Cigna 90 Day Nutrition Weight Gain

[AmyML 7]

Has anyone had issues with weight gain during the 90 day nutrition and getting denied?

My weight has been crazy with going back and forth and I have my final visit weigh in tomorrow and know I'm 3-4lbs higher than my previous weight. Of course I had thought my previous weigh in was my final one so I didn't follow my eating plan as closely as I should have since birthday and all going on.

[dede0314 356]

Check the requirements for Cigna. I have Aetna and in the bulletin it says that you can not have a net gain during the supervised weight loss program. I gained during the 90 days and sure enough I was denied. I was later approved but that's a long story . But it really depends on the requirements of you insurance company. If it doesn't say anything about having a net gain then I think you should be fine.

[AmyML 7]

Check the requirements for Cigna. I have Aetna and in the bulletin it says that you can not have a net gain during the supervised weight loss program. I gained during the 90 days and sure enough I was denied. I was later approved but that's a long story . But it really depends on the requirements of you insurance company. If it doesn't say anything about having a net gain then I think you should be fine.

I checked the requirements and I didn't see anywhere that it stated I have to lose or maintain the start weight. So hopefully it won't matter, would hate to have to start the 90 days all over again.

[northmsgirl 3]

I have Cigna and my plan policy is that I cannot have a net gain during my 3-month supervised weight loss (can't weigh more at the end than at the beginning). Hope yours is different! (Anyway you can postpone your is it for 3 or 4 days and drop some Water weight?)

[AmyML 7]

I have Cigna and my plan policy is that I cannot have a net gain during my 3-month supervised weight loss (can't weigh more at the end than at the beginning). Hope yours is different! (Anyway you can postpone your is it for 3 or 4 days and drop some Water weight?)

I thought the guidelines were pretty much the same for Cigna in general minus the fact that employer could opt out, this is the one they kept reading to me when I asked for the their policy

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

I searched through the whole thing and I didn't see anything on weight gain or loss during the 90 day nutrition, when I called several times I asked the representative as well (although they can't be 100% trusted with exact details) but she said I should try not to gain but she didn't see anything in it that stated I had to lose.

I actually already had my weigh in on Saturday and I did gain 3 lbs from my last weight from Water weight for certain reasons, so I guess we'll see what they say as she was supposed to be resubmitting tomorrow or the day after.

[northmsgirl 3]

Was your weight still lower than when you started your program?

My surgeons office is the one that told me no net gain for Cigna. Maybe it's not a hard and fast rule.

Edited September 23, 2015 by northmsgirl

[Sleevegirl1018 30]

I have Cigna. My weight was higher on my last visit. I was still approved. But my Dr says if I'm higher on the day of surgery, he won't do it. ????

[BellaD08 0]

Hi there! I have cigna and I gained during my 90 days and I was still approved. Once you do your liquid pre op diet I lost the extra weight. I just had my surgery 9/15! Good luck!

[AmyML 7]

Was your weight still lower than when you started your program?

My surgeons office is the one that told me no net gain for Cigna. Maybe it's not a hard and fast rule.

Yeah it was a few lbs higher then before because I hadn't been strict with my eating since I had no idea I had to do another month.

I have Cigna. My weight was higher on my last visit. I was still approved. But my Dr says if I'm higher on the day of surgery, he won't do it.

Oh good! Thank for the feedback!

She said she was resubmitting my paperwork Monday so I'm hoping they come back with a quick response and approbal this time because I want to get my surgery date setup and they only have one more spot for the week of October the 12th. Not that I mind booking into the week of the 19th either but I'd rather do it sooner if possible.

My Doctor said he wanted me to do a 2 week diet to shrink my liver and I think they said I might do 2-3 days at the end of liquid not sure yet though.

Hi there! I have cigna and I gained during my 90 days and I was still approved. Once you do your liquid pre op diet I lost the extra weight. I just had my surgery 9/15! Good luck!

Awesome! Thank you for the info, I can't wait for a response from them as the anticipation is killing me lol but knowing that people are still getting approved even with some weight gain puts my mind at ease quite a bit.

[AllisonK1986 68]

I have Cigna great west and no one has said anything about weight gain. I've been on and off prednisone and with my meds it's so hard to lose weight (my lupus meds) so I'm praying they don't consider my yo yo weight an issue bc I hopefully file this week. I follow the diet 98% of the time and try to get my steps in and I've quit smoking!

[AmyML 7]

Just got the call this morning that I was approved for surgery!!!

My surgery date is set for October 26th!

So apparently the weight gain didn't cause issues, my paperwork was resubmitted on Monday so it was a fast response as well.

Edited October 1, 2015 by AmyML

[dede0314 356]

Congrats! My surgery is Oct. 22nd.

Edited October 1, 2015 by dede0314

[AllisonK1986 68]

My surgery is going to be on November 24. And I'm still waiting for insurance approval.