cigna anyone

January 12, 2006

they paid for my in 5/03 then we had to change ins and starting 2/1 I will have cigna again... same company and everything ... what are the odds of me getting my band maintenance covered?

Mvpo8961 · January 30, 2006

I have not been banded yet but my surgeon told me if the fills are done under flouro then it is considered an xray and billable to CIGNA.

January 31, 2006

When Cigna approved my band (03) they paid for a fill under fluro (03) and would have continued to had I stayed on I suppose but hubby changed jobs and my new BCBS policy did not cover it. Then that job switched to Cigna but I was pg so never found out if they covered it. Now he has returned to original job and starting tomorrow we have Cigna with them agian. I hope to get band maintaince covered so I can get the show on the road and not feel like a failure. I have no idea how to go about trying to get them to cover it. Anyone asked their ins to maintain their exisiting band? I hope I have a chance since they are the ins that paid for the install....

Is cigna putting your band in???

Mvpo8961 · January 31, 2006

Well that is a long story. I currently have CIGNA. They now require a six month weight loss attempt documented monthly by your PCP before they will approve WLS. I am 4 1/2 months into the 6 months. I have not been able to get a straight answer from my HR benefits coordinator or CIGNA if LapBand is an included benefit of my CIGNA plan. So I have funding in place to go the selfpay route if necessary. I am going to finish the six months submit to CIGNA possibly do one appeal if I am denied and then proceed to selfpay. UNLESS I get something in writing from CIGNA in the next few weeks where LapBand is an exclusion. Then of course I would go ahead and selfpay and just get it done.

As far as the fills go my surgeon has a local surgery center do them. You know one of those free standing day surgery kinda places. Where do you live? Is it around DFW? I believe it is sometimes hard to find a doc to do fills if you are no longer close to your original doc. M

January 31, 2006

I live just outside of Charlotte NC. I have a surgeon less than an hour away who will fill me. (he did it once but actually put nothing extra in because he was not sure how much I had the 1st time)

My original surgeon is only 2hrs away and if I get ins. coverage I can go to him. W/o it I cant afford him as he was charging over $1300 for a fill the last time I checked (2004)

CYNDEL · January 31, 2006

I have Cigna and they paid for my band in 7/05 and have paid every fill since. I live in Penn. and see my Dr. in Port jervis NY.

ShannonPA-S · February 8, 2006

I am still in the process of considering the lap band, but I just found out that Cigna (at least mine) changed from not covering Lap Band to covering it sometime in June 2005. When I tried to get approved last year, they said it was "experimental." That was also listed on their coverage position on the website. Now their coverage position says that it is covered, including the fills, etc. You can go to cigna.com and type "bariatric" in the search bar. If you can't get to it that way, look for their coverage positions. It's listed in their coverage positions section twice (under the "B" for Bariatric and under the "S" for surgery).