Cigna

[TTMarie 1]

Hi there.. I'm brand new here and just starting on my weight loss journey. I have my initial consult August 11th. I'm a little nervous about being deemed not a good candidate for surgery. The first reason being that I had a child in October. It may sound silly, but I don't know if there is a specific time that has to pass after childbirth (c section) before you can be considered. Also I'm scared that my history of extreme yoyo dieting will negatively affect me as a candidate. I've lost, and gained, 100-120 pounds about 4 times (I'm 34). I've gotten down into my 150's through starvation and extreme exercising but then over the next few years it comes back. I have Cigna insurance, who is also my employer, and I don't THINK they require the past weight history anymore. But I'm nervous regarding my circumstances. Does anyone else have the same yoyo history or concerns?

[Jenn091308 1]

I just got approved yesterday for gastric bypass with Cigna. I know my requirements included a 5 year weight history, so if you fall under the 40 BMI with no comorbidities or 35 with comorbidities within that time frame it might be an issue. I was also required to do a 3 month supervised diet, psych eval, nutrition classes, etc. I did not read anything about recent surgeries in the bariatric literature they sent me on qualifying. But you are already 9 months since your surgery and if you have to do the supervised diet that will put you at a year. So I don't think that will be an issue. In the end I think it is if the surgeon is comfortable performing it. Good luck with your appointment on the 11th, that's the date of my upper GI and final consult before surgery.

[Luvin_Life125 558]

I am working through my preoperative requirements for my Cigna policy right now. The policy from my summary plan description requires a physician monitored weight loss and exercise program monitored for at least 3 months monthly visits (>89 days) which actually means 4 visits. I also had to have a psych exam, and a few other things that I can't think of right this minute. I was referred to Cigna policy 0051 updated 05/2014 for the bariatric surgery.

Good luck to you on this journey and remember there is always tons of support and knowledge here for you!

[Luvin_Life125 558]

Also with Cigna- check if your policy requires bariatric surgery to be performed at a Center of Excellence. If so, the hospital must be a Cigna designated Center of Excellence in Bariatric Surgery. Just because a bariatric surgeon are in network for your plan does not mean those surgeons operate at a Center of Excellence facility! The easiest way to search for a provider is to first find the hospitals in your vicinity that have earned the Cigna bariatric center of excellence. Keep in mind, the hospital may not be all that close to you depending on where you live. My closest is about 3 hours away. Once you find the hospitals, review their website to find the bariatric surgeons on staff.

I mention this because there have been a few people on the boards who have chosen an in network surgeon (who wasn't associated with a Cigna bariatric center of excellence) and have gone through the entire preoperative process. They don't find out the hospital doesn't qualify until they are ready to schedule surgery. Then they have to search for a new surgeon and hospital and sometimes start the whole process completely over. Some surgeons don't want to accept the education and preparation done with another office because each doctor and office has their own rules & program.