Insurance denied....

[kphoping 47]

I have so many different feelings built up inside me I just want to cry. Cigna told me it was because of my bmi which is 37.5. But with Cigna it states they will approve based on a bmi between 35-39.9 with one comorbidity or more and I have high blood pressure as well as a heart condition. You would think they would want to help me. Right? Now they are saying my doctor needs to request a peer to peer review. Has anyone else experienced this and what is the normal outcome and length of time? Thank you all for being there and listening to me vent. I appreciate it.

[feb27bandwoman 112]

I had battles with Cigna.They are very strict.I ended up having several(3!)peer to peer reviews.

Finally had to take it to the state's insurance review board.It was a huge hassle and incredibly stressful.

This took several months.A good outcome in the end but I felt like I was battling an overwhelming obstacle.

Good luck.

[kphoping 47]

Thank you! I going to call my surgeon, PCP and my cardiologist tomorrow to see if they can do the reviews. I thought I was almost at the finish line and they come and kick me back. I will not give up just keep pushing.

[Lady VS 1,147]

Good for you. If Kphoping did then I know you can too. Do whatever it takes to get them to approve it. Your health depends upon it. Good luck.

[Ms.Vickie 68]

Omg I hope Cigna doesn't act like a donkey with my case. My BMI is at 40 and I have no comorbidities. The shrink advised me to get a sleep study done since I have poor sleeping habits. Maybe if I do that and actually have sleep Apnea maybe that will help with them approving my claim.

[L1C4 5]

I almost have a bmi of 70 and they denied me. Because it wasn't "necessary", even though I have HBP. Go figure, i appealed it and the insurance company approved it after a few months. Surgery is tomorrow morning

[Marycusa29 60]

I also have Cigna and have a bmi of 41 and was just denied. Did everything they asked for. So now it was sent again for an appeal. So stressed.

[Gardnergirl2 96]

Doctors hate peer to peer reviews, but they are required many times. It's not abnormal. It's simply where the doctor at the insurance company talks with your doctor to determine the necessity of the surgery. Usually, if all goes well, a decision can come retry quickly after that ( at least in my experience)

[kphoping 47]

My surgeon is having a peer to peer review today with Cigna. I have done everything they require and so now I am hoping that my doctor can get me an approval today. From what the insurance coordinator told me we shod have an answer today. It's so frustrating because I do have a comorbidity and its high blood pressure with me being on meds for it. I will keep you informed once I hear something. To all that that have Cigna good luck. It's tough.

[Marycusa29 60]

Cigna is making me do a 4 month of nutritionist. So I should be approved after that. So now I'm waiting another month. Next appt is 8/22.

[kphoping 47]

Okay so I just heard back from my surgeon and I have to go to my PCP one more time and she has to write a letter stating my blood pressure would not be controlled if I were to come off of the medication. I go see her tomorrow so keep your fingers crossed. This journey has been a long and trying one but it will all be worth it once it is approved.

[Marycusa29 60]

Good Luck!!! I have my fingers crossed for the both of us :-)

[kphoping 47]

Same here. Thank you so much for listening and being supportive. I will update after I leave doctors in the morning. :-)

[Sophiasmommy1 4]

From what I was told from my insurance which is united health care, high blood pressure is not being considered a comorbidity anymore because even skinny people can have high blood pressure.

[Sophiasmommy1 4]

But keep pushing. The only thing that can stop you.... Is you yourself!