I was referred by my PCP to a bariatric center for evaluation for gastric bypass surgery. I am desperately in need of this surgery and have been denied by Cigna. They change their criteria as it suits them. The doctors who are issuing the denials are in some cases not even actual doctors, but nurses who are working under a doctors license.
If I am denied, at least I want the courtesy of a real doctors denial. At first they asked for evidence that I had followed a weight loss plan. I furnished that and then they came back in my denial and now say that I must follow a six month doctors supervised diet with an excercise plan and also behavior modification. Three different plans. Ok, I'll go along with that.
But they also state that the goal of therapy is not massive weight loss but merely a reduction of 10% of excess body weight. So, if I lose 10% I will still be mobidly obese and still have my physical problems but they probably will not cover it then, either. We pay good money for this coverage and I have turned down for three different medications that my doctor has recommended because some LVN said I did not need. What are we paying for, anyway?
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