Question:
Newly Covered By Cigna since 4/1- How long should I wait before submitting for WLS?

I've only been covered by Cigna PPO since the 1st of April and was wondering if that would make a difference as to whether or not they will pay for WLS since this will probably be the first claim they receive from me. Anyone know?    — Katherine L. (posted on May 6, 2003)

May 6, 2003
Hey, My coverage with Cigna began 3-1, and I have already been denied twice. GOOD LUCK... Joy
   — kjonhjk

May 6, 2003
I've had cigna ppo since the first of Jan. and I went ahead and applied right away and I'm having my surgery on May 22. Good luck and God bless!
   — Lynda M.

May 6, 2003
Be aware, CIGNA requires 26 weeks of dieting. Might as well get that under your belt NOW. I myself, am currently under "dieting quaranteen"..LOL! If by PURE LUCK, I get approved, GREAT!! If not, by Sept I'll be "eligible" anyhow. Patience, while it's hard to learn in this process IS a must, or you'll go insane!! My paperwork should have been submitted end of April so I should know at LEAST by the end of this month, though I know full well it'll be denied. That's OK tho..I'm ready to fight!!
   — [Deactivated Member]

May 6, 2003
I dont want to sound rude but Cigna DOES NOT require 26 weeks of dieting. Many members thing that if they are required that everyone is and that is not the case. Coming directly from Cigna themselves... they approve or deny on a case by case basis. They have no guidelines that everyone must meet to be approved other than "medically necessary." I think it all depends on how your Dr's office presents your information to them. I had a BMI of 42, with minimal co morbidities and was approved in 1 hour by them. Feel free to read my profile. I also found letters here on this site to send along with my packet explaining my co morbidities and how my obesity effected my daily life and why I needed this surgery. That might have helped also. And I did not have ANY supervised diets at all, I just sent them a summary of all the diets I attempted and when. Good luck and be persistant, you know what your answer will be if you dont try, right?
   — missysworld

May 6, 2003
My insurance changed to Cigna on 1/02 and I applied shortly thereafter. I summarized my diet history and sent my medical records from way back (not much in the way of Dr. supervised weigh loss-especially not 26 weeks worth). I didn't have any problems with the approval. Good Luck! Mary Beth
   — Beffy W.

May 7, 2003
All I can say is GOOD LUCK!! I have submitted twice to CIGNA..and have been denied twice... I have a great support system by both my PCP and GYN... My diet history was complete.. but not everything was documented by docs.. I have tried to get my records for the past 12 years... but all but one of my "proofs" are no longer practicing and my records are no where to be found...This has been a nightmare.. been battling them for 6 months.. I have complied.. and my letter from CIGNA says they do require 3 medically supervised diets one within the past year...I had it all..still wasnt good enough...so.. ANY SUGGESTIONS FOR ME?? I AM DESPERATE!!
   — chris S.

May 7, 2003
APPLY NOW. MY COVERAGE STARTED 4/1/02 I APPLIED THE SAME MONTH AND IT TOOK A UNTIL MARCH 28, 2003 TO FINALLY HAVE SURGERY. THE CONSULTATION, PSYCH AND INSURANCE APPROVAL IS WHAT TOOK AWHILE. SO GO FOR IT AND GET A CONSULT....
   — HEATHER S.

May 9, 2003
As I said to Melissa in an e-mail: Hi there, I too, am an Obesityhelp.com "viewer/participant" Your post MADE MY DAY, regarding the 26 weeks of "required" dieting. (Or rather, CIGNA NOT requiring it!!) > > I am SOO glad you stated/clarified. I only knew that to be "true", as that is what my hopefully soon-to-be surgeon told us @ our seminar!! While I am being very patient, I always hold out hope for the chance I'll GET approved without going though all the diet BS again. > > I surely didn't take offense to your post, nor did I think you were being rude!! Heck, if I could have HUGGED you, I would have!!! We need people like you!!! > > I feel so encouraged now. THANKS!! > Michelle Przybylla
   — [Deactivated Member]

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