My surgeons office is submitting the paperwork for approval tomorrow. I have a Cigna ppo plan, but know little to anything about insurance. According to my plan, it says they only cover 50% of any weight loss procedure...but surgeons office said the most I'd pay out of pocket is the 5k yearly maximum. Needless to say I've been seeing doctors left and right to bring that 5k down. I'm still figuring I'll have to pay 3300 or so. Does anyone have a similar plan that didn't have to fulfill the yearly max?

I don't know much about that. I have medical mutual but it's through the hospital I work at. They pay 90% of any surgery procedure and I pay the rest, up to $500. That's what the insurance company is telling me anyhow... I am still very skeptical.

I have the same plan as you. Cigna is based off of deductible program. They give you a set dollar amount every year ( mine was 1500) for routine dr appointment and after that you have a co-pay of 10% of what the bill is up to 5,000. After you reach 5,000 dollars out of pocket everything else is covered 100%. I was fortunate enough to be doubled covered with my wife's insurance that my co-pays were covered by her insurance do I didn't have to pay a dime for my surgery. I hope this helps.

Thanks for the info. I figured I'd have to cough up the remainder to fulfill the yearly max, but was hoping I could get out cheaper. Although I'm planning to have surgery over my summer break off from work (one of the perks of working at a college)...the waiting for approval is feeling like its taking a lifetime.

My Cigna plan is a group plan through my union. They pay 100% of hospital and surgeon costs. All I pay is a $25 co-pay for each doctor visit.

I also have CIGNA. I have a $2500 deductible. I had surgery end of February. The surgery bill was around 19,000 and they paid 91% that left a balance of $1780 which I paid in full today. However I had many other bills from other doctors at the hospital as well. But after paying the $1780 and other bills I had paid this year I had met my deductible so they paid 100% of those bills. I had put $2500 in my flex spending account so that cover the $1780.

Your lucky, I have Cigna also, and Cigna would not cover a dime of a Gastric Sleeve Surgery. I went to Mexico and had it done there.