Cigna

bmatthews · September 26, 2011

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.

Tai29 · October 3, 2011

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. :-)

Tai29 · October 3, 2011

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!

cindy lynn · October 3, 2011

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. :-)

bmatthews · October 18, 2011

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.