CIGNA Recent Approval

[sher0929 17]

Anyone approved by Cigna recently? My surgeon's coordinator just submitted my info to Cigna today and I'm SO nervous! She told me that denials don't happen often and they are usually able to overturn them if they do. She even gave me a surgery date already. April 24th! I met all of the requirements and I know the team knows what insurance companies look for. Just can't help but freak out a little! The last few months have been crazy and it would suck to be denied when I'm finally almost at the finish line.

I'm curious to hear recent experiences with Cigna. It seems most of the topics I find on here about Cigna are from a while ago.

[Orchids&Dragons 9,047]

I had two wls with cigna last year. No problems, quick approval.

[KarenLR75 496]

On 3/26/2019 at 4:53 PM, Orchids&Dragons said:

I had two wls with cigna last year. No problems, quick approval.

Hey Orchids&Dragons,

Not sure if I recalled that you had CIGNA too. Sent you message after my meeting with Dr. Dyslin yesterday.

I'm stunned and confused by what they said Cigna requires for seeing a nutritionist for 6 months...back to back consecutive months with no break..not even sure they care about the 1 year supervised weight loss I had with primary. Am just devastated.

Am so confused by the differences I'm kind of seeing...did Cigna just change their policy?

sher0929 - did you have to see a nutritionist every months for 6 months BEFORE you were approved for surgery. To me I figured I'd have a partnership with nutritionist and see them BEFORE..a couple of visits and AFTER surgery. I NEVER EVER Expected such a long and confusing requirement.

Dr. Dyslin indicated there was never an 'appeal' that could be done with Cigna....but I thought I just read recently on someone else's post that they could appeal. SO VERY CONFUSED! AND MAJORLY DISAPPOINTED. Seems like 'hoop jumping'. I learned a ton about myself from the supervised weight loss that I initiated and all the work I've done and looked into the past FOUR years. Don't see the value of a nutritionist for SIX LONG MONTHS prior to SURGERY?!?! Don't mistake me...I know I need to meet with a nutritionist..it is the length of time and the fact that they don't factor in seeing one after as well...and that my supervised weight loss SEEMS like it means nothing.

[sher0929 17]

@KarenLR75 I'm sorry I'm just now getting back to you! Cigna required 3 months of consecutive medically managed weight loss appointments that could be done with either your primary care physician or a registered dietitian/nutritionist. It was four visits all together. Cigna recently changed it's policy though and they removed the 3 months of appointments requirement. As far as Cigna insurance approval goes, you just need a letter from your doctor recommending you for surgery, stating that you have tried and failed to maintain weight loss in the past, and clearing you physically for surgery. There are a few other things you've gotta do for them to approve you but there is nothing in the new verbiage that states you have to have a specific number of monthly visits. You can check the Cigna website or google Cigna bariatric surgery requirements and you should find a pdf that outlines it all.

I know some surgeon's offices have their own set of requirements in addition to the ones required by insurance. I have heard that some surgeon's require 6 months of appointments and a certain amount of weight loss prior to prove that you are mentally ready for surgery and are able to be disciplined. Since the surgery is just a tool, they want to make sure when they perform the surgery, the patient is going to follow through on their end.

If I were you, I'd get a copy of Cigna's bariatric surgery requirements for approval and then speak with your surgeon's office to figure out what is required by them outside of Cigna's requirements.

Sorry that was long winded! Hopefully helpful though!

[Chardonnay40 153]

Also, CIGNA is different by state and employer. I only need 4 months of back to back consecutive nutrition visits

[KarenLR75 496]

My CIGNA policy required now back to back nutritionist visits even though my dr's office insisted they did. I was so glad mine didn't require it as I had already spent 15 months preparing myself and working with CIGNA before I ever walked into my surgeon's office.