Cigna Approved Surgery!

[Banterwonder 63]

The CIGNA policy I am on excludes anything related to weight loss surgery and weight loss management.

Depending on your state laws, cigna may HAVE to cover weight loss surgery. Check the legislation in your state. I know that in New York, insurance companies are required to cover it. They may make you " jump through hoops", but in the end it will be worth it.

[janders 0]

n2animals, I certainly didn't mean to hijack this thread. Congrats on CIGNA approving your surgery. I'll continue to see a way around the policy language, but it seems pretty clear.

[readytogoforit 172]

Congrats N2animals!!! you go girl..... enjoy the journey.

[Gerry Juarez 2]

Congratulations! I also have Cigna and the six month program was not bad in my opinion, I learned a lot during that time

[n2animals 5]

n2animals, I certainly didn't mean to hijack this thread. Congrats on CIGNA approving your surgery. I'll continue to see a way around the policy language, but it seems pretty clear.

No problem, whatever it takes to get answers. Let me tell you a little bit about my process, maybe you may have to dig deeper.

I started thinking about lapband surgery a little over a year ago. I was on my companies Cigna ***. I was prepared to switch to our PPO when open enrollment came around so that I could start this process. I looked at our companys plan and exclusions and right there it stated that they do not cover any type of weight loss surgery even if you have health related issues. I was so heart broken. I still asked a company to look up my information and was told "yes" it was covered. I asked them if they were sure and read the exclusion I had on my plans forms, they then told me "no" then it is not covered. Bummed again.

So then I checked my husbands insurance, they covered the surgery...yippee! The downside was that I needed to wait over 4 months before I could get on his insurance during open enrollment. So I waited. I was very impatient, started seeing some different doctors for opinons for when I could do the procedure. As it came closer to switching, I decided to check with Cigna directly and I was told it was covered under *** & PPO. To get further clarification, I emailed our HR coordinator who was in charge of the coverage, she told me yes, indeed the surgery was covered and emailed me a copy of the coverage which laid out all the requirements I must complete to be approved. I was so elated, I decided to still switch to PPO since it was open enrollment already and I just felt it might be easier than ***.

I had lapband VIP call and verify coverage. They were told i was not covered that it was excluded. I told them yes it is covered and emailed the copy of the policy with the requirements. They called back and found out it was covered, but only with an in-network provider (which lapband vip wasnt). They worked with an in-network provider so then they would approve that.

Had I known all this in the begining, I would have been banded by now. It took alot of research, time, and persistance. I am not saying that it will work out for everyone in the end, but dont take the first "no its exlude" as bible. Keep digging and make sure that is the case. My plan specifically said it was exculed, but turns out that was wrong or old information.

Good luck to you and everyone else out there on this journey. Sorry this was so long winded.

[janders 0]

When I retired from consulting engineering for other pursuits, I went on my wife's policy. it's the only one we have, and the language is very clear. I appreciate your input. After more research, it looks like self-pay is the only way I can do this...and that's not in the budget right now.

[n2animals 5]

When I retired from consulting engineering for other pursuits, I went on my wife's policy. it's the only one we have, and the language is very clear. I appreciate your input. After more research, it looks like self-pay is the only way I can do this...and that's not in the budget right now.

The language was very clear on mine as well that it was not covered, but again, after checking deeper, it was covered and that exclusion was apparently wrong information.

I understand how you feel. I was thinking before the ony way for me was to self pay and I definately couldnt afford it. Good luck to you!

[redhead154 0]

I was so so so happy my husbands company switched from BC/BS...they didnt cover anything having to do with weight loss...I called Cigna tonight and they cover surgery...almost passed out...lol...my bmi is 49 will I still have to do the six month program...I am fine either way..whatever it takes.Any input on anything is appreciated as I know nothing just starting..ty

[n2animals 5]

I was so so so happy my husbands company switched from BC/BS...they didnt cover anything having to do with weight loss...I called Cigna tonight and they cover surgery...almost passed out...lol...my bmi is 49 will I still have to do the six month program...I am fine either way..whatever it takes.Any input on anything is appreciated as I know nothing just starting..ty

That's great news! You need to check with your particular insurance plan to see if they require a 6 month diet, I don't believe so if your bmi is over 40, but best to double check.