losinit512

Hi everyone, First off, I would like to apologize for the length of this post, but I'm at the end of my rope here and SO upset!! Second, if anyone has ever been through something like this please feel free to add your input. Like a lot of you I've never been so motivated and excited in my life for my upcoming surgery. My husband's employer has CIGNA insurance. They have never covered bariatric surgery until what I thought was this year. In prior years they had our plan documents on their website so you were able to see the specifics of what was covered and what was excluded. We had many changes this year but for some reason they have never put this detailed information up on either the employee website or the CIGNA website this year. Needless to say, I contacted CIGNA for this information on more than one occasion. FINALLY, I received information in the mail with very detailed information saying that weight loss surgery WAS covered. Imagine my happiness!! I even contacted CIGNA via phone to verify this and it was confirmed as covered. I started all of my paperwork and submitted it to my doctor's office. The doctor's office ALSO contacted CIGNA and they were given an approval of coverage for the surgery and a reference code for the call. The requirements were for 3 months of doctor supervised weight management along with the usual psychological evaluation, high BMI, sleep apnea (check), diabetes (check), high blood pressure (check), etc. Therefore, my journey began and I stuck to the program like crazy. I went in this past Monday for my final doctor's visit and they submitted my paperwork to CIGNA. My claim was immediately denied by CIGNA saying that weight loss surgery is not a covered benefit. If you could only see the look of despair on my face. The doctor's office informed CIGNA that my surgery is scheduled for June 23rd and that I have done absolutely everything required. CIGNA told the doctor's office that they have given the case to their supervisor and that my doctor's office would have to submit an appeal (IN WRITING, which will only slow down matters). My husband also contacted the HR benefits manager who was livid that this had happened. She informed him that they have never covered bariatric surgery and that there is NO appealing this situation. I am having a very hard time believing that nothing can be done, especially on the part of CIGNA's more than one error. They informed my doctor's office that the employee who told them that I was approved would be reprimanded - do they honestly think that is going to make me feel any better? What about the others who sent me the information in the mail and by phone? I contacted CIGNA on Tuesday and said that they apparently have problems with training their employees. This is not something that can be brushed off as a slight error! CIGNA needs to pay for their mistakes! One other thing of mention is that CIGNA has paid ALL of my claims regarding this preparation for the surgery, including my BARIATRIC Vitamins at 100%!! I just don't get it. I don't know what to do with myself at this point. I am just absolutely heartbroken and numb. I've worked so hard for this and to have the rug pulled out from underneath me at the last minute is just wrong. Thanks for reading and your understanding! losinit512

I've noticed this too. I had insomnia before my surgery but it is much worse now.

Whew! I thought it was just me getting frustrated with my scale. I had my 2 week post op on Monday and got the green light to start full liquids. The doctor said that once my calorie intake increases that the weight will come off. I was only getting in 300-400 calories during my 2 week clear liquid stage so I guess we'll see how it goes. I feel like I'm constantly reminding myself to eat these days. Why couldn't that have happened years ago??

Hi Sue, I hope you're not going through the same thing I did either. That's something I couldn't understand either - why they approved everything up until the last minute. Patience is not my friend either and it was one LONG nerve-wracking week of fighting. I guess the only advice I can give is to keep pushing up the ladder. If you can't get a response from who you are talking to ask for a supervisor. I hated having to do that but I just couldn't settle with them telling me no. I have a close friend who is going through this as well. Her surgery is scheduled for July 14th and she is also having to be persistent and fight. I'm beginning to think the denial process is becoming standard practice among the insurance companies. Good luck to you and keep me posted on how it goes! Nancy

Cloud nine is an understatement, haha!! I was out to lunch with my son and was starting to feel defeated but I couldn't make myself order anything unhealthy. I'm so glad I stuck to my guns because right when they brought our food out, the phone rang with THE call. I'm so excited!

After a week full of non-stop battle, Cigna has decided to make right of their error. I can't think you all enough for your comments and suggestions. You all are the best!!

Sharon1964, you are my hero. Thank you so much for posting this link!! I've been fighting with the insurance company for three days straight now and I refuse to give up hope. Thanks again!

I am so happy you were able to get your surgery covered. Another member of the forum sent me the link to your story. I am unfortunately in the same boat right now with Cigna and am beyond devastated. I am less than two weeks from my surgery date and everything has been paid for thus far, and Cigna provided documentation to me (both written and verbal) that the surgery was covered. They also authorized the benefit to my doctor's office before I got the ball rolling. I am fighting this so hard and just knowing that I'm not alone in going through this is so helpful. I'm sorry you had to fight it too, but your information is invaluable. Thank you!!

Thanks, everyone. My doctor's office contacted me this morning and said that CIGNA has clearly admitted fault; however, they will not do anything about it. My husband's HR manager has said that they will not cover it. You would think that paying for this surgery would be a smart option for them considering how much they are having to shell out year after year for all of my medications. I'm just completely at a loss here. I have another call into CIGNA but am waiting for a callback. I will continue to escalate this as I cannot find a feasible excuse for their mistakes.