Jump to content
×
Are you looking for the BariatricPal Store? Go now!

Recommended Posts

I found out that Cinga denied me because of Medical Necessity....WTF!!!!! I'm not a happy camper. My BMI is over 40. I did everything they asked for. So know they are going to appeal. Stressed grrrrr

Share this post


Link to post
Share on other sites

Cigna denied me the first time around because they were not satisfied with the documentation my Surgeon and Staff provided them. It was not until I provided exercise logs and food journals that they finally approved me. Don't give up and make sure your Surgeon and his Staff communicate directly with Cigna on your behalf.

Good Luck!!

Share this post


Link to post
Share on other sites

Thank You!!! Yes she told me not to worry that they will get it approved. So I really hope it does. I can't pay the money to do it on my own. So I'm keeping my fingers crossed.

Share this post


Link to post
Share on other sites

I saw denied the first time (by CIGNA) because they needed an explicitly needed a Letter of Medical Necessity from my PCP. Was able to see her 2 days later, submit the letter the next day and was approved within a week. Hang in there!

Share this post


Link to post
Share on other sites

I found out that Cinga denied me because of Medical Necessity....WTF!!!!! I'm not a happy camper. My BMI is over 40. I did everything they asked for. So know they are going to appeal. Stressed grrrrr

Most insurance companies deny the first time around. Mine did and after the appeal and medical necessity it went through. If you did everything according to the insurance requirements hopefully CIGNA will pass you and approve everything this time. Insurance companies are notorious for denying claims. They don't want to lay the big bucks if they can help it. Hoping for positive results on your appeal. Good luck!

Share this post


Link to post
Share on other sites

Thank u all...I'm trying to stay positive :-)

Share this post


Link to post
Share on other sites

cigna also declined me. my bmi is 68! 68! and they said it wasn't medically necessary for me to get banded. Needless to say I appealed it through my hospital and they overturned it about 3 months later. Getting banded tomorrow

Share this post


Link to post
Share on other sites

Yea they don't care about BMI unless of course you are under the requirement. I had a BMI of 78 and they denied on the first attempt. They're just real sticklers for proper documentation and I also think they deny with hopes people will just accept the denial and walk away.

Share this post


Link to post
Share on other sites

My info was resent back to Cinga. Keeping my fingers crossed.

Share this post


Link to post
Share on other sites

I have CIGNA and I've heard its one of the hardest insurances to get approval from. They are huge sticklers on documentation so make sure its all there. My nurse was awesome and it only took four days to hear back with an approval on the first and only try. But I was a crazy lady making sure my nurse had EVERYTHING they needed and I jumped through all CIGNAs hoops. Fingers crossed for you!

Share this post


Link to post
Share on other sites

The office called me yesterday and told me cigna asked me to complete one more Nut. Visit so it can be approved. Cant wait!!!!

Share this post


Link to post
Share on other sites

Yay!!! Did you not do 3 months worth already?

Share this post


Link to post
Share on other sites

Cigna denied me at first as well, wanting a letter of medical necessity from my PCP. Was leery with the wording from my pcp, because he didn't outwardly say he would recommend the surgery, but did say I would benefit from it. I was approved a couple of weeks later. Hang in there!

Share this post


Link to post
Share on other sites

I did the 3 months, but they are asking me to do a 4th one. I go on vacation on 10/10. So I'm hope its done early Sept.

Share this post


Link to post
Share on other sites

I went today for the 4 month appt Cigna requested. Now the waiting game again. Cant wait to finally get aproved and have a date. Fingers Crossed!!!!

Share this post


Link to post
Share on other sites

Create an account or sign in to comment

You need to be a member in order to leave a comment

Create an account

Sign up for a new account in our community. It's easy!

Register a new account

Sign in

Already have an account? Sign in here.

Sign In Now

  • Trending Products

  • Trending Topics

  • Recent Status Updates

    • LeighaTR

      I am new here today... and only two weeks out from my sleeve surgery on the 23rd. I am amazed I have kept my calories down to 467 today so far... that leaves me almost 750 left for dinner and maybe a snack. This is going to be tough for two weeks... but I have to believe I can do it!
      · 0 replies
      1. This update has no replies.
    • Doughgurl

      Hey everyone. I'm new here so I thought I should introduce myself. I am 53y/o and am scheduled for Gastric Bypass on June 25th, 2025. I'm located in San Antonio, Texas. I will be having my surgery in Tiajuana Mexico. I've wanted this for years, but I always had insurance where bariatric procedures were excluded. Finally I am able to afford to pay out of pocket.  I can't wait to get started, and I hope I'm prepared for the initial period of "hell". I know what I have signed up for, but I'm sure the good to come will out way the temporary period of discomfort and feelings of regret. I'd love to find people to talk to who have been through the same procedure or experience before. So I look forward to meeting you all. Hope you have a great week!
      · 2 replies
      1. Selina333

        I'm so happy for you! You are about to change your life. I was so glad to get the sleeve done in Dec. I didn't have feelings of regret overall. And I'm down almost 60 lbs. I do feel a little sad at restaurants. I can barely eat half a kid's meal. I get adults meals often because kid ones don't have the same offerings at times. Then I feel obligated to eat on that until it's gone and that can be days. So the restaurant thing isn't great for me. All the rest is fine by me! I love feeling full with very little. I do wish I could drink when eating. And will sip at the end. Just a strong habit to stop. But I'm working on it! You will do fine! Just keep focused on your desire to be different. Not better or worse. But different. I am happy both ways but my low back doesn't like me that heavy. So I listened (also my feet!). LOL! Update us on your journey! I'm not far from you. I'm in Houston. Good luck and I hope it all goes smoothly! Would love to see pics of the town you go to for this. I've never been there. Neat you will be traveling for this! Enjoy the journey. Take it one day at a time. Sometimes a few hours at a time. Follow all recommendations as best you can. 💗

      2. Doughgurl

        Thank you so much for your well wishes. I am hoping that everything goes easy for me as well. We don't eat out much as it is, so it wont be too bad in that department. Thankfully. Also, I hear you regarding your back and feet!! I'd like to add knees to the list. Killing me as we speak! I'm only 5' so the weight has to go. Too short to carry all this weight. Menopause really did a doosey on me. (😶lol) My daughter also lives in Houston. with her Husband and my 5 grand-littles. I grew up in Beaumont, so I know Houston well, I will be sure to keep in touch and update you on my journey. I may need some advice in the future, or just motivation. Thank You so much for reaching out, I was hoping to connect with someone in the community. I really appreciate it. 💜

    • Alisa_S

      On day 4 of the 2 week liquid pre-op diet. Surgery scheduled for June 11th.
      Soooo I am coming to a realization
      of something and I'm not sure what to do about it. For years the only thing I've enjoyed is eating. We rarely do anything or go anywhere and if we do it always includes food. Family comes over? Big family dinner! Go camping? Food! Take a short ride or trip? Food! Holiday? Food! Go out of town for a Dr appointment? Food! When we go to a new town we don't look for any attractions, we look for restaurants we haven't been to. Heck, I look forward to getting off work because that means it's almost supper time. Now that I'm drinking these pre-op shakes for breakfast, lunch, and supper I have nothing to look forward to.  And once I have surgery on June 11th it'll be more of the same shakes. Even after pureed stage, soft food stage, and finally regular food stage, it's going to be a drastic change for the rest of my life. I'm giving up the one thing that really brings me joy. Eating. How do you cope with that? What do you do to fill that void? Wow. Now I'm sad.
      · 1 reply
      1. LeighaTR

        I hope your surgery on Wednesday goes well. You will be able to do all sorts of new things as you find your new normal after surgery. I don't know this from experience yet, but I am seeing a lot of positive things from people who have had it done. Best of luck!

    • Alisa_S

      On day 4 of the 2 week liquid pre-op diet. Surgery scheduled for June 11th.
      Soooo I am coming to a realization
      of something and I'm not sure what to do about it. For years the only thing I've enjoyed is eating. We rarely do anything or go anywhere and if we do it always includes food. Family comes over? Big family dinner! Go camping? Food! Take a short ride or trip? Food! Holiday? Food! Go out of town for a Dr appointment? Food! When we go to a new town we don't look for any attractions, we look for restaurants we haven't been to. Heck, I look forward to getting off work because that means it's almost supper time. Now that I'm drinking these pre-op shakes for breakfast, lunch, and supper I have nothing to look forward to.  And once I have surgery on June 11th it'll be more of the same shakes. Even after pureed stage, soft food stage, and finally regular food stage, it's going to be a drastic change for the rest of my life. I'm giving up the one thing that really brings me joy. Eating. How do you cope with that? What do you do to fill that void? Wow. Now I'm sad.
      · 1 reply
      1. summerseeker

        Life as a big person had limited my life to what I knew I could manage to do each day. That was eat. I hadn't anything else to look forward to. So my eating choices were the best I could dream up. I planned the cooking in managable lots in my head and filled my day with and around it.

        Now I have a whole new big, bigger, biggest, best days ever. I am out there with those skinny people doing stuff i could never have dreamt of. Food is now an after thought. It doesn't consume my day. I still enjoy the good home cooked food but I eat smaller portions. I leave food on my plate when I am full. I can no longer hear my mother's voice saying eat it all up, ther are starving children in Africa who would want that!

        I still cook for family feasts, I love cooking. I still do holidays but I have changed from the All inclusive drinking and eating everything everyday kind to Self catering accommodation. This gives me the choice of cooking or eating out as I choose. I rarely drink anymore as I usually travel alone now and I feel I need to keep aware of my surroundings.

        I don't know at what point my life expanded, was it when I lost 100 pounds? Was it when I left my walking stick at home ? Was it when I said yes to an outing instead of finding an excuse to stay home ? i look back at my last five years and wonder how loosing weight has made such a difference. Be ready to amaze yourself.

        BTW, the liquid diet sucks, one more day and you are over the worst. You can do it.

    • CaseyP1011

      Officially here for a long time, not just a good time💪
      · 0 replies
      1. This update has no replies.
  • Recent Topics

  • Hot Products

  • Sign Up For
    Our Newsletter

    Follow us for the latest news
    and special product offers!
  • Together, we have lost...
      lbs

    PatchAid Vitamin Patches

    ×