*sigh*  I’ve been going through the motions to get approved for weight loss surgery, specifically Gastric Bypass.  I got the letter from my insurance on Friday that I have been denied.  I spent the weekend crying.

I’ve been trying to get approval for months.  There are so many steps that need to be completed before it ever even gets submitted to your insurance.  You have to get a referral from your primary care doctor, there are lots of tests to be done.  These vary from surgeon to surgeon, I’m sure, but I was required to get an EKG, full metabolic blood panel, and chest X-ray.  I also had to undergo a psychological evaluation to be sure I was stable (HA!).  All this took me about 6 months.  It’s all just a big waiting game and not for the impatient.

So I had been on pins and needles waiting to hear.  Then it came, in big bold letters:

“NOTICE OF DENIAL OF MEDIAL COVERAGE”

Apparently, Cigna thinks that there is a “lack of medical necessity.”

It seems that weighing nearly 300 pounds (yikes, I’ve never admitted that before), being in extreme pain every waking moment, and having an excruciatingly painful hernia that they won’t fix until I lose weight, isn’t “medical necessity.”  Stupid Cigna Insurance.

I wish that they could spend one day in my shoes and tell me it’s not necessary to get this weight off of me as quickly as possible.  I’d like them to feel the pain with every step I take.  The pain I feel when I try to get up and take care of my kids.  The hernia pain that puts me in the recliner for hours, unable to walk.  It truly sucks eggs.

Anyhow, if anyone reading has dealt with this before, I would love to hear what you did.  How did you finally get approval?  Did you give up?  I need to start planning my “grievance” so that I can appeal their decision.  I would love some insight on what to include to get them to understand.