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Insurance denied....

I have so many different feelings built up inside me I just want to cry. Cigna told me it was because of my bmi which is 37.5. But with Cigna it states they will approve based on a bmi between 35-39.9 with one comorbidity or more and I have high blood pressure as well as a heart condition. You would think they would want to help me. Right? Now they are saying my doctor needs to request a peer to peer review. Has anyone else experienced this and what is the normal outcome and length of time? Thank you all for being there and listening to me vent. I appreciate it.

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Update on insurance through Cigna. After peer to peer review was denied ins said that they wanted another visit with PCP and letter from doctor. Found out from PCP I now have hyperlipidemia and am pre diabetic. So doctors office resubmitted forms on Friday to the original reviewer who denied it. Geez, I am so overwhelmed and frightened at the same time. Good luck everyone else who is in the same boat as me.

OMG ~ insurance companies are so ridiculous..Wishing and hoping that you all get approved, my heart goes out to you all....Best Wishes

Don't give up. I have my appt next week the 22. Per Cigna they requested a 4th visit. I'm so ready!!!!

  • 2 weeks later...
  • Author

So today I received great news. I was APPROVED. I am so happy. The approval process took a good month or so to get. Now I am waiting to hear back from the surgery scheduler to see when my surgery will be. K was td it will be between September and November. I will keep you informed and thanks to everyone for all the kind words and support.

Awesome!!!!!

  • Author
Awesome!!!!!

Marcycusa29... I hope you get your approval soon as well!!!!

Woohoo I'm approved and have a surgery date of Sept 10th. So happy!!!!

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Congrats I am still waiting for surgery scheduler to call me back with date. I also have to take a class per hospital requirements prior to surgery.

Keep me posted!!!!

  • Author

Hey Mary. I have gotten my surgery date which is October 10th. I am super excited!!! Can't wait to get to the other side. :-)

That's awesome!!!! My date might be changing. The automated service for Cinga say approved. So dr office went ahead and scheduled it. But now Cigna says its not completely approved. They are still leaving the date in hopes it gets completed within the next few days grrrr.

  • Author
That's awesome!!!! My date might be changing. The automated service for Cinga say approved. So dr office went ahead and scheduled it. But now Cigna says its not completely approved. They are still leaving the date in hopes it gets completed within the next few days grrrr.

Keep me posted!!! I hope all gets straightened out.

From what I was told from my insurance which is united health care, high blood pressure is not being considered a comorbidity anymore because even skinny people can have high blood pressure.

Hi there, I have United Healthcare as well and they are not going for my comorbitities (high blood pressure and sleep apnea) -- their only requirement is a BMI of 40 and they don't seem to be budging on that no matter what. I am a little borderline and so have had the mind-bending project of keeping my weight up and even cheating at the scale. Imagine cheating in the other direction, to be heavier? So screwed up! Like 240s are not fat enough? Meanwhile hospital is dragging its feet a little and United ("Passport" here in my state, there's a Harvard Pilgrim rider attached to United) went from 100 percent down to 90 percent. If we don't get this scheduled soon I worry they'll come up with other ways to make it difficult to pay out.

That's awesome!!!! My date might be changing. The automated service for Cinga say approved. So dr office went ahead and scheduled it. But now Cigna says its not completely approved. They are still leaving the date in hopes it gets completed within the next few days grrrr.

Keep up the good fight -- seems like you are almost there! It's going to be so worth it, all this hassle. Best wishes to you -- I hope you get there soon.

Yippee!

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