Weight loss surgery is covered by most Cigna insurance. Some coverage plans, however, expressly prohibit bariatric surgery. To find out if your plan covers weight reduction surgery, contact Cigna directly.
Cigna and Great West Healthcare recently merged. The following is also true for Great West Healthcare.
Does Cigna pay for weight loss?
Weight loss surgery is covered by most Cigna insurance. Some coverage plans, however, expressly prohibit bariatric surgery. To find out if your plan covers weight reduction surgery, contact Cigna directly. Cigna and Great West Healthcare recently merged.
Does Cigna Cover skin removal after weight loss?
If the weight loss is due to bariatric surgery, the operation for excision of excess skin should be delayed until at least 18 months following the surgery and only when the weight has remained constant for at least the last six months.
Does Cigna Cover Stomaphyx?
Although the majority of Cigna’s insurance policies cover weight loss surgical treatments, some benefit plans specifically exclude them. If you’re unsure whether your plan covers surgical procedures for weight loss, contact Cigna directly to find out.
All of the following weight loss surgery standards and conditions for Cigna health insurance policies also apply to Great West Healthcare, which Cigna recently merged with.
Unless you have a policy that expressly states that weight reduction surgery is not covered, surgery will be covered if you fulfill Cigna’s particular conditions. All of the following requirements must be met:
- You must have documented proof of a BMI greater than 35 and a serious comorbidities. The following are examples of qualifying comorbidities:
- You must demonstrate that previous weight loss programs have failed. This entails enrolling in a weight-loss program that is medically supervised. Monthly documentation of your nutritional program, activity routine, and weight will be required to demonstrate that weight loss surgery is medically essential.
- You’ll need formal confirmation from your primary care physician that weight-loss surgery is being recommended.
- You’ll also need to have a psychological evaluation to ensure that you’re ready to make the necessary lifestyle changes to lose weight after weight reduction surgery.
Regular filling of your band to alter its tightness and your capacity to lose weight is a part of receiving a Lap Band or Realize Band. If Cigna covers and pays for your gastric banding treatment, they’ll also cover the necessary band fills while you’re getting used to it.
Some surgical methods for weight loss are not covered by Cigna. These are some of them:
If you have one weight loss surgery operation and don’t get the results you want, Cigna could be willing to pay for a second procedure. The operation must be declared unsuccessful by Cigna, which means you must be unable to decrease 50 percent of your excess body weight after the treatment.
It’s important to remember that “extra body weight” refers to the amount of weight you need to shed, not your overall body weight.
Cigna does not have many restrictions on where you can have your weight reduction surgery, however picking an in-network practitioner is usually the best option. When you choose an in-network surgical provider, you will have lower out-of-pocket charges, which means you will spend less overall for this surgery. Make sure you speak with Cigna directly to learn what forms of weight loss surgery are and are not covered, as well as whether you qualify. The sooner you start documenting your weight loss journey, the sooner you’ll be able to have the weight loss surgery you require.
What is the BMI for bariatric surgery?
You must meet the following criteria to be considered for weight-loss surgery:
- Have a BMI of 40 or more, or a BMI of 35 to 40 and an obesity-related ailment, such as heart disease, diabetes, high blood pressure, or severe sleep apnea.
- Weigh fewer than 450 pounds, which is the maximum weight allowed by hospital imaging equipment. A nutritionist can assist you if you need to lose weight to meet this criteria.
- Check to see whether your health insurance will fund bariatric surgery at UCSF if certain criteria are satisfied. Please be aware that we only accept Medi-Cal patients who are residents of San Francisco County.
How long does it take for Cigna to approve a surgery?
Your insurance carrier will either approve or deny your prior authorization request within 5-10 business days of receiving it.
Does Cigna reimburse for Weight Watchers?
CIGNA Healthy Rewards gives you exclusive discounts on programs and services that will help you improve your health and wellness. Weight Watchers, Jenny Craig, Pearle Vision, Bally Total FitnessTM, Curves, drugstoreTM, and more brands are among the offers. Good health is a reward in and of itself.
Does Cigna pay for labiaplasty?
Labiaplasty is not covered by Cigna since it is considered aesthetic rather than medically required. For details on the labiaplasty operation as part of initial gender reassignment surgery, please see the Cigna Coverage Policy for Gender Reassignment Surgery.
Does Cigna cover gynecomastia surgery?
Because it is not medically essential, Cigna does not cover surgical treatment of gynecomastia for ANY other reason.
Does Cigna Cover diastasis recti surgery?
Surgical techniques to correct diastasis recti are purely aesthetic and not medically necessary for any reason. When performed alone and not as part of a medically necessary panniculectomy treatment, suction-assisted lipectomy is considered aesthetic and not medically necessary.