kplant

I called cigna, got all of their new requirements. I have been 260 for 2 years which is slight more that 40% BMI for my 5'7 1/2" ht. I have to show that I have been this weight for 24 months. I ordered all the medical records and the only one I have that is from 18 months ago (I need to finish the 6 month dr supervised weight loss -- I actually did this last year - for 5 months so I *know* it won't count). It says I was 256 AND 5'8" which means I am 39% BMI! The other drs didn't even measure how tall I am. I have slightly elevated bp but not enough (according to cigna). Grrrr. I am in NYC so I would probably go to Fielding. Should I make an apt to discuss this with the drs or is it pretty hopeless? It is $24,000 here so there is no way I can afford it.

I mean cathychatts! Sorry! I think I was hoping you would be chatty and spill more info!

thanks Chattycathy! The surgeons had a few weightloss drs they recommended. None are related to their practice (they said that also, that it couldn't be related). Could you give me your BMI #s? Did you have a 24 month track record of being at that weight or did you not need to show this?

I would actually need to gain 4 pounds to make it. Which is bloat + chugging water and not peeing. I think I will go after the height. What I am wondering is if they didn't measure me and I said 5'8. Oddly, I never lie about my weight but I do about my height. Came back to bite me.

I think the surgeons I am working with seem to be great at working with insurance. I would imagine the 5'7" vs 5'8" would be easy to prove which would put me over the edge. I guess the next step is seeing the drs. The 5 month thing wasn't the only issue. I only saw the dr 4 times during that 5 months and I need to see him once a month. I am not SO concerned about that as I need 6 months anyway AND the practice of fielding has a nutritionist that works with lapband candidates who I would like to see. He also offers a special for 6 months (in order to satisfy ins requirements)

My BMI has been 40 for 1 year and my insurance (cigna) requires that it be 40 for 24 months or 35-39 and other complications. I have (documented) "high" blood pressure. I put it in quotes as it was actually in normal range (Diastolic of 90) but then the cut off was revised several years ago and 90 is now high. It has been on and off 90-100. Do you think this counts? I will be working with Fielding and Ren in NYC so I would imagine they are pretty good at working with insurance. TIA!

it was documented and I was given meds.