Sooverit!

I appologize if this is a dupe ...Not sure if my second post showed up. Re. being denied by Cigna, I meant to say that be sure you have a co mobidity with Cigna that they approve of. I had over a half dozen but they are currently managed with meds. Also some folks who have a BMI of 40 still get denied. I may appeal but just don't want the costs and headaches right now.

I really notice the difference in my appetite when I eat healthy foods ...lately (I'm not banded) that means most foods from Trader Joes. I'm much less hungry when I eat fruit, veg juice, lemon in Water...luke warm...cold just doesn't go down as easily. Start by forgetting about weight for now and focus on what makes our bodies healthy. Marg

I meant to say that you should be able to clearly substantiate the co mobidities that CIGNA specifies. I had almost a dozen "co mobidities" but they are in check with meds. I hear of those denied with a 40 BMI as well. I could apeal their denial but that is going to cost money and headache and :cool:I'm just not about to give out anymore.

Dear georgia girl: You are a sweatheart and a very kind person. I hope this doesn't sound odd but when I saw your picture I was stunned at how much you looked like my beautiful sister when she was young. I have been thinking all day...that I could either Switch Insurance Companies, get a loan, or lose the weight on my own. All not easy choices but maybe the loan part could be the most viable. Though I'm in no position to be in debt. I'll pray on it. And again Georgia your kind words helped to ease the sting of this new today. Gratefully, marg Hello Sooverit. I am really sorry that you were denied coverage. That sucks, especially since you have put a 1&1/2 years into this. Is the Lap Band out of picture for you now, or is there any way you can go the route of self pay or get a loan? Sorry this happened to you and I wish you the best! PS, I am sorry about your sister. I hope and pray you can find a way to make this happen. Today 09:41 AM

I was in a VERY gray area....I had to know if what where happening (being approved) would happen to me. Just giving a warning for others to not go through all this with Cigna Point of Service.:confused2:

Believe it or not I rushed into this It's taken me almost a year and a half of work but it's over at least. This...meaning insurance approval with Cigna. I was Denied because I was shy a 40 BMI by 10 -12 pounds when I submitted everything they were looking for I jumped thru every hoop and paid out every last cent to docs. etc. but I should have know (and not listen to people on this site that said Cigna does cover with no co mobidities - NOT TRUE) they clearly state that they do not cover those under a 40 BMI unless you have grave illness that don't respond to meds.. Not only that but they will not approve any claim even related to this one in the future. Meaning if I gain 10 pounds in the next year.even if I maintain that for a year and..easy to do at my age...they won't even consider it. My fear is of dying of a heart attack like my twin sister did of obesity last year. My chest is so huge it strangles me at night and causes sleep apnea that doesn't appear on the "test" ...another few hundred bucks there. My warning to those seeking insurance approval with CIGNA....if you're not starting out with a 40 BMI save your money until you are or get a loan unless you can clearly prove a comobidity. __________________

<TABLE cellSpacing=0 cellPadding=0 width="100%" align=center border=0><TBODY><TR><TD vAlign=top> <TABLE cellSpacing=0 cellPadding=0 width="100%" align=center border=0><TBODY><TR><TD vAlign=top> <TABLE class=tborder id=post808534 cellSpacing=0 cellPadding=6 width="100%" align=center border=0><TBODY><TR vAlign=top><TD class=alt1 id=td_post_808534 style="BORDER-RIGHT: #d9d9d9 1px solid">Believe it or not I rushed into this <HR style="COLOR: #d9d9d9; BACKGROUND-COLOR: #d9d9d9" SIZE=1>It's taken me almost a year and a half of work but it's over at least. This...meaning insurance approval with Cigna. I was Denied because I was shy a 40 BMI by 10 -12 pounds when I submitted everything they were looking for I jumped thru every hoop and paid out every last cent to docs. etc. but I should have know (and not listen to people on this site that said Cigna does cover with no co mobidities - NOT TRUE) they clearly state that they do not cover those under a 40 BMI unless you have grave illness that don't respond to meds.. Not only that but they will not approve any claim even related to this one in the future. Meaning if I gain 10 pounds in the next year.even if I maintain that for a year and..easy to do at my age...they won't even consider it. My fear is of dying of a heart attack like my twin sister did of obesity last year. My chest is so huge it strangles me at night and causes sleep apnea that doesn't appear on the "test" ...another few hundred bucks there. My warning to those seeking insurance approval with CIGNA....if you're not starting out with a 40 BMI save your money until you are or get a loan unless you can clearly prove a comobidity. __________________ financing </TD></TR></TBODY></TABLE></TD></TR></TBODY></TABLE></TD></TR></TBODY></TABLE><TABLE class=tcat style="MARGIN-TOP: 3px" cellSpacing=0 cellPadding=0 width="100%" align=center border=0><TBODY><TR><TD vAlign=center width=7></TD><TD class=tcat vAlign=center width="100%">food and Nutrition</OPTION> <OPTION class=fjdpth2 value=82> Cooking, Baking and Recipes</OPTION> <OPTION class=fjdpth1 value=81> Fitness & Exercise</OPTION> <OPTION class=fjdpth1 value=11> Doctors and Hospitals</OPTION> <OPTION class=fjdpth1 value=20> Fill Doctors</OPTION> <OPTION class=fjsel value=8 selected> Insurance & Financing</OPTION> <OPTION class=fjdpth1 value=12> Cosmetic and Reconstructive Surgery</OPTION> <OPTION class=fjdpth0 value=122>Lap Band Support Groups</OPTION> <OPTION class=fjdpth1 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It's taken me almost a year and a half of work but it's over at least. This...meaning insurance approval with Cigna. I was Denied because I was shy a 40 BMI by 10 -12 pounds when I submitted everything they were looking for I jumped thru every hoop and paid out every last cent to docs. etc. but I should have know (and not listen to people on this site that said Cigna does cover with no co mobidities - NOT TRUE) they clearly state that they do not cover those under a 40 BMI unless you have grave illness that don't respond to meds.. Not only that but they will not approve any claim even related to this one in the future. Meaning if I gain 10 pounds in the next year.even if I maintain that for a year and..easy to do at my age...they won't even consider it. My fear is of dying of a heart attack like my twin sister did of obesity last year. My chest is so huge it strangles me at night and causes sleep apnea that doesn't appear on the "test" ...another few hundred bucks there. My warning to those seeking insurance approval with CIGNA....if you're not starting out with a 40 BMI save your money until you are or get a loan unless you can clearly prove a comobidity.

If any of you are fighting a denial I cant stress to you how important it could be for you to contact ObesityLaw.com, I would never have been approved without thier help. Janine Congratulations Janine...it's always good to hear a story like this! Good for you for not giving up! May I ask you for some help. I am just so tired of spending 1000s of dollors on this whole process and countless hours of my time just to be rejected. I am afraid to lay out any more money on this. Could you please help me with the following questions. I would be most grateful. ` What was your BMI? ` Did you have co mobidities? ` How much did the attorney's charge you each time? ` I was rejected due to a BMI not being 40 for a year or more. It was a 38 at the time. If my BMI is 40 NOW (which it just became) and I start the process all over again will my visits to the Phych, Nutritionist, Surgen still be good after over a year? They told me I had to have a BMI of 40 for a year and they didn't approve my non life threatening comobidities due to meds help. Well I can start the clock now but go through all that again!!?? I guess I'm wondering at what point is it worth fighting them. Should a wait a year or two where I will totally be a 40BMI with some co morbidities for them too. Will they reject me because I tried to apply before?

I faxed my paperwork to the surgeon's office on February 11th (paid 23 bucks to do it by UPS) and got a letter from Cigna saying they received my paperwork on March 28! A week later they denied my claim.

Just looked on the appeal site that was posted by someone here and I change my mind I CAN NOT throw any more money away on this...! I will not appeal....thinking of perhaps changing to Aetna if possible and starting the procees all over again now at a BMI of 40 - not that that's not gonna cost me too.... Any opinions?

Well...it took 6 weeks supposedly for CIGNA to receive my paperwork from my surgeon's office then it took Cigna 2 weeks to turn down my claim because my BMI was not 40 for a year. I plan to appeal and then start this up again as I am a 40 BMI now. I may change surgeon's as well to a local doc Dr. Geiss on Long Island. Yes it cost me a small fourtune to go through all this but I can write a book about the whole proceedure now....good to see the positive. Marg Oh and it took a year for my PCP to get the 6 month diet paperwork correct! :thumbs_up:

Hi guys ...I have Cigna point of service plan or PPO (forget what this stands for). When I called last week CIGNA said they were waiting on verbal authorization from my PCP. Which could take a whlie with the crazy secretary there who has been the only one throwing wrenches into my year long plan here. Not sure why...unless her ins. doesn't cover lap band and she's sore. The guy on the phone said you haven't been declined they just need more clincial info. I am almost feeling excited here. ....will let you know tho.:biggrin:

Hey Susie: Thank you so much for taking the time out to share your words of wisdom. You gave me strength to put up a fight for my insurance rights! I am very similar to you ...same BMI and age! Though I haven't weighed myself in months I could be higher by now. I have sent in my very lengthy physcian's approval on his letterhead and all the rest exactely the way they want it. So how are you doing now? Have you been banded yet? How have you been doing feeling? Thanks again, YOurs, Marg

Finally today a letter from CIGNA saying ..."We received a resquest from you on 3/25/08 (faxed my paperwork _$30.00 UPS store on February 20th to the Sugeon's office! - trusted the coordinator there- silly me) and they said To process your request, we need the following additional information: - Clinical information for medical necesity is needed fax info to 132438948923 I sent them EVERYTHING they asked for!!? Has anyone ever received this? They are closed today of course ...what is clinical info exactly? :thumbup:

Dear IRC....good for you for taking a step in a heathy direction....looks like you are the pefect candidate for this surgery! Good for you for jumping through the hoops and making it work! I am 49 now and probably in a few years I will be the perfect candidate too....too bad they want us to wait that long! all the best, marg keep us posted on your journey from here

Wow! Aren't you lucky....I've been sitting here for over 5 weeks :-)...Congratulations! Do you mind sharing your BMI and if you had comobidities...sorry if I'm being nosy...I just want this saga to end!!!

My surgeon's office sent in my paperwork over 5 weeks ago and they have not heard from Cigna either way. I am hoping that this is a good sign? I heard that approvals take longer than denials? Does anyone know what an average waiting time is for approval from Cigna is? Any feedback would be appreciated. This journey is getting old...I've been working on this for over a year now!! Thanks, Marg

I am 5 ft. 9 and a BMI of 36/37 (getting larger by the day as I am pre op). I really like when people say "Your not t h a t fat ...you're just BIG"...oh okay...that's better, that means I can't do anything about it...great. Or from thin people well your are very overweight but you're not one of those people that need surgery for weight loss!! The truth is I am 85 pounds heavier than I was only 12 years ago..but because I am tall and large boned I carry it well but my heart doesn't think so. Have heart disease & Type II diabetes in my family big time! Actually when ever I tell a medical professional I am considering the lap band...there responses are ...from a nurse: "Cool" good for you...from Doc's....Good ...as you get older you'll be less active this will be good for you". or just Okay...as long as you know that you will still have your mind to deal with (head hunger). Great topic thank you~

Are you still in the "mushy" phase? Can you try eating food that has fiber in it? I would think soft (steel cut) oatmeal with fruit,.scrambled eggs, protein drinks, soups, fish ..I really like Dr. Oz's books "You on a Diet" etc. If you are really hungry try to force yourself to eat healthy first then go for the "bad" stuff after your full from the good stuff. I think there should be better nutritional counceling when you go for something like this! IT's not your fault...call your surgeon asap! .

Burger rings?? Yikes that's would really tourture me to tempt myself like that!

Whenever I add Extra Virgin Olive Oil 1/2 tsp a day to my diet...my hair responds in about a week and looks shiny, slightly wavy and healthy. Also adding fish to diet helps too.

Andrea: I remember this happening to me after investing 2 months everyday at the gym for 2 hours a day and only eating health foods, I went on the scale for the first time there (I don't own one) and only saw 1 lb. down...I remember the frustration you are feeling and I immediately stopped going to the gym and then my weight really got out of hand. Thinking back I shouldn't have trusted the scale because in honestly my clothes were fitting better and I felt better.

Hi everyone, I know this question's been posted but I was wondering if anyone knew the latest turn around time for Cigna to issue an approval? Meaning from the time paper work is faxed to Cigna and call from Surgeon's office> approximate?

I don't know but be careful ...I'm in the same dilemma and I think they could ask to see past proof that you had a 40 BMI for the past year! I would check this out before gaining. I am 38.5 BMI ...it's so frustrating...if I only had not gone to the gym for all those years! crazy!