That is the exact same thing mine said! I just actually received my letter from them saying they are denying me AGAIN because I lack the medical necessity for them to cover my surgery - this is all over five pounds too!!! So! I'm going to talk to my surgeon about (this is a sin I know) gaining the five pounds and starting over from scratch (if it's allowed). But my letter got me no where but back to where I started. Depending on why they are saying it's not necessary I would probably suggest the same, only because I've waited 3 months fighting after a year of working for it and it's just too much time that I'm worried I don't have.

Best of luck though in whatever path you take!

This is my first post and I have been reading different posts for several months.  My primary insurance is united healthcare and my secondary insurance is Medical Mutual of Ohio.  My primary insurance (united healthcare) didn't cover bariatric surgery including gastric bypass surgery but Medical Mutual did if you met all of the requirements.  I have gone through all 6 months of the supervised diet, got my psych test, got the scope of my stomache, went to the heart docotor and got the heart test, ect.  My docotors office first submitted my paperwork to my primary insurance(just to get the denial letter) so they could submit to Medical mutual.  My doctor's office submitted the paperwork to Medical Mutual on Monday morning.  I called the insurance and checked the status every day that entire week.  Finally I called on that same Friday (two days ago) and they just told me that I was approved!!!!  Just to double check, I even called again to make sure I got the same answer.  I have been so worried that I may get denied.  It feels amazing to know that I have the approval.  I have prayed so many times to God over the past 6 months and I believe He knew how important it was to me and He made it such an easy process to get approved.  Now I have to finish up my 2 hour nutrional class and I am ready to get the surgery.  Medical Mutual of Ohio couldnt have made it any easier and seamless.  Good luck to anyone trying to get the approval!!!

Ericha2, did they elaborate on how it was to be documented by the doctor? I have Cigna as well and this 6mo requirement is my biggest fear. I have proof from Jenny Craig that started in 4/2009 till 10/2009 which I'm hoping they still consider within the previous 2 year mark but I didn't do it with a doctor.

I really hope others post their experience with this, a 6 month delay would be so disheartening

Good Luck to you!!!!

Hi,

I have Aetna and myself and my three kids all have had surgery.  Aetna approved and covered eachof our surgeries.  Aetna does cover WLS, it must be that your employer has an exclustion to their policy to not cover it.  I would talk with someone in your HR department and see if there is any chance of  them changing the exclusion. 

Good Luck to you!
Nan