Did Cigna change their policy?

nod · June 30, 2009

I am looking to get the lapband surgery and have Cigna. I have read the hoops you have to jump through to be approved. One hoop appears to be a 2 year BMI history. However, looking online at cigna documentation, I don't see that stip. This document from cigna was put in place on Jun 15, 2009. What are your thoughts?

http://www.cigna.com/customer_care/healthcare_professional/coverage_positions/medical/mm_0051_coveragepositioncriteria_bariatric_surgery.pdf

nod · June 30, 2009

Nevermind - just called cigna and my plan doesn't cover it... go figure - $545/mo and they don't cover it...wow

ParrotheadCathy · June 30, 2009

Somewhere in the vicinity of 55% or so of all insurance policies don't cover WLS, so you're definitely not alone. I knew before I started the process that I would be self-pay and was prepared with cash and financing in place. I will say that you get your surgery a lot more quickly as a self-pay because you don't have any hoops to jump through for an insurance company. I had to do the chest xrays, some blood work, upper GI, cardiac clearance and sleep study. A big hint. Find out what testing is required and get your primary care physician to do or order all the testing with referrals to in-network providers. That way your insurance will cover that part. The sleep study doctor billed my insurance almost $5,000 so that was a significant savings to me. Since my insurance doesn't cover WLS, it doesn't cover any of the doctors who provide it...so if they surgeon's office had referred me, I would have been completely out of network.