Brianna_Nicole

Thanks! Thats good to know about the dietitian. He started me on a 1200 calorie diet and gave me a bunch of recommendations for Protein shakes and 0 calorie drinks for after surgery (high calorie drinks are a huge problem for me!), so I actually did find him very helpful and knowledgeable. Its purely insurance that was worrying me.
How has your experience been with the sleeve so far? I see that you've lost 55 pounds already? That is incredible! Congrats!!! :-)

Hi there. Your stats are similar to mine. I am also five feet tall and was 267 lbs. I also have Cigna. I needed to have three months steady of doctor supervised weight loss/dieting. I did not have to lose any weight, just have it documented with the doctor. You should be OK insurance wise.
As far as the surgery you want, talk to the doctor and explain why you want the DS. If he has a problem with it, you will know that he's the wrong doctor for you.
Regarding the amount of weight you expect to lose, just know that my PCP told me to get a gastric bypass since I needed to lose at least 100 lbs. and her experience was that I'd only lose about 40 lbs. with the band. I went with the band because that's what I was comfortable with and I lost 150 lbs. I weigh less than my PCP now so don't assume the weight loss based on the surgery.
Good luck and keep us posted.

Your reasons are why I chose the DS as my surgery.
It's your body. Tell him you want the DS. I would also go over your reasons with him. Show him you have done your research.
I also have Cigna. And they approved me no problem. But I would call them and discuss it. And make sure you note the times and who you spoke with.

Hello everyone! :-) This is my first post here. I was recommended to check out this site after posting on OH.
Some info about me: I'm 25 years old, female, 5 feet tall and 263 pounds. I want the DS surgery. So far I've had my surgeon consultation and first dietitian appointment. I have all my other evaluations scheduled in the next month.
My first issue I'm hoping for advice with: I went to my consult adamant that I want the DS surgery. Unfortunately I am NOT good at standing up for myself or disagreeing with doctors. When the surgeon asked what surgery I want, I said DS and he basically said that I do qualify at my BMI, but he would recommend I do the sleeve because I'm young and have a long time ahead of me to deal with the side effects and deficiencies that come with the DS. He said that if I'm not successful I can always have the 2nd part done and convert to a DS. He asked me what I thought about that and because of my shyness I said okay to the sleeve. After coming home and doing even more research, I'm even more adamant that I want the DS for many reasons:
1. I want to lose 120 pounds and KEEP IT OFF. The DS has the best results and least chances of regain, which I have a long history of. It looks like the average weight I can expect to lose with the DS is at least 90-100 pounds, while with the gastric sleeve I would probably only lose about 60. While losing 60 pounds would of course be wonderful, I would rather have the surgery that can take me to my total goal.
2. I have heard that the DS lets you eat the most normally.
3. I want to have the best possible surgery now, one time. I don't want to have to go through surgery again.
4. On the same note, getting a second surgery approved will be extremely difficult and probably denied, so if I don't lose enough weight or if I gain a lot back, I will have to self pay which I cannot afford.
5. Taking Vitamins and committing to blood work and follow-ups is not a problem to me. I look at it this way - I can have this surgery, take daily Vitamins and go to the doctor regularly to check levels; OR, I can not have the surgery and continue to have weight issues, take daily medicines for co-morbidities and go to the doctor regularly for my health problems.
So, I plan to call the office today and let them know I have changed my mind and want the DS. I'm worried that my Dr. will be offended or something, because I have known a lot of doctors that can be arrogant and hate being questioned. At my consultation he was extremely nice and didn't give me any indication that he was that type of person, but I'm still nervous!
So my question is: what do you recommend I say to the doctor to support why I disagree and want the DS? If for some reason he refuses to do it for me, can I transfer the evaluations I've done to another practice/surgeon without having to start all over?
Next issue: I had my first dietitian appointment on Monday and I'm very worried that he doesn't know and understand my insurance requirements. My Cigna plan requires 3 months (so 4 consecutive monthly appointments) of a physician or dietitian supervised weight loss program. When he mentioned I would be seeing him one more time, I told him that my insurance requires 3 months of visits. He went and got a packet with a description of the requirements for all the different insurance companies and said I was right about that. He then said that I could just see my PCP for some of the appointments. I said I want to do the 4 appointments all with him because it is supposed to be with the same doctor and I do not want to do ANYTHING that could get me denied. He said that was fine and we could meet monthly. Another concern of mine is that my monthly weight loss program requires documentation of my weight, dietary program and physical activity. He recorded my weight and taught me about the 1200 calorie diet plan he is prescribing for me and gave me papers with all the details and recommendations, and he taught me about the Protein and other diet requirements for after my surgery. The appointment was very informative and helpful, but we never touched on a physical activity plan at all. Maybe I am being paranoid, but I'm very worried about problems with insurance after the horror stories I've seen in the forums. I want to make sure every detail is perfectly followed.
So what I was thinking of doing is seeing my PCP every month on top of the dietitian appointments, just in case it's not done correctly by the dietitian. My PCP is great and strongly supports my surgery. I'm positive he would do the weight loss program with me and follow all my requirements. Do you guys think this is a good idea? Could seeing both the doctor and dietitian at the same time for the weight loss program possibly be a problem for any reason you can think of?
Okay, now one more topic! I am really sorry for this incredibly long post, I just have so many questions and concerns.
I have checked and confirmed my bariatric surgery coverage in a few ways. I call the Cigna customer service line twice to confirm that my specific plan covers weight loss surgery and both times was told yes, it is covered. But I just don't trust the people on the phone to always be correct. I also signed into my account on the Cigna website and used the cost estimator for my plan, and it said that I can expect to pay a $300 co-pay for bariatric surgery. Lastly I read the coverage booklet posted by the employer providing the plan. The only mention of bariatric surgery is in the exclusions section, but this is what it says: "Payment for the following is specifically excluded from this plan: .... • for medical and surgical services intended primarily for the treatment or control of obesity. However, treatment of clinically severe obesity, as defined by the body mass index (BMI) classifications of the National Heart, Lung and Blood Institute guideline is covered if the services are demonstrated, through peer-reviewed medical literature and scientifically based guidelines, to be safe and effective for treatment of the condition."
Is it just me or is that a bit confusing? I'm thinking this means that the plan does not cover any obesity treatment for those who do not have "clinically severe obesity". A BMI over 40 or between 35-39.9 with co-morbidities is defined as clinically severe obesity. So I definitely meet this requirement with a BMI of about 52. I'm also thinking that the last part about treatments that are peer reviewed and scientifically shown to be safe and effective means that the 5 procedures covered in the Cigna bariatric surgery coverage policy are all covered (gastric Bypass, gastric banding, RNY, vertical banded gastroplasty and BPD/DS for those with BMI over 50).
I just find it odd that weight loss surgery is ONLY mentioned in the exclusions section. This booklet may be outdated - the "effective date" in the beginning is February 2009.
Well, if you made it through this post, I appreciate it and applaud your patience! :-) Thanks so much for any advice or insights you can provide.

Hello everyone! :-) This is my first post here. I was recommended to check out this site after posting on OH.
Some info about me: I'm 25 years old, female, 5 feet tall and 263 pounds. I want the DS surgery. So far I've had my surgeon consultation and first dietitian appointment. I have all my other evaluations scheduled in the next month.
My first issue I'm hoping for advice with: I went to my consult adamant that I want the DS surgery. Unfortunately I am NOT good at standing up for myself or disagreeing with doctors. When the surgeon asked what surgery I want, I said DS and he basically said that I do qualify at my BMI, but he would recommend I do the sleeve because I'm young and have a long time ahead of me to deal with the side effects and deficiencies that come with the DS. He said that if I'm not successful I can always have the 2nd part done and convert to a DS. He asked me what I thought about that and because of my shyness I said okay to the sleeve. After coming home and doing even more research, I'm even more adamant that I want the DS for many reasons:
1. I want to lose 120 pounds and KEEP IT OFF. The DS has the best results and least chances of regain, which I have a long history of. It looks like the average weight I can expect to lose with the DS is at least 90-100 pounds, while with the gastric sleeve I would probably only lose about 60. While losing 60 pounds would of course be wonderful, I would rather have the surgery that can take me to my total goal.
2. I have heard that the DS lets you eat the most normally.
3. I want to have the best possible surgery now, one time. I don't want to have to go through surgery again.
4. On the same note, getting a second surgery approved will be extremely difficult and probably denied, so if I don't lose enough weight or if I gain a lot back, I will have to self pay which I cannot afford.
5. Taking Vitamins and committing to blood work and follow-ups is not a problem to me. I look at it this way - I can have this surgery, take daily Vitamins and go to the doctor regularly to check levels; OR, I can not have the surgery and continue to have weight issues, take daily medicines for co-morbidities and go to the doctor regularly for my health problems.
So, I plan to call the office today and let them know I have changed my mind and want the DS. I'm worried that my Dr. will be offended or something, because I have known a lot of doctors that can be arrogant and hate being questioned. At my consultation he was extremely nice and didn't give me any indication that he was that type of person, but I'm still nervous!
So my question is: what do you recommend I say to the doctor to support why I disagree and want the DS? If for some reason he refuses to do it for me, can I transfer the evaluations I've done to another practice/surgeon without having to start all over?
Next issue: I had my first dietitian appointment on Monday and I'm very worried that he doesn't know and understand my insurance requirements. My Cigna plan requires 3 months (so 4 consecutive monthly appointments) of a physician or dietitian supervised weight loss program. When he mentioned I would be seeing him one more time, I told him that my insurance requires 3 months of visits. He went and got a packet with a description of the requirements for all the different insurance companies and said I was right about that. He then said that I could just see my PCP for some of the appointments. I said I want to do the 4 appointments all with him because it is supposed to be with the same doctor and I do not want to do ANYTHING that could get me denied. He said that was fine and we could meet monthly. Another concern of mine is that my monthly weight loss program requires documentation of my weight, dietary program and physical activity. He recorded my weight and taught me about the 1200 calorie diet plan he is prescribing for me and gave me papers with all the details and recommendations, and he taught me about the Protein and other diet requirements for after my surgery. The appointment was very informative and helpful, but we never touched on a physical activity plan at all. Maybe I am being paranoid, but I'm very worried about problems with insurance after the horror stories I've seen in the forums. I want to make sure every detail is perfectly followed.
So what I was thinking of doing is seeing my PCP every month on top of the dietitian appointments, just in case it's not done correctly by the dietitian. My PCP is great and strongly supports my surgery. I'm positive he would do the weight loss program with me and follow all my requirements. Do you guys think this is a good idea? Could seeing both the doctor and dietitian at the same time for the weight loss program possibly be a problem for any reason you can think of?
Okay, now one more topic! I am really sorry for this incredibly long post, I just have so many questions and concerns.
I have checked and confirmed my bariatric surgery coverage in a few ways. I call the Cigna customer service line twice to confirm that my specific plan covers weight loss surgery and both times was told yes, it is covered. But I just don't trust the people on the phone to always be correct. I also signed into my account on the Cigna website and used the cost estimator for my plan, and it said that I can expect to pay a $300 co-pay for bariatric surgery. Lastly I read the coverage booklet posted by the employer providing the plan. The only mention of bariatric surgery is in the exclusions section, but this is what it says: "Payment for the following is specifically excluded from this plan: .... • for medical and surgical services intended primarily for the treatment or control of obesity. However, treatment of clinically severe obesity, as defined by the body mass index (BMI) classifications of the National Heart, Lung and Blood Institute guideline is covered if the services are demonstrated, through peer-reviewed medical literature and scientifically based guidelines, to be safe and effective for treatment of the condition."
Is it just me or is that a bit confusing? I'm thinking this means that the plan does not cover any obesity treatment for those who do not have "clinically severe obesity". A BMI over 40 or between 35-39.9 with co-morbidities is defined as clinically severe obesity. So I definitely meet this requirement with a BMI of about 52. I'm also thinking that the last part about treatments that are peer reviewed and scientifically shown to be safe and effective means that the 5 procedures covered in the Cigna bariatric surgery coverage policy are all covered (gastric Bypass, gastric banding, RNY, vertical banded gastroplasty and BPD/DS for those with BMI over 50).
I just find it odd that weight loss surgery is ONLY mentioned in the exclusions section. This booklet may be outdated - the "effective date" in the beginning is February 2009.
Well, if you made it through this post, I appreciate it and applaud your patience! :-) Thanks so much for any advice or insights you can provide.

Hello everyone! :-) This is my first post here. I was recommended to check out this site after posting on OH.
Some info about me: I'm 25 years old, female, 5 feet tall and 263 pounds. I want the DS surgery. So far I've had my surgeon consultation and first dietitian appointment. I have all my other evaluations scheduled in the next month.
My first issue I'm hoping for advice with: I went to my consult adamant that I want the DS surgery. Unfortunately I am NOT good at standing up for myself or disagreeing with doctors. When the surgeon asked what surgery I want, I said DS and he basically said that I do qualify at my BMI, but he would recommend I do the sleeve because I'm young and have a long time ahead of me to deal with the side effects and deficiencies that come with the DS. He said that if I'm not successful I can always have the 2nd part done and convert to a DS. He asked me what I thought about that and because of my shyness I said okay to the sleeve. After coming home and doing even more research, I'm even more adamant that I want the DS for many reasons:
1. I want to lose 120 pounds and KEEP IT OFF. The DS has the best results and least chances of regain, which I have a long history of. It looks like the average weight I can expect to lose with the DS is at least 90-100 pounds, while with the gastric sleeve I would probably only lose about 60. While losing 60 pounds would of course be wonderful, I would rather have the surgery that can take me to my total goal.
2. I have heard that the DS lets you eat the most normally.
3. I want to have the best possible surgery now, one time. I don't want to have to go through surgery again.
4. On the same note, getting a second surgery approved will be extremely difficult and probably denied, so if I don't lose enough weight or if I gain a lot back, I will have to self pay which I cannot afford.
5. Taking Vitamins and committing to blood work and follow-ups is not a problem to me. I look at it this way - I can have this surgery, take daily Vitamins and go to the doctor regularly to check levels; OR, I can not have the surgery and continue to have weight issues, take daily medicines for co-morbidities and go to the doctor regularly for my health problems.
So, I plan to call the office today and let them know I have changed my mind and want the DS. I'm worried that my Dr. will be offended or something, because I have known a lot of doctors that can be arrogant and hate being questioned. At my consultation he was extremely nice and didn't give me any indication that he was that type of person, but I'm still nervous!
So my question is: what do you recommend I say to the doctor to support why I disagree and want the DS? If for some reason he refuses to do it for me, can I transfer the evaluations I've done to another practice/surgeon without having to start all over?
Next issue: I had my first dietitian appointment on Monday and I'm very worried that he doesn't know and understand my insurance requirements. My Cigna plan requires 3 months (so 4 consecutive monthly appointments) of a physician or dietitian supervised weight loss program. When he mentioned I would be seeing him one more time, I told him that my insurance requires 3 months of visits. He went and got a packet with a description of the requirements for all the different insurance companies and said I was right about that. He then said that I could just see my PCP for some of the appointments. I said I want to do the 4 appointments all with him because it is supposed to be with the same doctor and I do not want to do ANYTHING that could get me denied. He said that was fine and we could meet monthly. Another concern of mine is that my monthly weight loss program requires documentation of my weight, dietary program and physical activity. He recorded my weight and taught me about the 1200 calorie diet plan he is prescribing for me and gave me papers with all the details and recommendations, and he taught me about the Protein and other diet requirements for after my surgery. The appointment was very informative and helpful, but we never touched on a physical activity plan at all. Maybe I am being paranoid, but I'm very worried about problems with insurance after the horror stories I've seen in the forums. I want to make sure every detail is perfectly followed.
So what I was thinking of doing is seeing my PCP every month on top of the dietitian appointments, just in case it's not done correctly by the dietitian. My PCP is great and strongly supports my surgery. I'm positive he would do the weight loss program with me and follow all my requirements. Do you guys think this is a good idea? Could seeing both the doctor and dietitian at the same time for the weight loss program possibly be a problem for any reason you can think of?
Okay, now one more topic! I am really sorry for this incredibly long post, I just have so many questions and concerns.
I have checked and confirmed my bariatric surgery coverage in a few ways. I call the Cigna customer service line twice to confirm that my specific plan covers weight loss surgery and both times was told yes, it is covered. But I just don't trust the people on the phone to always be correct. I also signed into my account on the Cigna website and used the cost estimator for my plan, and it said that I can expect to pay a $300 co-pay for bariatric surgery. Lastly I read the coverage booklet posted by the employer providing the plan. The only mention of bariatric surgery is in the exclusions section, but this is what it says: "Payment for the following is specifically excluded from this plan: .... • for medical and surgical services intended primarily for the treatment or control of obesity. However, treatment of clinically severe obesity, as defined by the body mass index (BMI) classifications of the National Heart, Lung and Blood Institute guideline is covered if the services are demonstrated, through peer-reviewed medical literature and scientifically based guidelines, to be safe and effective for treatment of the condition."
Is it just me or is that a bit confusing? I'm thinking this means that the plan does not cover any obesity treatment for those who do not have "clinically severe obesity". A BMI over 40 or between 35-39.9 with co-morbidities is defined as clinically severe obesity. So I definitely meet this requirement with a BMI of about 52. I'm also thinking that the last part about treatments that are peer reviewed and scientifically shown to be safe and effective means that the 5 procedures covered in the Cigna bariatric surgery coverage policy are all covered (gastric Bypass, gastric banding, RNY, vertical banded gastroplasty and BPD/DS for those with BMI over 50).
I just find it odd that weight loss surgery is ONLY mentioned in the exclusions section. This booklet may be outdated - the "effective date" in the beginning is February 2009.
Well, if you made it through this post, I appreciate it and applaud your patience! :-) Thanks so much for any advice or insights you can provide.