Plastics With Cigna Insurance

[JamaicanGirl2011 27]

I called Cigna regarding plastic surgery and I was told that it would have to be considered "medically necessary" by my doctor.

The representative was unable to provide more details. She said to just submit the documentation.

Has anyone been approved for plastics by Cigna?

If so, what is the process and time line?

What has your experience been?

I would greatly appreciate it if you could share as much as possible.

Thanks!

[Bufflehead 6,358]

I haven't done plastics with Cigna, but I have looked at their coverage policies, just thinking about what may be down the road. They are pretty strict. You need to have cellulitis, dermatitis, etc. and have tried 3 - 6 months of treatment including systemic antibiotics, antifungals, etc. They don't care about things like back pain (won't consider that evidence of medical necessity) because they don't believe there is evidence that extra skin is associated with back pain. Here are their general policies:

http://www.cigna.com/assets/docs/health-care-professionals/coverage_positions/mm_0027_coveragepositioncriteria_abdominoplasty_and_panniculectomy.pdf

http://www.cigna.com/assets/docs/health-care-professionals/coverage_positions/mm_0470_coveragepositioncriteria_redundant_skin_surgery.pdf

[JamaicanGirl2011 27]

I haven't done plastics with Cigna, but I have looked at their coverage policies, just thinking about what may be down the road. They are pretty strict. You need to have cellulitis, dermatitis, etc. and have tried 3 - 6 months of treatment including systemic antibiotics, antifungals, etc. They don't care about things like back pain (won't consider that evidence of medical necessity) because they don't believe there is evidence that extra skin is associated with back pain. Here are their general policies:

http://www.cigna.com...niculectomy.pdf

http://www.cigna.com...kin_surgery.pdf

Bufflehead,

Thank you for your response.

ok, with all these rules, I may just have to pay for it myself!!

I may have to get a second job or just start some kind of "donation plan". LOL

[BeachGirl 3]

Cigna is the worst; they would not pay for anything. Ended up paying out-of-pocket. Fortunately, my Dr. had an arranged a pre-set price with the hospital, which was a fraction of the what the hospital would have charged: $48,000 vs $15,000!

[JamaicanGirl2011 27]

Cigna is the worst; they would not pay for anything. Ended up paying out-of-pocket. Fortunately, my Dr. had an arranged a pre-set price with the hospital, which was a fraction of the what the hospital would have charged: $48,000 vs $15,000!

Well, I called Cigna to find out if they would cover removal of excess of skin.

The rep. said "yes" but would not provide any more details!

What???

[tallysfunny 363]

Call again and ask them to send an "explanation of benefits". It should say what it covers and what it doesn't. Along with any stipulations.

[gustavo52974 369]

I have Cigna too, so I'd be interested to find out as well. They covered my surgery, but by the time I need to have skin removed, their policy will have changed to not cover it.

[JamaicanGirl2011 27]

Call again and ask them to send an "explanation of benefits". It should say what it covers and what it doesn't. Along with any stipulations.

Thank you!

I will call and let you you know the details.