Cigna

[tinhuviel]

The more I read about other people's struggles to get Cigna to approve gastric bypass, the more fearful and pessimistic I become.

From what I understand, Cigna now requires at least one 26 week diet within the past year to even begin to qualify. I'm about a year too late for that.

I can't help but feel I'm setting myself up for the biggest disappointment of my life.

Comments

[debrafortune.livejournal.com]

How would they know except for what you tell them?

[tinhuviel.livejournal.com]

It has to be documented by a physician. Oy..

[lausa.livejournal.com]

Do you mean a "medically supervised" diet? If it's not a medically supervised diet, get out your calendar now and start filling in the last year's worth of days with diet details from the past, elaborate, lie, anything just to document it.
Hmmm...26 weeks = 6 and a half months. Yes that would be most discouraging. But not impossible.
I REALLY want this to work out for you!

[tinhuviel.livejournal.com]

yeah, it has to be medically documented, and there's still no guarantee that Cigna will approve even after that. It's gonna be a fight.

[aditi-.livejournal.com]

*crosses all bits for ya*

[tinhuviel.livejournal.com]

thankies!

[falkenna.livejournal.com]

I'm with Lausa. Over here if it were approved by the NHS you'd still have to wait probably a year. 6 months of dieting -- disappointing and not good fun, but if you translate as "sensible eating" -- it can only help you, whatever the outcome.

[tinhuviel.livejournal.com]

If sensible eating under medical supervision would do nothing but help me, then I should have been helped a long time ago. There's more to it than that. Despite proof of a 26 week program, Cigna can still deny the claim, so I may just be spitting in the wind.

[lausa.livejournal.com]

You may well have already have combed every single site out there, but I found these links that sounded somewhat pertinent to your case:

http://cgi.ebay.com/ws/eBayISAPI.dll?ViewItem&item=2854103428&category=46795
Written more for the physician than patient, but shows hows the case for surgery can be made stronger.

And, you can sometimes challenge successfully:
http://www.duodenalswitch.com/Patients/LeeAnne/leeanne.html
One woman's successful fight against denial of coverage for WLS

[tinhuviel.livejournal.com]

Thanks for the links. I'm in the process of collecting good appeal tactics and this chicks story is really gonna help.

The first link didn't really work. It took me to a "stunning chanel dress with matching jacket". Even if I could afford it, there's no way I could squeeze into it. ;)