Low BMI/ Cigna approval??

[kfgates 0]

I have Cigna and am willing to dot my i's and cross my t's, but could use some help. My BMI is low (low according to insurance..lol) I do have co-mobidities ie: herniated discs in my lower back, Gerd, Stress incontinence and knee and joint pain. I am afraid I am setting myself up for disappointment. I know I am the perfect candidate for this procedure (as does my PCP) but want to be prepared for submitting to Cigna. Anyone out there submit to Cigna with low BMI?? I have already begun my 6 month diet with my PCP just in case. Thank you in advance for any help you can offer. Kimberly

[NEWME10 1]

How low? Mine was 37.5 and after about 9 months and 1 appeal with 2 comorbidities I was approved by Cigna. You will have to be very persistent and as soon as you are denied get the surgroned office to appeal it right away. I started this process last October 1 and had surgery on May 14th this year. It seemed like they were never going toapprove it. I had already met the 6 month supervised diet thing before I started in October. They think if they deny you you will go away. Just stick with it. Go to one of the seminars about it and get you first consult in with the surgeon so that you will be on track. They know everything you have to do. I have Cigna through Dupont and I ddo not think all Cignas are the same. But your surgeon would know best if they will approved it or not before you have to jump through all the hoops. Good luck and stay after them all the way.

Susie

[kfgates 0]

Right now it is 36.8 and I am fighting to keep it there. I am hardwired to diet and summer is usually when I drop lbs and pack it back on in the winter. If only I had a BMI of 40! I have contacted 2 other docs for letters regarding Stress incontinence and plantar fasiitis. I am setting myself up for an appeal already. I am from Maine and have my first appt with WLS doc on the 29th. Thanks for your help...what were your co-morbidities?? Kimberly

[oscarel 0]

Here's what Cigna requires as of 5/08 and from what I can tell they update it in May of each year so keep that in mind if you go beyond next May submit you paperwork: http://www.lapbandtalk.com/f8/cigna-revised-coverage-position-5-15-08-a-63835/

I would think your weight loss center or doctor would be the best to answer these questions since they work with this on a daily basis. Insurance is not the same for everyone, even with the same insurance company due to the way the policies are contracted. They may not be the same with 2 people from the same company either. Follow their requirements and call them to verify if they have the paperwork once you do submit, and appeal or escalate when required.