and
go to the site cignasqueakywheels.com. it is only people trying to get
approved for wls with cigna. I got a lot of info there and found the lady
that helped me appeal at that site. I have not seen anyone on that site or
heard of anyone get approved without 6 month supervised diet. you may get
lucky but it isnt likely. I worked on my whole thing since mar. so it isnt
easy but worth it to finally get approved. good luck
melinda
— taterbug898
December 4, 2004
It is funny, I guess everyone has a different experience. My experience
with CIGNA was that I went to the surgeon for a consult. He wrote a letter
of medical necessity, very detailed. I faxed it to CIGNA with no other
documentation, ie., 6 months supervised dr. Diet, no psych eval or
anything. Just the surgeons letter. One day later I called them to make
sure they had recieved it, and low and behold, I was approved! Two months
later, I had surgery. The rest for me is history, I am down 300lbs.
— [Deactivated Member]
December 4, 2004
You probably will not get it covered without the supervised diet trys. My
husband had a bmi over 55, even had supervised diet trys (years worth), had
a letter of medical necessity from Cigna of all people and they STILL
denied him. We did not fight it because he was covered with my insurance
BCBS of IL PPO and they took him without the supervised diet before
surgery. BCBS approved him before they instituted the supervised diet trys
themselves. Cigna and Aetna are really tough to get beyond the diet trys,
there are a lot of questions here and on the message board about them. Put
a question on your own state board to see what kind of response you get,
maybe someone local can help you. Also do a library search in the Q & A
to see what kind of answers you may get.
— ChristineB
December 5, 2004
Why do you want to bypass the 6 month diet? This is to prepare you for
what life will be like with the bypass surgery. Remember this surgery is a
diet tool. You will be watching what you eat for the rest of your life.
— Linda R.
December 6, 2004
CIGNA is very difficult in my opinion. i have already been denied even
though I have everything they have asked for. We just rec'd a letter from
my husbands work from Cigna, as of 1/5/05 they will no longer cover GB
Surgery, breast reduction, panniculanemy (sp?)plus a few others. Even with
medical necessities. Good luck, I ended up changing Ins. companies...
— jesstal
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