Approved for VSG with Cigna

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I got home from work last night to find a letter from Cigna insurance stating they needed more information. So when I called them to see what else they needed the lady tells me "oh, it's already been approved the office must have faxed it in already.":lol0:

Yay, the 6 month diet paid off.

I called the insurance coordinator today to see what my next step is, just waiting to hear back from her. I've already had a pulmonary clearance and I go for my Cardiac evaluation on Friday. Both required by my surgeon due to hypertension, Asthma and sleep apnea.

I know they make you see the nurse first. Then get all the clearances (I knew they would require these so I scheduled them early). Then I can schedule my date and get an appointment for preop.

Origionally trying for a november date but now thinking mid to late September if I can pull it off. Wish me luck.

[kooterpooters 2]

CONGRATULATIONS>....I bet it feels good to know you are approved..I have anxiety over not knowing yet...

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Yes very nice to know that part is done. Now I am waiting for the nurse to call to get me scheduled.

[kooterpooters 2]

Keep us posted......:biggrin0:

[mythreechildren2001 7]

Does Cigna require a certain amount of weight loss during the 6 month medically supervised diet? I started this process a couple of weeks ago, and I've actually gained weight. I won't actually have coverage until Jan so I'm trying to get ahead of the game.

Thanks for your help!

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I lost a whole 2 pounds in 6 months. And, I was approved in 6 days. So I don't think it matters if you loose or not.

[mythreechildren2001 7]

Thanks for you reply. I'm so anxious for the next 5 months to pass quickly. Is there anything I will have to do for cigna other than the 6 months of medically supervised diet?

I appreciate any and all information you can offer. :biggrin0:

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They require Psychiatric Consult, and I think a letter of medical necessity from your primary also. I included the link to Cigna's policy on Baritric surgery. I do know they require it be done at a "Bariatric Center of Excellence". I am lucky to work next door to the only center of excellence in my area. Hope this helps. My process went really smoothly. The hoops that everyone says you have to jump through really aren't that bad. Plus I would rather know if I have conditions that put me at greater risk of complications ahead of time.

Good luck to you on your journey.

Tracey

http://www.cigna.com/customer_care/healthcare_professional/coverage_positions/medical/mm_0051_coveragepositioncriteria_bariatric_surgery.pdf

[laylasmojo 10]

The requirements some times change with the different companys that you work for. I have Cigna and I had to fill out a packet that they sent me that included a phych eval, two tobaco tests, 5 EAP sessions, could not have gained 20% of the weight in the past year, but I did not have to do a supervised diet YEA!! So I would recomend talking to your surgens staff thayhave the most experience with the insurance companys. Good Luck!

[mythreechildren2001 7]

Thank you both for the information. I appreciate it so very much!

[venisflytrap 0]

I got home from work last night to find a letter from Cigna insurance stating they needed more information. So when I called them to see what else they needed the lady tells me "oh, it's already been approved the office must have faxed it in already.":lol0:

Yay, the 6 month diet paid off.

I called the insurance coordinator today to see what my next step is, just waiting to hear back from her. I've already had a pulmonary clearance and I go for my Cardiac evaluation on Friday. Both required by my surgeon due to hypertension, Asthma and sleep apnea.

I know they make you see the nurse first. Then get all the clearances (I knew they would require these so I scheduled them early). Then I can schedule my date and get an appointment for preop.

Origionally trying for a november date but now thinking mid to late September if I can pull it off. Wish me luck.

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What happens if the loss during the 6 mos is not so good? We have Cigna too, are they looking for a huge loss during that 6 mo suprvsd diet? What if your MBI at the end is too low under the required amount after 6 mos?

[venisflytrap 0]

What happens if the loss during the 6 mos is not so good? We have Cigna too, are they looking for a huge loss during that 6 mo suprvsd diet? What if your MBI at the end is too low under the required amount after 6 mos?

[mythreechildren2001 7]

What happens if the loss during the 6 mos is not so good? We have Cigna too, are they looking for a huge loss during that 6 mo suprvsd diet? What if your MBI at the end is too low under the required amount after 6 mos?

Unfortunately for me, I gained 15 lbs. My Cigna policy had no requirements in regards to weight loss, just that I actually met with my dr each month and discussed what I was eating and how I was exercising. By the time I began that process, I truly didn't have it in me to even attempt another 'diet'. Twenty-five years of failure was enough for me. I got approved on the first attempt!

[Guest Rosalind]

Cigna requires:

6 mos supervised diet.......that is one visit per month........doesn't have to be a calendar month,

height, weight, bmi

psych eval

nutritionist eval

medical recommendation

bariatric reccomendation

a list of comorbities.....if any

Losing weight is not required but some docs recommend. Some docs may not recommend if you don't make an effort.

[FloraBama Girl 116]

Congrats to you on your approval and best of luck on this journey. I have all the requirments for Cigna insurance except the psych eval. Hope they get that report this week because they have me on the schedule for surgery for August 24, Dr. Marema is doing my surgery at Flagler Hospital. The process and support is with US Bariatric Center. All I have left other than the approval is my education class and any more blood tests I have not completed.

Best wishes,

Stephanie