I have Cigna too, but my doctor said my plan had an exclusion...He didn't want to even help me appeal it.  I spoke with one worker with Cigna and was told It could be covered with a doctor stating it is medically necessary.  I explained this to the doctor I went to see last saturday and he said NO, If it has an exclusion your out of luck.  I'm sorry your having a hard time, and I'm thinking I need to find another doctor that will want to help me.

 I want to start this process,what I am supposed to do first? I went to seminar. Do I need to make an appointment with my primary care? Or should I try to let this surgeon staff to call tricare ? I don't know how to start  this process with tricare. I have GERD,fatty liver,back problems,PCOS etc. I am over  70 lbs my weight now. I tried many years to see different dietitians and I am currently seeing a psychologist in regards my weight. Any suggestions and answers will be appreciated it.
Thanks! I am stained in Ft Sam Houston San Antonio for now.

These days more and more insurance companies are covering bariatric surgery.  Of course, that's not to say they won't make you jump through some hoops to get it.  But, w/ your height/weight you should not have problems qualifiying from a BMI standpoint.  I am a federal employee w/ Aetna, and they cover lap band, VSG, RNY.  A friend of mine, also a federal employee, has BCBS and she said they approved her lap band without hesitation.  Probably your best bet is to shop around by going on various websites of insurance companies and seeing what they cover.  Or give them a call and actually talk to a human to see what is covered, what the prerequisites are, if there is any waiting period...stuff like that.  I think you might be surprised to see what is available.  Good luck to you!

The wonderful team at Dr. Heiders office requested approval for the VSG last Friday afternoon, and Monday afternoon they called me with an approval, from BCBSNC.  My surgery date is set for August 11th!!! 

 

Has anyone else dealt with CIGNA?  I am working on getting together the information for the weight management program.  The clinic I am working with wants it to have consecutive 6 months.  The policy states it needs to be at least 6 months without significate gaps.  The Clinic says that CIGNA is very strict with this portion of the requirements.  When I speak with CIGNA, they tell me to still with what the policy states.  They do not really have a definition of significate gaps.  Also, the clinic wants more data then what is stated in the policy.  The policy asks for weight, diet and exercise.  Calling CIGNA and they say that is all they need.  But again the clinic is telling me they need very detailed information such as notes on discussions (with the doctor and noted by the doctor) on why I am overweight, what triggers eating and so on.  The clinic keeps trying to get me to start a new 6 month program with one of their people. 

So...do we think that the benefits people at the clinic know what they are talking about or do the people at CIGNA? 

Has anyone else worked with getting their surgery approved through CIGNA?