Denied .. Due To A Clause By The Company I Work For

[mel2643 68]

I was scheduled for July 9th and I just received a call from my surgeons office that Cigna denied me due to a clause the company I work for has on their policy , Cigna was just recently changed to 3 months from 6 months well according to them my workplace has a cause of 6 months ... so even tho Cigna changed the clause on the company policy is 6 months ..... I am so frustrated that I feel like just giving up ...I know its only another 3 months however its always something ..... feeling depressed

[shangefan 193]

It is frustrating, but you can make it for the three additional months. Don't give up.

[Spatters3 315]

Have you brought the issue up to your company insurance person or HR rep ? This may have been an oversight. If not, then another 3 months compared to the rest of your life....

[aroundhky 1,174]

Hang in there! You'll be glad you did. You just have to figure out if you want enough to jump through the hoops. It's very frustrating, but in the end, I'm sure you'll be glad you stayed the course.

[Ms skinniness 3,003]

Please don't give up. This is just another 3 months to get your body prepared for the beautiful transformation that will be happening. It's worth an extra 3 month wait. Put your head up and keep going forward. yes, it is totally frustrating all the hoops the insurance company is making you jump through. I had to do the six months also, but took it one day at at time. Even up to the OR room, I couldn't believe it was actually going to happen. I woke up and it was reality. Keep on going, it will happen.

[Itsanewdaycassandra 45]

I agree with everyone who posted. Don’t give up, it is frustrating but try to use the additional time to prepare for a lifestyle change like no other. You will get there in time…good luck!

[Donna M 2]

Don't give up! As frustrating as it is you will be happy with your results. Another 3 months to help get yourself better prepared for your fabulous transformation! This hurdle will only make you stronger! Have faith all will work out in the end. Good luck!

[Patrick Curl 424]

Don't give up - why not pretend today is your surgery and try eating the post-op kinda diet till you are ready - imagine if you could lose 20 or 30 pounds before you even get to the operating table!

[mel2643 68]

Thank you all , I know you guys are right.... I was so prepared, I will take it day by day and start to work on the new me as suggested by Patrick ... I just hope that at the end of the 6 months I am approved with no issues ....

[Rootman 1,101]

Stick with it! As said above it's worth it.

On the same note this is why I went self pay in Mexico. I heard of 2 people who worked for my company years ago with insurance issues. One waited nearly a YEAR for surgery as they kept delaying and jerking him around between Drs. paperwork and insurance hoops. The other guy gave up after he lost weight on the supervised 6 month diet and then they pulled the plug and said he was then ineligible, last I heard (before he was laid off) he was fatter than ever and completely gave up on WLS.

I'm not suggesting you do the same but self pay worked for me.

[mel2643 68]

Have you brought the issue up to your company insurance person or HR rep ? This may have been an oversight. If not, then another 3 months compared to the rest of your life....

Ok just finished speaking to my Benefit rep and Cigna (3 way phone call ) they have instructed me to appeal through my insurance carrier , which will take 30-45 days , then if Cigna denies me again ... then I have to appeal through my employer ... another 30 days ... That is almost the 3 months I had to wait to re-submit , with that said I will just wait the 3 months... Hey, I at least tried and feel better that I did ...

[ebonisekim 1,713]

I'm just now starting my six months I wish I had 3 more months to go .. That's good u tried my coordinator just inormed me that on the six month diet I could lose as much as I want they just want to see if I'm following the rules ... I think u should use the time to loss more weight and practice presurgery reginmen ... Good luck to u

[Ms skinniness 3,003]

Just to let you know. If you lose weight under the acceptable BMI, the insurance company can still deny you. I have Kaiser and I did lose weight as required and then the referred surgeon's office said I was under the allowed BMI and wouldn't be able to do the surgery. Then I reminded the Doc that I had a dx of diabetes but choose not to take any meds, but was taking Lisnipril. It was a battle. I won, and here I am, 8 months later, lost 74 lbs.

[ebonisekim 1,713]

I guess it depends on insurance companies ... This what my coordinator for my surgeons office said .. Hope it to be true I want to lost thirty pounds

[cmw10000 35]

just hang in there ..... I understand your flusrtration..... it seemed like every time i got close there was one more thing I had to do.... finally got there and now 3 months post op and 50 lbs later ... its definantly worth it.