Getting approved

[Vanessa Kiro 4]

Hello. I have Cigna open access. I have done nothing. Can some one please share their process from beginning to surgery date. I have no idea where to start or what to do. All I know is I’m doing it in America and my insurance says I’m covered as long as I meet deductible My BMI is above 42. Thank you

[catwoman7 11,212]

insurance generally doesn't require you to jump through a bunch of hoops (as long as you qualify, which you said you do) other than many policies require a diet supervised by a physician or dietitian (often for six months) - although not all have this requirement. Your bariatric clinic, on the other hand, will likely have you go through several medical clearances, though - blood tests, sleep study, EKG, etc. Some also require you to go through classes. You may first need a referral to a bariatric surgeon from your PCP - so I would start there. Once you're an official patient at a bariatric clinic, the process will begin..

[Dhana Jeane 2]

I have my consultation on Thursday. I’m excited but nervous! My insurance requires a 6 month program before surgery so that’s a bummer.

[Vanessa Kiro 4]

Thank you. This is good to know. Seems like most of the hoops come from the medical team and not insurance.

[2Bsmaller18 436]

I would call the insurance company and find out. If you have seen a surgeon their office may have that information too.

[Blueslily 94]

2 hours ago, Vanessa Kiro said:

Thank you. This is good to know. Seems like most of the hoops come from the medical team and not insurance.

Interesting responses here. There are indeed some insurance plans that have requirements of things they want you to do prior to approval for the surgery. Yes, the medical WLS program requirements are separate. Indeed some people have insurance that do not require anything. But if you do a search on this site, it's not just about hoops from the medical staff. Folks indeed report that their insurance required 3 months, 6 months, weight management, etc. And, for some of the "hoops" reported, some can be regarded as helpful in some ways just for your own medical care perspective and preparation for surgery. You can tell which programs prepared folks and which did not when you read posts on here. But, people also have all kinds of programs and insurances. Plus, some folks are self-pay and move through the process faster. From the medical program perspective, blood work and an EKG seems simple to me. Plus, some do EGDs before to see if you have a hernia that needs repairing or if there is anything internal that might cause a problem with the surgery. That's cool with me. I haven't had a lot of other surgeries, but getting information beforehand and tests that provide information about my health seem like a good deal to me. I guess that's also because from my perspective I wasn't trying to race through this process. Man, after surgery you certainly can't race through the process either. I think that if I had to wait more than 6months, I would be annoyed, but 3-6 months seems tolerable to get info, prepare mentally, prepare physically, fully understand what the program does and does not do, etc. I think one of the better "hoops" that people report is meeting with a therapist who understands bariatric surgeries, food addiction, eating disorders, etc. For folks on here who report not meeting with a therapist prior, many times it is recommended after. This is not a fast process. I'm glad that I had time to really fully understand and know what I was getting into. I recommend a good therapist for everyone going through this process. Good luck