Cigna Question

[mc2017 45]

Hi guys this is my first post and I have a few questions for those that have Cigna about the approval process. I currently have UHC, however, I will be starting a new job in January and they offer Cigna. I am currently finishing up the six months of dietician visits required by UHC and I have just one month left before I would be able to submit for insurance approval. However, now that I will have Cigna through my new employer I have been researching their requirements. From what I have seen all In need is 4 months of appointments however my fear is twofold:

1. I never discussed exercise with my dietician and I see that is one of Cigna's requirements, how strict are they about this in your experience. I plan on discussing it at my next appointment so I will have it on my records but that would be only one month so would that be grounds for denial.

2. I have gained weight since starting this process. I have gained about 15lbs from the time I started to now. I am now working on my emotional eating and am making progress but I don't know if a pattern of weight gain will be grounds for denial from Cigna. Do any of you know?

Thanks for all your insights!

[TexasMommy80 297]

I have Cigna and have my first appointment on January 9th. I’ve already talked to my patient advocate and he warned me that once I start my three month diet, if I gain a single pound, I will be denied. He also said if you lose too much, they also deny you because “you can do it on your own.” Basically, you want to be no more than a few pounds away from your starting weight. Ugh, I am more nervous about those three months than the actual surgery.

[mc2017 45]

Thanks for replying to my question Texas Mommy, I have started my new job and I have reviewed the insurance policies in full and none of them cover bariatric surgery in any capacity so it seems I will be going the self pay route but thank you so much for giving me some insight.

[domi 237]

I have Cigna. They do cover surgery if you're >40 BMI or >35 with diabetes, hip or other diseases. I had to get another referral that shows my current insurance,

[livethislife 0]

I have Cigna and am currently trying to get the sleeve. Went in for my first doctors appointment he laid everything out for him. Going for my second appointment soon, still need to set up the Psychiatric appointment then go see another doctor and see if he/she would also recommend the surgery for me.

A bit upsetting knowing that I have to go through some many hoops to have this done, but I feel it will be worth it in the end.

[domi 237]

I have Cigna and am currently trying to get the sleeve. Went in for my first doctors appointment he laid everything out for him. Going for my second appointment soon, still need to set up the Psychiatric appointment then go see another doctor and see if he/she would also recommend the surgery for me.
A bit upsetting knowing that I have to go through some many hoops to have this done, but I feel it will be worth it in the end.

Jumping through hoops helps you know you’re willing to do the work. I started this process in June. My surgery is on Thursday. I know I’m ready now. It is a lot of work, but so far it’s worth it.

[TexasMommy80 297]

I have Cigna and I started with one bariatric clinic and ended up choosing another. The first told me that Cigna is very strict and to not gain a pound or I would be denied. They also had a chart to fill out that had a box for diet and exercise, and that if both were not filled out, it wouldn’t be approved. The second clinic did not mention a thing to me and even allowed a visit with my primary care doctor to be counted as my first month. We talked about dieting and obesity, but not like I do with the weight loss clinic. I am not sure what was in the notes but I can’t imagine it was much.

Cigna approved my claim in 48 hours due to being 37 and already having a knee replacement.


Age: 37
Height: 5’6
BMI: 37
VSG scheduled for 4/16/18
GW: 160
MFP: Fit4LifeAR

[TexasMommy80 297]

Oh, and Cigna does have weird requirements like getting a letter of approval from someone other than your bariatric surgeon, the psychiatrist and the endoscopy.


Age: 37
Height: 5’6
BMI: 37
VSG scheduled for 4/16/18
GW: 160
MFP: Fit4LifeAR

[Maried 0]

I am new to this site and started my journey January 13th with Cigna Open Access in NJ. I was told not to gain a single pound as well. Today was my last nutrition appointment and my 90th day. I have now gained 3 pounds. The nurses are giving me till Tuesday (The day after Memorial weekend by the way) to lose the 3 pounds. If I don’t lose the 3 pounds they are saying Cigna will deny the claim. Does anyone know of this is true? Not only that, if they do approve the claim and I have gained any weight since my first visit, my surgeon will cancel it. I am totally freaking out. I worked hard the 4 months and now my 50th Birthday is approaching.... I would hate to have it cancelled now. I am doing everything I can to lose the weight and I don’t plan to enjoy my birthday (6/7) with any favorite foods or alcohol any more. 😪

[Anabugg 3]

I have Cigna and lost 30 pounds during my 3 month diet, and I was approved. My sleeve surgery is set for Dec 17th

[jbond1825 10]

What link cigna sent me .https://cignaforhcp.cigna.com/public/content/pdf/coveragePolicies/medical/mm_0051_coveragepositioncriteria_bariatric_surgery.pdf

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