Question:
hi i currently have cigna hmo which i understand is very difficult to get an appvl
from so in jan00 i will switch to cigna ppo please let me know if anyone has been apvd with this insurance as i am desprite and dont want to be dissaponted! thank you deborah — [Anonymous] (posted on June 25, 1999)
June 25, 1999
I have cigna hmo and I received an approval in about 1 1/2 weeks.. I would
welcome any questions you may have. I am 12 days post-op
— Teresa L.
June 25, 1999
I got approval from Cigna PPO - It took a while but I got my surgery
Kathy in Dallas
— kathy942
June 25, 1999
Dear Deborah,
Well, I work for CIGNA in Health Services HMO. Last August there was a
corporate wide acceptance of new criteria for WLS. It includes having a
BMI of over 35 with mutiple cormorbidity or a BMI of 50 or greater. I both
instances one must be able to document having been on two weight loss
programs with in the last 5 years and one with in three months of asking
for the WLS. What state are you in? CIGNA HMO is ready to approve my
surgery however, I will not be working for them as of July 31. PPO's are
generally more giving but your out of pocket cost more than likely will be
greater. I will try to help you best I can if you want you can e-mail me.
Sorry, I do not carry alot of impact on any medical directors decisions
but, I certainly know how the game works and their criteria.
I send you light and love.
Jeannette Cheeks
— Jeannette C.
June 25, 1999
I have been denied by Cigna Healthcare for Seniors, their medicare HMO.
They claim there is no "emergent or urgent" need for the surgery.
In pressing them further, the customer service reps. didn't know what WLS
was nor of any doctors who performed this surgery!!! I sent them the name
of a surgeon who is a Cigna provider as is the hospital he uses but this
too fell on deaf ears. I now have legal counsel to do my appeal,
— Diane S.
June 30, 1999
I am just starting out with Cigna (PPO). I have talked to surgeon, but the
insurance company has not received any info yet. I will keep you updated
if you like.
Debbie
— Debbie W.
June 30, 1999
I have Cigna/PPO insurance and didnt have any problems obtaining approval.
The trick is to have all your information upfront and show a medical
necessity.
— Julie M.
June 30, 1999
I have CignaHealthcare (HMO) in New Jersey, I was approved in about 5 days.
My Doctor submitted all the paperwork and I am not aware of any problems
getting it approved. Good Luck!
— Carrie G.
July 1, 1999
I have Cigna PPO in Virginia. No problems getting approval. My surgery
date is July 22. Approval took about 2 1/2 weeks.
— Peggy51
August 29, 1999
I live in Indiana. I was denied initially and approved after the first
appeal. I am also an attorney so I wrote my appeal on my legal letterhead.
It's possible this might have helped a little. I think it hurt me initially
that while I did have medical problems that were weight related, I was not
actively treating for them since my family doctor felt we would only be
treating the symptoms, not the underlying condition which was weight
related. After explanations as well as detailing how this impacted my life,
I was approved. Make sure you let them see you as a person, not just a
claim number. And NEVER stop appealing!
— Vickie B.
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