KateTheGreat

Alright, I had my appointment with my PCP and we were able to pull records for the last year or so where we've discussed my obesity, diet and exercise plans. The first two months have a 3 1/2 month gap, and there's one that has a two month gap, otherwise the rest are month-to-month. I have my consultation on Friday and a bunch of other things so I imagine they'll submit insurance on Friday since I do have 6 months worth. I'm crossing my fingers that it'll be enough!!!:scared2:

Actually, I have a BMI of 38.1 and I've always had excellent bp--- 110/60:)

That's so frustrating!!! Their criteria says " a BMI (Body Mass Index) ≥ 40 a BMI (Body Mass Index) 35–39.9 with at least one clinically significant comorbidity, including but not limited to, cardiovascular disease, Type 2 diabetes, hypertension, coronary artery disease, or pulmonary hypertension" They don't list everything because they want a reason to rule you out. LAME. I'd definitely file an appeal. Have you been tested for obstructive sleep apnea?

Call Cigna and ask for the pre-determination department and ask ask ask ask ask. Bother the heck out of them until they give you a satisfied answer. I spoke w/ Cigna today and they said it's only a week wait to find out if you're approved or denied. Never take no for an answer. :wub:

Oohh too bad she's not a Hawkeye fan:( lol! I found the specific requirements on Cigna's website about bariatric surgery (I called and they pointed me to this location): http://cigna.com/customer_care/healthcare_professional/coverage_positions/medical/mm_0051_coveragepositioncriteria_bariatric_surgery.pdf :thumbup:

Just attended a seminar in CF last week, and handed in paperwork on Friday to Dr. G's office. Hopefully I'll hear from them tomorrow!:thumbup:

You are definitely not alone in that fear. I'm definitely an emotional eater--have been all of my life. When I'm not eating emotionally, it was anorexia and sometimes bulimia. Constant struggles!!!:thumbup:

I hear you...I am a very impatient person. I'll be talking to my PCP and WLS clinic tomorrow, so hopefully I'll know a little bit more to speculate on:)

How did everything go???

Hehe, isn't that crazy, we're both Kathy's!! Okay...so maybe I'm not w/ a C, but still:) Since we're both w/ Cigna and starting the same point, perhaps you can help me speculate (I over-analyze everything...hehe)! I've seen the doctor for illnesses and such over the last few months and I've been weighed and had my BP taken each time. I wonder if instead of having a separate piece of paper with each weight and stuff, if my doctor can include in his documentation just a summarization of the dates seen and my weights and BP, and if that would count towards my 6 months? Because then I'd be much farther along:thumbup:

They've recently updated the requirements, and as of last night they do accept Weight Watchers and Jenny Craig and stuff like that, as long as you are still meeting w/ a doctor every month.

I actually work in a Medicare guidance center for an insurance company (we use Humana, however they aren't very competitive in Supplement plans yet). My suggestion is to call your SHIIP (senior health insurance information program) in your area. I'm not sure what state you're from, but the following link has the numbers: SHIIP:: Other States Resources We often refer people to the SHIIP program because we aren't very competitive in some areas. They are a volunteer organization made up of seniors that have access to ALL health plans in your area and all of the coverages and rates. It's 100% free because seniors volunteer to do it. Hope that helps!!!

It didn't need to be consecutive, but she had only 4 months total.

Omigoodness, I don't know if I'd like it there...seems like it might get in the way of intimacy and breastfeeding :wink2:

I have CIGNA as well, and I've got the plan where they'll pay 90%. I've had quite a few medical expenses this year (had to have a biopsy that came back non-cancerous, thank god), so I've already got my deductible and maximum medical out-of-pocket met. I'm just beginning my 6-month program though. A coworker of mine had hers done a year ago, and initially it was denied because she had only completed 4 of the 6 months. In total, it took her about 10 months to go through the 6-month diet and approval from insurance. :frown:

The way I've interpreted Cigna's policy is that if you have a BMI OVER 40 you can do the diet thing within the last 5 years, otherwise if your BMI is 35-39.9 then it has to be within the last 2 years. Does that make sense? I also have Cigna and am beginning my 6-month diet now.