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I had my surgical consultation today for revision, but on the off chance that it is not deemed medically necessary for revision, I do qualify for bariatric surgery in general, repeating all of the requirements as if it were a new procedure. My question is regarding Cigna coverage. Most plans require a monitored 3, 6 or 12 month diet/nutrition/weight loss management through PCP or somewhere similar. Cigna's policy says NOTHING about this, only that "a statement from a physician other than the surgeon, that the individual has failed previous attempts to achieve and maintain weight loss by medical management" - it gives no other requirements or indicators. I called Cigna today to inquire and they couldn't tell me anything more about this. So, for those of you that have been approved in the past few months (Cigna's policy requirements look to be effective 10/9/18 through 7/15/19), what did you provide for this? I have to have a letter from my primary anyway that recommends bariatric surgery. Would this be the same letter or separate? And what did you submit/have your PCP write to say that you had failed previous attempts? Thanks in advance for your help!

I had surgery Monday. This particular plan through Cigna does not require any time period of medically managed visits for nutrition or weight loss and is accurate per the page I posted. I was approved first go within 3 days.

I had surgery Monday. This particular plan through Cigna does not require any time period of medically managed visits for nutrition or weight loss and is accurate per the page I posted. I was approved first go within 3 days.

FYI Cigna sent my approval today so we are correct on the no 6 month thing for our plans. :)

I will say that I believe Cigna having some policies without this requirement is new as of last year. Some also still have 3, 4 and 6 month requirements but not our policy (I specifically picked it knowing I was having revisional surgery and that it would give me the best coverage) and I don't think, at least with my surgeon's office, that they've had any roll in yet. I dunno haha. I'll let you know what I find out about my surgery being approved so you can at least have some additional ammo or information!

I'm in MD and my policy is in NJ but it's the same as your policy. I'm not sure why my office thinks this is also a requirement but they at least relented and said they'd turn in my paperwork to see if it would go through. I do trust that they do this regularly and have a lot of experience dealing with it but I can read and have confirmed numerous times. They said they called and talked to cigna too and confirmed but i'm thinking someone didn't do that. Either way, I'm glad to hear I'm not the only person that is getting this weird issue. Weird that they told you not to call. it's your insurance, you can call them whenever you want

So. I am still in the middle of this process. My surgeon's office is also telling me i have a 6 month nutrition visits, but I've spoken to cigna THREE times in the past two months, and they have continually assured me that the specifications i've been given (above) are correct, and there's no 6 month requirement. my surgeon's office basically said that they'd submit the paperwork and we'd see what happens. I figure if they deny and we have to appeal, it's pretty obvious that the plan does not outline that this is a requirement. the only thing that says 6 months is that we have to have all of the requirements done within a 6 month period. the insurance coordinator at my surgeon's office is adamant about the 6 month thing, but i've spoken to a few people on bariatric forums that have said their cigna also did not have the requirement, so between that and my talking to cigna multiple times, i feel OK (but not 100%) about being approved. I will let you know once I find out, I'm guessing it'll take a week or two to get an answer back from them. My theory is that if cigna wants me to meet with a nutritionist for 6 months it should be clearly listed in the bariatric surgery requirements for my plan. it is not. and they have confirmed. sigh. i feel you. i would suggest that you call cigna, they will tell you the same thing as i just did, and then tell your office that you've spoken to them.