Cigna of TN, WLS on exceptions list

[MountainMama 5]

Hi there everyone. This board has been a God send, all of the information is wonderful. I have an easy insurance to deal with, federal BCBS, my question however is for my sister in law.

She has Cigna in TN and the policy that she has says WLS is not covered. Her BMI is 52, she has high blood pressure, epilepsy, joint problems, had back surgery, incontinence, fibromyalgia, and lupus. Is there any chance that she can get approval even though her policy says it does not cover the band?

I have started my process and my doc says I wont have any problems (fingers crossed), I really want to help out my SIL because she is so upset and depressed. She has tried for years, like all of us, but has not had success in keeping off her weight either.

What would she have to do to get the ball rolling to possibly get approval. Any information is appreciated.

[Humming Bird 275]

I can not help with the insurance stuff because I have not had insurance for years. Has your SIL looked at self pay options? Some surgeons offer much lower total cost for self pay. I financed mine. There was 0% interest for the first 6 months and then 10% fixed for the balance. Maybe check to see if there is some sort of funding through your state? What about some help from a family member?

[DrHekier 0]

Unfortunately if she has an exclusion it is almost impossible to overturn that. In desperate cases, I suggest seeking the services of an attorney advocate for weight loss surgery patients, Walter Lindstrom. Obesity Law and Advocacy Center

Walter himself has undergone WLS.