Question:
Anyone who has Cigna PPO what did they require you to provide them to qualify?
— blank first name B. (posted on November 4, 2002)
November 4, 2002
I was approved by Cigna PPO verbally in 24 hours from the time my surgeon's
office sent a letter of necessity. My plan only covered gastric bypass if
it was deemed medically necessary (anything related to weight loss is
automatically denied). Cigna required psych report, family history, my
dieting history, co-morbidies/existing health problems. My surgeon's
office did all of this so I never saw the final letter. It did, however,
take approx. 5-6 weeks of constant calling to back their verbal approval in
WRITING.
— Christina W.
November 4, 2002
It took awhile to get the approval through Cigna, but be persistant. I had
to have proof that I had attended at least 3 medically supervised weight
loss clinics/or doctors and then documentation regarding the medical
necessity for the surgery. After that, I got approval and they paid 100%
of my hospital bill and the hospital where I had my surgery was out of my
network! So I can only say good things about them. Good luck!
— Cheryl T.
November 4, 2002
CIGNA PPO coverage varies from employer to employer and state to state. In
NC, my CIGNA PPO was an absolute dream to work with. They required
absolutely nothing but a letter of medical necessity, for both my lap RNY,
and then again for my panniculectomy/brachioplasty. They approved within 3
weeks of the letters, no questions asked. Read your policy carefully, and
call the CIGNA 800-number and ask to speak directly to a case manager, to
determine your benefits and possible exclusions. Then, if you should
happen to be denied, don't be hesitant to fight for what you want and
need....many, many people are approved after going through the designated
appeal process for their individual insurance providers. Sometimes it
seems as if the insurance companies simply want to see just how badly you
want it :-) Good luck!
— Diana T.
November 5, 2002
Thank you everyone for your help! I won't actually have Cigna PPO until Jan
2003. So unfortunatly I can't call the 800#. I just want to get everything
that I can ready NOW. So when Jan comes & I ask for WLS from Cigna I
will hopefully be ready for their comeback. Thanks so much!!!!!
— blank first name B.
November 5, 2002
I had a hard time with Cigna but every plan is different. My requirements
were:
1) dr records for the past 5 years
2) have a BMI of over 40 for the past 5 years
3) had 3 medically supervised diets lasting at leat 12 weeks with one being
in the past year
4) attended a Nutrition program for 12 weeks (this coubts as one the 3
diets)
5) need some co-morbities - although this is not actaully a requirement but
they wanted to see some documentation about it.
If you get into a fight with them, dont give up~! Good luck!
— Debbie W.
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