My packet will be submitted to CIGNA next week. I have Open Access Plan, and my surgeon’s practice is a Cigna Center For Excellence.
Has anyone been denied despite meeting every criteria/co-morbidities articulated by the insurer?
Just curious.
Thanks.

16 hours ago, SleeveDiva2022 said:

Maybe it's because you only had pre diabetes and not full blown yet, so they didn't count it. And they usually require 2 comorbidites when your bmi is below 40. I'm really glad your office manager fought for you and you were able to get the surgery. How are you doing since you had it?

I also had severe GERD, which some insurance companies consider a comorbidity. I think that BCBS was just being mean and looking for an excuse because my starting weight was on the lower end (223 pounds).

I am doing okay on week 7 after surgery. Every day is a struggle to eat the right things and stay away from crackers. I discovered that I can very easily eat Skinny Pop popcorn, Goldfish crackers and Cheez-Its. Now I’m addicted and trying really hard to resist them. They are now banned from the house!

4 minutes ago, suzannethemom said:

I also had severe GERD, which some insurance companies consider a comorbidity. I think that BCBS was just being mean and looking for an excuse because my starting weight was on the lower end (223 pounds).

I am doing okay on week 7 after surgery. Every day is a struggle to eat the right things and stay away from crackers. I discovered that I can very easily eat Skinny Pop popcorn, Goldfish crackers and Cheez-Its. Now I’m addicted and trying really hard to resist them. They are now banned from the house!

CIGNA approved me. i met the criteria but i think they approved me because the hiatal hernia that has to be repaired is 'massive' to use my surgeon's words. The recommended repair procedure for a hernia this size IS gastric bypass. My gallbladder will be removed as well.

I was careful to keep my BMI right at 40. My surgeon had a sleep study done, and I now have a CPAP machine for sleep apnea. coupled with high blood pressure, cholesterol, I guess I sailed through approval.

However, the hernia is causing shortness of breath. Half of my stomach is in my chest and it is pressing on my heart and esophagus. It probably begin 21 years ago when I was pg with twins.