Bethanyblondie

Thanks everyone for your advice. Luckily Dr. Chae's office contacted me last week after I left my very stern message. They are going to set me up for my consultation in January. Yay!:tongue:

Thanks everyone, for your info. I have an appointment in Sept. with my doc, so I will have her begin the documentation then. I started the diet a couple of months ago, so this sets me back two months...but it will be worth it in the end.

Hey all! I visited my PCP in May to talk to her about the lap band and she referred me to a surgeon to talk to. The surgeon she referred me to was not willing to work with me because I have Cigna insurance, so I had to seek out other resources for the time being. ANYWAYS...my real question is...while I wait to meet a different surgeon, I have been doing Weight Watchers for the last couple of months as part of the six month weight loss plan requirement. Cigna says WW's is an acceptable program as long as it is conjunction with a physican's supervision. Does that mean I have to visit my PCP once a month to "check in" or can it be every couple of months? I haven't been back to see her since the end of May, so if I need to see her every month, then I'm going to have to get on it so I don't get too far behind! Any of you Cigna peeps out there willing to give a girl a hand with this?:wink2:

I tried to make an appointment with the bariatric surgeon my PCP referred me to, but they have twice now told me they really think I should look into working with doctors that are at a Cigna "bariatric surgery certified" hospital, which they aren't. I told her on Cigna's website that it says you do not have to get surgery at their certified hospitals...but once againg the lady at the surgeon's office said they know that Cigna might not cover near as much of the expenses if I don't go to one of their certified hospitals. None of the hospitals in Denver are certified, so i would have to go to Colorado Springs. Anyone recently get surgery that has Cigna insurance? Did you have to deal with this? The surgeon's office I talked to said they haven't seen any Cigna patients in almost a year because of this issue.

Your added info is appreciated! I've been going to doctors that are in Cigna's network and I called Cigna to confirm that they all were before I went. I've heard good and bad stories about Cigna in terms of the lap band...but I guess that's the case with any insurance company. I just assume they will find some problem when I finally turn in my stuff in the future and that I'll have to appeal. I figure if I just expect it then I won't be surprised if it happens. I'm right at the 100 pound overweight mark...so I sort of float between a 38-40ish BMI. I don't really have any co morbidities so I don't have much leeway on anything. But I am at a 40 BMI right now and have been in the past few years as well. I go up and down...as i'm sure you both deal with as well. I try not to talk myself out of continuing with this process on a daily basis. I get a little overwhelmed!

I'm so glad you responded! I had been putting off doing anything else because I was really apprehensive about having to everything in the Springs. Yes, it was Dr. Tilquist's office I talked to, and you are right...they REALLY don't want to work with us Cigna patients. I will give Dr. Chae's office a call. I keep going back and forth at times about if I still want to do this whole process...and I know it's mostly because of the fear of being turned down by insurance after I've done all their requirements. I'm about to start month three of Weight Watchers, which according to Cigna is an acceptable program to follow as long as you check in with your doctor. I've been going to a psychologist for several sessions already, so now I've just got to see a nutritionist and finish out my six months of dieting. Although I'm a little worried now because my doctor just told me my thyroid levels are low, so they've put me on meds for eight weeks to see if it helps. I don't want that to affect all my work towards getting a lap band. I've been heavier than I am now and my thyroid was fine, so I KNOW my thyroid is not what causes me to gain weight!

Hey Go Big Girl...just curious how you are doing? I've been a little sidetracked because I went on vacation. I had an appt. with a psychologist a week and a half ago and she didn't show up for my appt. She called apologizing profusely...saying she got the times mixed up and if I would give her another chance she'd waive the co-pay. So I have my new appt. this Thursday. Now I just need to visit with the surgeon. I'm starting Weight Watchers next week as well. Anyways, just was curious how things were going with you!

Tara, have you made an appt. with a surgeon yet? That's my goal this week...and with the psychologist. I am PRAYING that my bank records of my year at Slim4Life will count for the diet thing (Cigna says that if you are morbidly obese than proof of a diet program followed for at least six months in the last five years could count instead of doing the six months supervised now...all I have are my bank statements...we'll see if they accept that). I don't want to wait six more months just to SEE if insurance will approve me...but if that's what I gotta do I will. I think it would be foolish to not try and have insurance cover the surgery...why pay yourself when you don't have to? Keep me posted on your status with everything!

Hello! I am new here and I have a PCP appt. tomorrow to talk about the lap band. I have read Cigna's most recently revised requirements for WLS and I am wondering about the BMI of 40 for 24 months "proof." I haven't been great about going to the doctor for check ups since I moved out on my own many years ago. I did go to a weight loss center (Slim4Life) starting in April 2005 and weighed 255 at the time, which would definitely put me past a 40 BMI. But then my weight has gone down and up a lot during that time and I also was pregnant and had a baby. I did go to the doctor, I think, around Nov. 2005 because I felt like crap all of the time. He tried to tell me he thought I was depressed and offered me antidepressants, which I refused. At that time I had lost 40 pounds on my program...so my BMI would not have been as high. So does anyone know if I had to be a constant 40 BMI for the last 24 months to qualify for insurance coverage on this procedure? I do not have any health issues that would qualify as a co-morbidity, so I probably can't put myself in 35-39.9 BMI with a co-moribidity issue. Just curious if anyone has had that same issue. I am currently trying to get my records from my weight loss center from 2 years ago, but they don't have them in their current files so they are trying to track them down. They said there is a possibility that they were destroyed since I haven't been back since April 2006. Any advice or help would be appreciated. This whole process is pretty intimidating...but I am willing to fight the fight to get the help I need! Thanks!

Thanks. i didn't know if my weight while I was pregnant would count...but I got up to almost 260 while pregnant, and I only gained about 30 pounds..so I was up there when I got pregnant as well. I hope you get your approval! I sure would like to get mine in the next couple of months instead of having to wait six more months!

Does anyone know if bank records of paying for a weight loss program counts as proof of following one for six + months? I went to Slim4Life in 2005-2006, but had to quit due to becoming pregnant. I just called them to see if they still had my records anywhere and they have been shredded to protect my private information. But I CAN track down all of my credit card and bank statements showing that I consistently went there for a year. Will that work? Oh, and if I don't have a lot of documented proof of my weight from the last two years...do you think if I submit a self made porfolio with pics and my own chronicling of my weight and weight loss attempts that might be enough? I'd sure like to get on with this and not have to wait six months before I can get this done!

Well, I went to my PCP today and brought up the Lap Band. I was all prepared for a fight, but my doctor was surprisingly supportive! She gave me the name of a bariatric surgeon to call and a psychologist to talk to. Sooo...I sort of feel I might be on my way to really doing this! I plan to join Weight Watchers next week, which according to Cigna's (my insurance) guidelines is an acceptable program to follow for my six months of dieting. I am in the process of trying to contact Kaiser (my old insurance) to obtain any medical records with my weight recorded...but I threw away my old card with my ID number and all the contact numbers ask you for your ID number right away. Hmmm...I'm sure there is a way to get in touch with them though. I'm feeling less intimidated already. I think I can do this!:rolleyes2:

Well, I think all my doctor's visits that I have had will have my BMI under 40, because that's when I started losing weight from my diet program. Hmmm...this could be a hinderence.

Well, the weight loss center I went to two years ago has shredded my records since they were old. So now I have no formal records of my weight two years ago. Grr! How does one show "proof" that they've had a BMI of a certain range for 2 years if they don't have doctor's records or weight loss center records? I wonder if I just chronicle a detailed account of everything I've done and maybe find bank records to prove I was paying for the program if that would work? What do you guys think? Tara...do you have to have proof for your insurance that you've had a BMI of 40 for 24 months?

Well, Slim$Life has informed me that they shredded my records because they don't keep files that are more than two years old...which means they probably got destroyed just a few weeks ago. So this means I don't have any formal records of my year of weight loss with them. I am looking around for my own file with my food journals and program outline...I think I might still have it somewhere. If I can't find that, would my bank records showing my payments to Slim4Life count as anything? Or my records of paying for gym memberships or Weight Watchers or anything? Who the heck keeps around two years of PROOF that you are fat? Grrr...

Did your weight records have to be as recorded by a physician? I did Slim4Life on my own...not supervised by a PCP or anything. I mean...they are certified nutritionists...does that count? They would have the only recorded records with the exception of my one doctor's appt. I don't figure I can use any of my weight recordings from my pregnancy...which I started out my pregnancy about 220 and maxed out at 257. Did you still have to a physician guided diet for six months? If Slim4Life can find my records (keep your fingers crossed!), do you think my year with them would count?

Hello! I am new to this whole process as well. I've thought about the lap band for a long time, but never really had to courage to talk to my husband about it...now I have and he is a little hesitant about it, but is being supportive of my looking into it. I have a doctor's appt. tomorrow with my primary care physician and I plan to bring up the lap band. Hopefully she'll be supportive. I haven't met her before because I am on a different insurance than I used to be. I have Cigna insurance and have read up on the requirements for approval of surgery. I currently weigh about 243 and have a BMI of 40 or a little above. I know Cigna says they need proof of having a BMI of 40 for 24 months...but I've bounced around in weight the last few years and don't know how it's going to work out. In April 2005 I weighed 255, then lost weight down to 209. Then I got pregnant, had a baby, and now am back up to the 240s. I called the weight loss center I went to back a couple of years ago to see if they can pull my records to show I was in the 40 BMI range back then and hope that will show I've been up there in weight for a long time. I have no health issues that would be considered "co-morbidity." But I am tired all of the time, my legs hurt when I try to exercise, and I just feel bad about myself. A couple of years ago a doctor even tried to diagnose me with depression and offered me antidepressants - but I refused them. Doping me up with medication is not the answer to my problem. So I will start this journey officially tomorrow at my first Dr.'s appt and go from there. I know I will have to go through 6 months of supervised dieting to help get insurance approval...so let's hope I'll fit in with all the other categories that insurance requires!