Tomorrow marks my 2nd week waiting for my approval.

I received a letter in the mail today from CIGNA saying I was denied.  In the letter it states that I must be 18 years or older (I'm 27), a BMI over 40 (which I have), and must have at least one co-morb (mine is sleep apnea).  I also followed thru with their requirement of 6 months of supervised diet and exercise. 

I spent months going for all the necessary testing (sleep, pulminary, ultrasounds, egd, etc.). I even had my PCP write a note saying she's been seeing me since 1999 (I was a freshman in HS) and that I have struggled with obesity for years.  It said that I had been seen for help regarding weight loss many times in the past and this was my last step. 

I WAS EFFING DENIED?!?  How in the world can people smaller than me be approved with one or ZERO co-morbs?  Or people on Medicade???  I work hard and I pay for my insurance...I was even PRE-APPROVED at the beginning...

Obviously, being that its 8pm here, my surgeon's office is closed, what can I do?  The insurance co-ordinator has a 98% success rate for approvals (or something crazy high), do I wait to talk to her?  Do I have to dispute this?  I want to cry.  I'm just so upset.  I've waited since last March for this, and now they're saying NO?!?  Now that the holidays are here, I just know it's going to be even harder  :( :( :( 

I just want my life back.  I want to walk up stairs without being winded, go shopping with my friends, be a "NORMAL" 27 year old. 

My heart is broken.  Suggestions?

I have BCBSIL PPO and I just found out that I got approved. I was denied twice for WLS but after submitting them 300 pages of documentation and filling a complaint with the state of Iliinois department of insurance, I was approved in 1 day. If you need assistance with anything, I'll be more than happy to help you.

Ok..... I have Anthem BC&BC of Virginia and they require me to do 12 months of a weight management program(Weigh****chers) and do 12 months with a weight management coach(over the phone). Whats driving me crazy is that I started seeing my PCP for weight loss surgery back in July and have been monitored by her on a monthly basis. Last week was my first consultation with my surgeon and that's when my insurance is starting my 12 month program. Does anyone know if my insurance will accept the 5 months that I have ALREADY spent seeing my PCP for my weight loss? Or do I have to start from this point on?  This is so frustrating!! 

If your insurance requires the 6-month diet, then if the surgeon submits before that is up it will be denied. Don't worry, it will go by quicker than it seems.

Tonia

  I had to go for my 1st 6 month dr supervised diet this week.  The WLS Center gave me a paper that had what the insurance usually require for the dr notes.  I just got a copy of the notes yesterday.  All she did pretty much was copy down twice the criteria.  Not notes about me but about what the insurance wanted.  Not sure if that is sounded quite right.  She kept saying that it was a waste of time and money.  I was not happy when she quoted some of what I told her about the insurance requires her to only have dr notes on my supervised diet that you can't be seen for anything else. Instead of actually doing 2 different sets of notes she just wrote that I told her to do that.  She also put in there what I said about what the WLS Center said about my insurance company saying they are being sporadic about what they require for the surgery.  Why would she put those in my dr notes.  I told her I need her to put down calories, exercise, behavioral changes, weight, all my health issues, medications. ect.  I don't really know what to do about her office note because I don't think that the ins. is going to except.  Oh she also talked about when I asked her if we could use my Sept. and Oct visits to back date so we could use those. She actually wrote that in her notes for me to give to the ins. company.  Is she trying to sabotage me?  I don't know what to do. :(