Did doing Weight Watchers eliminate your waiting period (Cigna)?

[Mel24 51]

I have been doing WW since the beginning of 2011. I have lost up to 71 lb on it, but now am down 40. I have been going and have had my shares of ups and downs. I have Cigna insurance, and so I know there is a 3 month "waiting period" where you do a diet with a NUT. Have any of you heard if doing a WW program eliminates this diet. I have all the paperwork and records. I would just love to see that this 4 years hasn't been a "waste" of time in my insurance's eyes.

If you had Cigna, I'd love to hear about your experience. Thanks!

[Debbieduck4 399]

I submitted a year and a half of Weight Watcher records where I had weighed in weekly and had it recorded, only to have them decline them because this effort had not been followed by my primary care physician. The fact was, it HAD been followed by my PCP, just not at the exact incremental appointment schedule my insurance required. It was a crock. Every insurance is different though and I did not have the same one you have. If I were you and you have a relationship with your PCP, I would get him or her to sign your WW records before submitting just as an extra push. Weight Watchers is a wonderful program and 4 years should definitely be recognized! Best of luck to you!

[smile121 66]

Hi! I have Cigna, and sadly I have to do 3 months with a nutritionist no matter what. It is annoying! Best of luck!

[Mel24 51]

I submitted a year and a half of Weight Watcher records where I had weighed in weekly and had it recorded, only to have them decline them because this effort had not been followed by my primary care physician. The fact was, it HAD been followed by my PCP, just not at the exact incremental appointment schedule my insurance required. It was a crock. Every insurance is different though and I did not have the same one you have. If I were you and you have a relationship with your PCP, I would get him or her to sign your WW records before submitting just as an extra push. Weight Watchers is a wonderful program and 4 years should definitely be recognized! Best of luck to you!

Do you think having her sign off on them would be enough?? I could go back and have her sign on the weight record around the dates when I was there, but I don't know.

I saw a NUT in October to talk about what to do, then I saw my PCP in Jan where we talked diet pills. I just never really met with her just to talk my fatness. Besides I see my Neurologist more than I see her! Ugh, it's a mess. I just have to wait and hear what the surgeon's office says.

[Mel24 51]

Hi! I have Cigna, and sadly I have to do 3 months with a nutritionist no matter what. It is annoying! Best of luck!

We'll I guess I saw her a few weeks ago, so I need to go see her again in a bit and have the "weight record" on her books done. This is stupid, especially when I was doing what she said.

[Jovie62 135]

You need to call your insurance company and see what they require and then call again and again and again too make sure you understand the requirements. Document your conversations. It seemed every time I called the information was a little different. I was approved and surgery is on February 18. Good luck!

[mrsmith901 18]

I had to do WW while checking in with my PCP once a month to have it approved. He filled out a form each visit discussing what I was doing diet and exercise wise and what we discussed.

[Mel24 51]

You need to call your insurance company and see what they require and then call again and again and again too make sure you understand the requirements. Document your conversations. It seemed every time I called the information was a little different. I was approved and surgery is on February 18. Good luck!

@Jovie21 Thank you. I will give them a call tomorrow and see what they say. Then should I call again the next day to confirm it? I don't want to piss people off and stuff.

[smile121 66]

@@Mel24 Yes the insurance approval process seems daunting! I initially saw my surgeon, and they gave me a list of things i need to do. I have been slowly going through the list. I let the surgeon know i was doing WW at the time and she said that they can get a little strict about the rules and that i needed to see a nutritionist to track my weight and exercise. When i asked about doing it with my PCP, she said to be safe i should see a nutritionist because they will know exactly what to do, and what i need to be approved. The worst part is, is that it is actually 4 visits, the initial visit and then 3 more, AND they have to be 30 days apart. So i started on January 6th, my first "real" visit was Feb 6th, and i have 2 more to go... March 10th and April 6th.

I just want to do it right the first time and not go through the hassle... Good Luck!! Keep us posted on your progress with Cigna : )

[Mel24 51]

@@Mel24 Yes the insurance approval process seems daunting! I initially saw my surgeon, and they gave me a list of things i need to do. I have been slowly going through the list. I let the surgeon know i was doing WW at the time and she said that they can get a little strict about the rules and that i needed to see a nutritionist to track my weight and exercise. When i asked about doing it with my PCP, she said to be safe i should see a nutritionist because they will know exactly what to do, and what i need to be approved. The worst part is, is that it is actually 4 visits, the initial visit and then 3 more, AND they have to be 30 days apart. So i started on January 6th, my first "real" visit was Feb 6th, and i have 2 more to go... March 10th and April 6th.

I just want to do it right the first time and not go through the hassle... Good Luck!! Keep us posted on your progress with Cigna : )

@@smile121 Thanks. Maybe I'll touch base with the NUT that I saw in October... She was so nice and not judgmental at all... I am just waiting for my first appointment with the WLS center and then I can start, but I just feel like I need (must) do something to move things along "faster" than the current pace. I just am impatient and I know I am not the only one. Thanks!!!

[Luvin_Life125 558]

With Cigna you have to see a doctor monthly in conjunction with your WW meetings. You must do a total of 4 monthly doctor visits and at each visit the following must be documented each time:

-your weight

- your current dietary program (ie: WW, 1500 calorie diet, etc)

AND

- your physical activity (how much & how often)

Cigna is very strict with their requirements. You either meet their requirements or you don't. There isn't any wiggle room for ifs, ands, or buts with them. Here is the most current bariatric surgery coverage guidelines for Cigna. Please take the time to read and understand everything. It makes the process so much easier when you know what you need to do for approval.

https://cignaforhcp.cigna.com/public/content/pdf/coveragePolicies/medical/mm_0051_coveragepositioncriteria_bariatric_surgery.pdf

Please let me know if you need help with any of the Cigna guidelines or have questions. I will be happy to help with anything I can.

[smile121 66]

@@Mel24

The first step I made is with my surgeon. If you have a surgeon in mind that you want to use, i would suggest seeing them first. Mine had a nice little packet that included every step I needed to take for them, and for my insurance. They went through everything with me, and set me up with a nutritionist that works with bariatric patients and knows the approval process. It is a pretty long list of things to do, but just having it HELPS TONS!!!

I am in the same boat as you, It seems SO FAR away, but I find that it is actually helpful to mentally prepare for this, seeing as I am a food addict. So i find that making small changes now may help me emotionally.

It seems like we may be on a similar timeline so friend me if you would like : )

[Mel24 51]

@@smile121

I heard from the dr's office and I am scheduled for all the initial evals next Friday. I am bringing all my stuff from WW to add to their chart. I am going to see if getting my psych records from when I did counseling will help too. I did call Cigna's benefits and they looked at the same sheet we've all looked at. The confusion is where it states WW in their explanation. It leaves room for interpretation. Even the woman on the phone agreed it was a grey area. She told me to have the surgeon submit it all, and see what they say. In the mean time, I am meeting with my primary doc next Friday as well to do another weigh in. Crossing my fingers something works.

[CountryGirl5584 115]

Some insurances don't count weight watchers as a supervised diet

[cdenney123 103]

It did for me I got the records that I have been on it for 5+ years on and off and my insurance accepted it with no diet that was required for 6 months.