Jump to content
×
Are you looking for the BariatricPal Store? Go now!

Recommended Posts

Does anyone know if your BMI has to be 35 for 6 consecutive months with Cigna? My BMI has fluctuated be 33 and 35 and right now it is 35 at my 5th and 6th month. Going for my consult with surgeon tomorrow, was just wondering where I might stand with Cigna. I know i have coverage for the surgery. I have Fibromyalgia, Rheumatoid Arthritis, sleep Apnea and Type 2 Diabetes.

Share this post


Link to post
Share on other sites

Does anyone know if your BMI has to be 35 for 6 consecutive months with Cigna? My BMI has fluctuated be 33 and 35 and right now it is 35 at my 5th and 6th month. Going for my consult with surgeon tomorrow, was just wondering where I might stand with Cigna. I know i have coverage for the surgery. I have Fibromyalgia, Rheumatoid Arthritis, sleep Apnea and Type 2 Diabetes.

It's ALWAYS ALWAYS best to check with the insurance company first. The type of plan you have may differ from others depending on if this is employer/group or individual coverage. Also depending on which type of Cigna plan type/product (***, PPO, POS) you have. With that being said, what I have run into the most with Cigna is they want your BMI to be at least 40 OR a BMI 35-39.9 with a comorbidity such as sleep apnea, diabetes, or hypertension just to name a few. Your surgeon's office should submit a treatment plan, or pre-determination letter to Cigna including CPT and diagnosis codes to further guage if Cigna will consider you eligible for this procedure. I hope this helps. :-)

Share this post


Link to post
Share on other sites

It's ALWAYS ALWAYS best to check with the insurance company first. The type of plan you have may differ from others depending on if this is employer/group or individual coverage. Also depending on which type of Cigna plan type/product (***, PPO, POS) you have. With that being said, what I have run into the most with Cigna is they want your BMI to be at least 40 OR a BMI 35-39.9 with a comorbidity such as sleep apnea, diabetes, or hypertension just to name a few. Your surgeon's office should submit a treatment plan, or pre-determination letter to Cigna including CPT and diagnosis codes to further guage if Cigna will consider you eligible for this procedure. I hope this helps. :-)

I don't know why this appears as all asteriks but included in the description of plan types was H-M-O for Health Maintanence Organization.. cmon VST!

Share this post


Link to post
Share on other sites

hi,

i don't exactly remember under which forum you asked me which doctor i used...but wanted to reply to your question. i used dr. richard collier (conroe) - i had a great experience and love my sleeve. congrats on the progress with the process. my best advice is to follow what your surgeon tells you...and make sure you are surrounded by supportive people.

so excited for you!!

It's ALWAYS ALWAYS best to check with the insurance company first. The type of plan you have may differ from others depending on if this is employer/group or individual coverage. Also depending on which type of Cigna plan type/product (***, PPO, POS) you have. With that being said, what I have run into the most with Cigna is they want your BMI to be at least 40 OR a BMI 35-39.9 with a comorbidity such as sleep apnea, diabetes, or hypertension just to name a few. Your surgeon's office should submit a treatment plan, or pre-determination letter to Cigna including CPT and diagnosis codes to further guage if Cigna will consider you eligible for this procedure. I hope this helps. :-)

Share this post


Link to post
Share on other sites

Thank you for answers, I have a ppo plan, I meet all the requirements, now I am just waiting for the dr's office to submit to the insurance company. Getting a little impatient just waiting. I am surrounded by a great support so no problem there. Ready to get this process underway. Thanks again for your response. Hope everyone is doing well.

Share this post


Link to post
Share on other sites

Create an account or sign in to comment

You need to be a member in order to leave a comment

Create an account

Sign up for a new account in our community. It's easy!

Register a new account

Sign in

Already have an account? Sign in here.

Sign In Now

  • Trending Products

  • Trending Topics

  • Recent Status Updates

    • BeanitoDiego

      Still purging all of the larger clothing. This morning, a shirt that I ADORED wearing ended up on top. Hard to let it go, but it was also hard to let go of those habits that also no longer serve my highest good. Onward and upward!
      · 0 replies
      1. This update has no replies.
    • Onedayatatime365

      Looking to connect with others who are also on the journey of better health. Post-Op Gastric Sleeve (4/11/24).
      · 0 replies
      1. This update has no replies.
    • jparadigm

      Happy Wednesday!
       
      I hope everyone is having a lovely week so far! 
      It's been a bit of a struggle this last week...I'm hungry ALL the time.
      · 1 reply
      1. BlondePatriotInCDA

        Have a great Wednesday too! Sorry you're hungry all the time, I'm pretty much the same..and I'm sick of eating the same food all the time.

    • ChunkCat

      Well, tomorrow I go in for an impromptu hiatal hernia repair after ending up in the ER over the weekend because I couldn't get food down and water was moving at a trickle... I've been having these symptoms on and off for a few weeks but Sunday was the worst by far and came with chest pain and trouble breathing. The ER PA thinks it is just esophagitis and that the surgeon and radiologist are wrong. But the bariatric surgeon swears it is a hernia, possibly a sliding one based on my symptoms. So he fit me into his schedule this week to repair it! I hope he's right and this sorts it out. He's going to do a scope afterwards to be sure there is nothing wrong with the esophagus. Here's hoping it all goes well!!
      · 4 replies
      1. AmberFL

        omgsh!! Hope all goes well!! Keeping you in my thoughts!

      2. gracesmommy2

        Hope you’re doing well!

      3. NickelChip

        I hope it goes well! Sending positive thoughts for a speedy recovery!

      4. AmberFL

        How are you doing? any update?!

    • jparadigm

      Hello lovlies!
      Today is a beautiful day in west Michigan! I hope you all have a beautiful Tuesday and rest of your week!! 🤗
      · 0 replies
      1. This update has no replies.
  • Recent Topics

  • Hot Products

  • Sign Up For
    Our Newsletter

    Follow us for the latest news
    and special product offers!
  • Together, we have lost...
      lbs

    PatchAid Vitamin Patches

    ×