Bethanyblondie

I didn't have to do a sleep study, but I did have to do a bazillion other things before my surgeon's insurance coordinator would file my paperwork. I was VERY thorough in making sure I had everything before I turned it in to her. I got approved in a day and a half! I'm having surgery May 18th! I had to pay for six months of weight watchers and lots of doc appointments, therapy, nutrition classes, and other things. It does cost you some money but it's worth it!

Well...I've done it! I'm finished with my six months of supervised weight loss (lost like, a whole 8 pounds..woohoo). I worked my booty off this year gathering up all the information I thought Cigna needs to approve my surgery. As far as I know, I've "checkmarked" their list off and I've got/done everything they require. I have no co-morbidities, but my BMI is over 40, so I'm not really worried about that. My question is, I just called the lady at my surgeon's office who submits the insurance stuff, and all she wants from me are my six weight checks from the doctor and my psych evaluation. I spent $50 to get my medical records from Kaiser so I'd have proof of my weight from two years ago, and she didn't even ask for that. I know she's done this a million times...I just found it odd that Cigna's website shows ALL these things you have to have and she only asked for a couple of them. Have any of you recently been approved through Cigna? What kind of experience did you have? Do I just need to have that other stuff around "in case" they ask for it? Any responses would be appreciated!:welldoneclap:

Check out my new signature! I'm an official Bandito!

I've told my immediate family and a few close friends that I am getting the band. I figure when I start dropping enough weight to be noticeable in the near future and people ask me about it, then I'll be glad to share with them. For now, I'm not going to make a big announcement of it. I'm not hiding it, just not advertising it, ya know?

I'm not banded yet, but my nutritionist says that even if you chew bread up in your mouth thoroughly, as it goes down your esophagus the contractions "squish" the bread back together into a little dough ball, then lands in your stomach as a ball of dough that will block your band opening. I'm sure if you eat super teeny bites at a time that could probably be avoided. As for me, when I get banded, I'm going to try and avoid bread just because i know it's really not adding any nutrition into my tiny amount of food I can eat. It will truly become eating to live...not living to eat! Although...that's always easier said than done, huh?:smile:

I have Cigna insurance, but all they required was proof of my BMI being over 20 for the last 24 months, so I only sent in the medical records that had my highest weights on them. I was approved in a day and a half. Aetna doesn't have to see all your fluctuations...just send them your highest weights recorded at any doctor appointment in the last two years. Good luck!

I'm sure if your PCP will write you a recommendation letter they'll approve you. Especially if you've had the co-morbidities the last two years. Sounds like you've got everything else covered.

What insurance do you have? I've never heard of any insurance company not being able to tell you the information you requested. I have Cigna...which has the reputation of being incredibly hard to work with in terms of bariatric surgery, but I had NO issues with them and they approved my surgery 1 1/2 days after I submitted my paperwork. Cigna's requirements for bariatric surgery are available on their website, and I was able to "checkmark" each thing off the list before I submitted my stuff. Now I will say I did call one surgeon back in May (the one my PCP referred me to) and they practically hung up on me when I told them I had Cigna. So I had to find another surgeon on my own. I did have to go to their weight loss seminar, and their 5 hour nutrition class. And then the insurance coordinator in their office was never particularly easy to get a hold of...always took numerous e mails/phone calls to get a response. But overall the process was not near as daunting as I thought it would be...just time consuming! Almost all insurance companies that I've read about are okay with approving surgery for someone with a BMI over 40, even with no co-morbidities. I have a BMI of about 42, but am healthy as can be...just fat! But Cigna still approved me. It seems in general, for most insurance companies, that you have to do the 6 month supervised diet with your physician, meet with a nutritionist, have a psych evaluation, log your diet and exercise program, and either have proof of a BMI of over 40 (no co-morbidities required), or between 35-39 with two or more co-morbidities from the last 24 months. So if you haven't started your 6 months of dieting I would get on it...and call your insurance company again and ask what their requirements are for approving bariatric surgery, and if they say they can't tell you again ask for a manager. Also check their website. Good luck!

How exciting! I just got approved for surgery and am supposed to have a date set Monday or Tuesday. I'll be getting it in May sometime. I'm SO pumped! Woohoo! This is going to be a great summer for all of us!

I got approved in a day and a half by Cigna, but I had literally "checkmarked" everything off their requirement list for approval. But they do absolutely require your proof of a high enough BMI from the last 24 months. I'm not sure what to tell you if you don't have the BMI requirement. Hopefully there might be someone on the forum that has had the same issue that found a loophole?

Okay Ladies...do the HAPPY dance with me! I got APPROVED for surgery today! She submitted my stuff on Wednesday and I got the e mail today...so it took a whole day and a half. And to top it off, my husband got offered a wonderful new job this morning that pays better than his current one....so I'm feeling OH so good right now! They are going to call me on Monday to set a surgery date! Mayo Banditos here I come! AAAAAAAAAAHHHHHH!:):sad::tt1:

I have a feeling you aren't getting any response because pretty much most of us know Cigna's requirements for approval inside and out, and proof of your BMI for 2 years is one of their big requirements. I don't really know what to tell you...if your BMI hasn't been high enough you probably will not get approved with Cigna. Do you have any co-morbidities? What is your BMI now?

I have another question...when you guys turned in your stuff to insurance, what kind of detail did you include in terms of your diet and exercise? My doctor just put things like, "continuing to comply with Weight Watchers, low fat diet momentum plan, aerobic exercise 5xweek for 30 minutes, recommend to add weight lifting...," that kind of stuff. I am a little panicked (now that I have submitted my stuff of course), that that wasn't detailed enough. I don't know...maybe I'm just fretting over nothing. What do you guys think? How did your doctor document that stuff?

Ohhh, that's good advice...I will do that!

Congratulations on your approval! I bet it feels great to have a surgery date set! My paperwork has just been sent in to Cigna today and i was told to not expect any news for about ten business days. I'm so anxious to found out if I'll be approved! The waiting game is hard!:sneaky:

The "precertification specialist" left me a message today that she received my file and sent in my request for surgery to Cigna! She said she'll call me as soon as she hears anything, but that she doesn't expect to hear anything for about 10 business days. So hopefully in a couple of weeks I'll know if I'm approved and I can get my May date! YAAAAYYYY! I'm so glad you guys all have surgery dates. Amy, I bet you are over the moon right now! Hope I'll be joining you soon!

I do think insurance companies will do whatever it takes to make us give up....that way they don't have to shell out any money! Just keep fighting the fight...the more I talk to people on this forum the more I realize if you are persistent like no other with these insurance people that you will get approved! Sorry it's been such a hassle. I just submitted my paperwork and have now started the fun waiting game. I "checkmarked" every thing off the requirement list for my insurance, but am just waiting for them to find some tiny little thing to deny me for. But I'm not giving up! Good luck to you guys!

That's so exciting! I will probably start calling about Friday to see if my stuff has been submitted. I have no idea how long it should take my surgeon to write his letter for me, but the insurance coordinator said last night she'd have him do it ASAP, since I told her I really need to schedule surgery in May. I can't imagine that they wouldn't be able to get that done by Wednesday or Thursday...and then I assume they fax everything to Cigna? This waiting game is tough!:wub:

So inspiring.

Wow...that's shocking. What is your doctor's reasoning for keeping your records from you? I went to my doctor's office and requested my weight checks and she printed them for me on the spot, no questions asked, didn't even have to check with my doctor. They are YOUR records, for YOUR health issues. That makes NO sense that your doctor would keep them from you for your benefit. I agree with the other posts, that you should threaten speaking with an advocate. That might light a fire under their booties. Let us know what happens.

Okay, i talked to the insurance coordinator and told her I really need to get approved so I can get surgery in May. She e mailed me and said she would submit my papers ASAP. I told her with my school year coming to an end in June, and there being massive budget cuts next year, that I was concerned that my insurance policy would change in terms of bariatric surgery at that point. Hopefully that will make things happen in the next few weeks. I WILL get my May surgery date!