Cigna - need insurance opinions

I'll try and make this as brief as possible.   I have 8 years of weight medical records (only requires 5)  once in like 2001 i feel under the obesity by 1 lbs - but I'm assuming that it won't matter since it's past the 5 year mark.   I have the signed Psych letter and the Nutritional evaluation letter  I have the logs of everything I have eaten since starting my 6 month Dr. Assisted diet on 10/4/2007. Plus an exercise log and BP readings.  I am considered a 'lightweight' and am trying to get approved for lapband surgery!  I am 5'1 and started out at 222lbs in October when I began the process.  BMI of 41.9 /  went to surgical consult and if I remember correctly was at 210 which gave me a BMI of 39.7. I have since dropped to 202 (BMI 38.2).   Cigna requires either a BMI of 40 or 35-39.9 with a comorbidity.  I was diagnosed with high blood pressure in October and began treatment for it in November.  technically this is probably the reason I've lost the 20 lbs is mainly fluid due to it being a dieuretic.   clothes are looser - but body shape hasn't changed.  The meds for BP are not helping very much and I consistantly still have high BP and a very high pulse.  I've been 'told' that they look at your weight from the consult or beginning of dr. asst diet date and not the weight at the end of the 6 month diet/.  My problem has never been loosing 20 lbs to get to 200lbs  i just can't get under it and stay under it.   I was diagnosed with PCOS about a year ago and the insulin resistance has made it almost impossible for me to loose weight after many failed attempts.   I've had IBS for years / anxiety problems and other hormonal issues due to the PCOS.  All of these are weight related but not a 'comorbidity' other than the high blood pressure.   My Questions:  (I really did have some)  1. Do they look at starting weight or weight after the diet?  2. Since I fell into the 35-39.9 range during the 6 month dr assisted diet will it matter since I have High blood pressure that is not sucessfully being resolved with medications? 3. My six month diet started on 10/4/07 - my last appt with my PCP is 3/26/08 - will the difference between 3/26/08 and 4/4/08 make a difference on the six month diet? (each appt has been a little more than 30 days apart for the most part)  4. is there anything else that I can do to make sure my approval goes through???  HELP - I need to ease my mind.  I have called the surgeon's office - but have yet to hear back from them.  Thanks - Valerie  

Thanks Paul - you have such a vast knowledge of wls world.        I guess I am just getting nervous since it's close and the idea of them is denying me is just too much for me to comprehend some days.   That insurance companies can dictate things that affect our lives for the rest of our lives.

 

Thanks for the info - Valerie

Thanks Paul for the reminder that if it happens - it's not the end of the road!  Valerie