I just started this journey last week. Going to Dr's checking off the list of requirements. Anyone with Cigna could give me some insight of their experience would be truly appreciative.

@@cheerios45 - Correct. That was my understanding. They require "monthly" visits so 25 - 30 days apart only to qualify for "monthly".

I have Cigna as well. I have been going through the process since last July. Between the NUT and the Psych appts it can take awhile! It all depends on what Cigna plan you have as to what your requirements are and what copays, deducts, or out of pocket max's you have. Hope to recieve a date this week. Good Luck to you!

Chair1311 what are your requirements that you still haven't gotten your surgery date?

I have Cigna as well. I have been going through the process since last July. Between the NUT and the Psych appts it can take awhile! It all depends on what Cigna plan you have as to what your requirements are and what copays, deducts, or out of pocket max's you have. Hope to recieve a date this week. Good Luck to you!

I hate dealing with insurance... I am glad I started the process late last year. The cost of these test are expensive just for initial qualifications. I have already met my deductible. I think June or July should be the earliest I suspect.

For what it's worth, the process will likely move a little faster here at the beginning of the year as opposed to the end of the year when everyone is rushing to get surgery done once they have spent their deductible. I had my first consultation on Jan 20 last year and my surgery was on June 4. I actually could have had it a couple of weeks sooner, but couldn't due to some work conflicts. So in total 4 months was really what mine was but they told me to expect 5 months. It really depends on how quickly you can move through some of the pre-surgery requirements and how busy your doctor is.

Daisee68, so you have to have each appt within the 25-30 day window? Nothing over 30 days?

I had my surgery back in July, so I have no idea if anything has changed since then but there was nothing about this in their specifications when I went through it. It just said I needed to have 3 monthly weigh-ins in no less than 89 days, there was nothing about how spaced out they had to be. My first appt was on March 10 and my final appt was on June 15.

You should just look it up.

Here is their policy, which hasn't changed since my surgery in July: https://cignaforhcp.cigna.com/public/content/pdf/coveragePolicies/medical/mm_0051_coveragepositioncriteria_bariatric_surgery.pdf

I was approved on May 4, 2015. The requirements attached are dated May 15, 2015 which was after I was approved and I cannot link back to what was required at the time I was approved. Having said that, I don't know how one would consider "monthly documentation" to mean anything less than 25 days or more than 30 or 31 days. My point being, you cannot weigh in within 2 weeks of each weigh in and consider that "monthly".

3 consecutive months 89 days... Plus 1 final weigh in is what I take from it. So we will have 4 weigh ins....I've seen somewhere in this forum where someone finished their 89 days and went back 2 weeks later for final weigh in.

I'm sure Cigna & The Patient advocates can clear up any confusion

Hello everyone! I am new and my first appointment/consultation is January 28 and I've been told that it can take anywhere between 4-6 months for things to move along. I also have Cigna so I'm curious to know if anyone's surgery was not approved and what the reasons were.

I'm definitely confused about this 'between 25 - 30 days' thing... I've spoken to Cigna 3x so far and have never been told this and I did not see it in the coverage policy either. I'm scared now because I know I've gone over 30 days between appointments because that's the only way my work and doctor schedule will work. My next (last) appointment is 32 days after... I don't think a single one has been between 25 - 30 days! Can someone show where this is stated...?

@@ckrbaird it's not actually stated that way and no one from Cigna ever said it to me. It's been ppl who have dealt with Cigna who've always said the 25-30 day thing. I called Cigna again today because I've been worried as well. The person I spoke with conferred with a coworker who had Bariatric surgery through Cigna (go figure) and she said it is 30 days. I asked about weekends and the fact that my dr isn't in the office on Fridays because those things interfere with 2 of my appt dates. She said that I could have my dr get a pre-approval based on that information. I honestly don't think anyone knows for sure.

It is NOT 25-30 days. It is 3 consecutive months totaling greater than 89 days from first appointment to last. Therefore it cannot be 25 days between appointments because that would not get you to 89 days. It is not 30 days max because they are not going to be so rigid.

This really isn't something to stress about. The person scheduling your appointments will space things out accordingly. I just went back and looked at my calendar, all of mine were 32-39 days apart.

I have cigna I had my first appointment on July 10 2015 and my surgery is on Thursday I was denied at first due to not having a pcp recomendation they say you don't need a referral to see the surgeon but when you finish all your appointments and requirements they said I needed one.

Yes, I have CIGNA.

The denied coverage 2 weeks before the scheduled WLS procedure due to my not being on a medically supervised diet for at least 3 months and my PCP's not approving this surgery.

My doctor already approved the surgery and they were paying for my meeting with the hospital's dietician for almost 5 months at that point.

I spoke w/ the hospital, my PCP and CIGNA, we squared away everything.

If I ever need to have another procedure that involves more than just my PCP's approval, I will stay proactive with CIGNA to make sure they have all of the information on record and all of the "T's" crossed and "I's" dotted.

Edited January 26, 201610 yr by 4MRB4PHOTO