Cigna's 5 year weigh-in requirement

[jen.jazayeri 2]

Hello all-I am just curious how many of you had to provide 5 years of weigh-ins at doctor visits (for Cigna) in order to get approved for WLS...I rarely go to the doctor and my weight is like a roller coaster, up one minute...down the next...I'm afraid I won't be eligible because I haven't always had a BMI > 40... In the past 5 years it has ranged from the 20's to the forties!!! Help I'm stressed!!! I want/need this surgery so bad;)

[Pepper123 320]

Hiya…i don't have cigna..i have United and they want six months of weight five years wow!!! that a bit much!!!…I've never had a BMI of 40 even now but am a diabetic….with a BMI of 35

[jen.jazayeri 2]

Yea...you must have six consecutive months supervised by a doctor and nutritionist recording weight/height/BMI but u must have a prior history of obesity over the past 5 years...someone said 2...does anyone know about this?

[Jim1967 3,569]

Hi Jen,

Have you spoken directly to Cigna and had them send you the documented requirements? 5 years sounds pretty strange not to mention unreasonable to me. I had Cigna cover my surgery and they required a 6 month supervised diet along with weigh ins and exercise journals and approved me pretty quickly once I met that. I do realize coverage also depends on what your employer paid for coverage.

If you haven't spoken to Cigna directly I highly recommend it. When I spoke to them they actually emailed me the PDF of requirements so I got it instantly. From what I recall Cigna dropped their requirement from 6 months to 3 months. At least that is what I heard. I no longer have Cigna.

[kimk1999 450]

Banded Dec 2013 with Cigna paying

1. Had the 3 month physician supervised diet plan. BMI was at 35, so in couldn't really lose any weight with this plan. Just a waste of money for documentation. Weight watcher types not approved. Needed to be a physician.

2. My surgeon as part of my medical history I did fill out a form of the different types of diets that I had done over the past 7-10 years (can't remember). It wasn't official in any way. Just my memory. Dates (to-from), diet type (weight watchers, HCG, B-12, diet / exercise), starting weight and ending weight. Nothing was 'officially' documented, no proof. Cigna didn't question it as far as I know of. I don't know if my surgeons office did anything to try to back it up - called HCG clinic, B-12 clinic or left it alone.

[jen.jazayeri 2]

I'm happy everything worked out well for you guys;) I called Cigna twice for confirmation about 5 years of visits to the doctor...they both said the same thing...they want all medical records from PCP that has my height and weight recorded...fingers crossed that I'm eligible... I never go to the doctor(so hard to get in)!!! I usually go to a Walgreen's when I am sick:/ but I have faith that it will all work out;)

[kimk1999 450]

Wow! I have not heard of that before. Good luck!!

[betty_s 476]

My form to my PCP also said last 5 years of weigh ins. I've only been going to her for practice for 3 years (I've only been in this area that long), and that's all she gave. My weight also fluctuated up and down, but it was a overall increase of 20 lbs a year.

She only gave the 3 years and my insurance company didn't reject me because of that. I was approved last week.

[jen.jazayeri 2]

Thanks Betty S.-I'm a little more hopeful now;)

[ren0318 81]

I have Cigna and only needed a 3 year weight history, and a 3 month weight management plan prior to surgery.

[skewlteacher 6]

I have Cigna through husband's work. Google and download the PDF of their policy. Three months for me- they changed it from 6 to 3 a few years back. I got lucky- I go to my Ob/Gyn every year since as long as I can remember. I had yearly records from the same practice starting back 9 years ago when I got pregnant with my first baby. Lesson learned tough, write down every single reference number and reps name when you call Cigna and become great friends with your insurance claims person at your surgeons office! I went round and round trying to verify bariatrics was under my policy and thank goodness finally got a yes from Cigna and the benefits coordinator from my husband's employer!

Edited April 22, 2014 by skewlteacher