Cigna Center of Excellence 2+ hours away

[Luvin_Life125 558]

Hello! I have been researching my insurance coverage of bariatric surgery and Cigna will only cover the procedure at one of their (Cigna's) designated Center of Excellence for Bariatric surgery. I found the closest one which is about 2.5 hours each way. I contacted them and I have to have all appointments with their clinic as far as dietician, psych, etc for a total of 5-7 visits prior to surgery plus the post surgical appointments. I just have to say that sucks big time! I have chronic back pain from an injury over 10 years ago when I was in my early 20's and now also have nerve roots impinged. Driving is sheer torture over 20 minutes, and the hubby cannot take that many days off work just to shuttle me back and forth. Besides the fact he is the only one working and we can not do without his income. Grrr, Sorry, I just had to vent my frustration. Don't get me wrong, I will find a way to make it work because I need to have this surgery in order to get my pain down. I just wish it didn't have to be so far away for that many appointments.

[Jersrose43 837]

I am sorry to hear this. Is there another center in a bordering state ? If not you might want to have a conversation with Cigna to see if they have options for you such as a hospital local to you that may be affiliated with the other facility

Good luck

[Susan-031314 179]

Hopefully you can double up visits such as psch and regular visit at same date or NUT and reg visit on same day. It may be difficult, but it will be worth it!!!

[Teri Turnmire 0]

I would call and talk to Cigna. I also have Cigna and they do not require me to use one of their preferred facilities.

[aramey75 0]

Do your research and call Cigna. According to one dr. I saw a few years ago the Center of Excellence designation is no more - the governing body was working on a new designation system. I want to say the research I did at the time supported that claim.

[woo woo 872]

I would call again and see if there is anything closer that will work. Cigna has had trouble keeping things straight in my case with regards to this very issue.

[Jersrose43 837]

I've worked there for 5 years

The designation is based on numerous quality factors to get the designation. An outside body (multiple medical associations) may make their changes and recommendation and may affect a Cigna designation eventually.

I would just call and make sure you must use or is it just a better out of pocket experience

For many Cigna plans the use of center of excellence reduces your out of pocket

Mine is reduced 10% for instance

No affect on my deductible - just coinsurance

[Andrew0929 1,101]

I too have CIGNA and actually found them to be very reasonable when going through the process. As others have said, call them and state your case. I was surprised as to how smoothly my case was handled and I ended up having 2 surgeries due to a complication.

[Luvin_Life125 558]

I gave it the old college try and it was a no go! I spoke with someone in the authorization department, customer service, and someone from HR at my husband's employer. Everyone confirmed bariatric surgery is only covered at a Cigna designated center of excellence no ifs, ands, or buts about it. It was worth the try and I tried a few different avenues to make sure the information was accurate. I worked as a medical billing manager for quite a few years and I know Cigna customer service reps aren't known for being the most knowledgeable.

[marfar7 1,528]

My COE clinic was 3 hrs each way. In 2009, when I was banded, they consolidated my pre op appts so I could do my surgery consult, psych and nut appts in one day. Then, I had to come the day before for my last surgeons visits and spend the nite. Had to spend at least 1 nite in town after my 1 nite in the hospital. Then, for the next 3 yrs, I had to make the trip often for fills/unfills/tweaks. It sucked. It was a whole day affair.

10 mths ago, when I had my sleeve revision, they made me 1 appt the day before my surgery for my nutrition class update and my surgeons appt. I spent 2 nites in the hospital and was required to spend 1 nite in town before heading home. When I got out of the hospital, I was so ready to just go home, so I didn't spend the time in town.

I've had 1 post op visit (moved out of state 5 mths ago so the 16 hrs trip is prohibited). It's much nicer to have 1 post op visit vs the monthly trips for fills, as I did after my lapband.

C if they can book at least a cpl of ur appts at once. And remember, u won';t have many follow ups...Good luck!

[Luvin_Life125 558]

Thanks for the tips! I just emailed the coordinator to see about moving my surgeons appointment to a day or the day before either of my NUT and Psych appointments. My in laws live about 70 miles from the office and it will be easier to stay overnight there than drive all the way home for appointments one day apart. I am really glad I am not doing the band because that would suck making that trip for fills.