Does Cigna Insurance Cover Weight Loss Surgery?

People who are overweight can benefit from weight loss surgery. Surgical procedures are divided into two categories. They can be restrictive or restrictive and malabsorptive at the same time.

  • Restrictive surgery reduces the size of the stomach. It restricts how much food the stomach can hold.
  • Malabsorptive: This procedure alters the intestine’s route. Food circumvents (or bypasses) a section of the intestine. Because nutrients are generally absorbed in the small intestine, skipping a portion of it limits the amount of nutrients that can be absorbed. This could result in weight loss.

Weight-loss surgery is normally reserved for people with a BMI of at least 40. If your BMI is at least 35 and you have other health problems related to your weight, surgery may be an option. If you have a BMI of 35 or greater and have attempted for at least 6 months to lose weight with diet and exercise, surgery may be an option.

  • Adjustable gastric banding: A band is wrapped around the top region of the stomach by the doctor. A small tube is attached to the band and leads to an access point that is hidden beneath the skin. The doctor inserts a needle into the access point about 4 to 6 weeks after surgery to add or remove salt water (saline) from the band. Adding saline to the band tightens it and shrinks the stomach. If the band is excessively tight, the doctor can remove the saline.
  • Gastric sleeve: Your stomach is removed in its entirety, leaving a thin vertical sleeve, or tube, roughly the size of a banana. This procedure is not reversible because a portion of your stomach has been removed.
  • A tiny portion of your stomach is used by the doctor to produce a smaller stomach. The new stomach is attached to the small intestine’s central section. The rest of the stomach and the upper part of the small intestine are bypassed by food. Bypassing a portion of the small intestine, the body consumes less food, nutrients, and calories. This may result in weight loss. A Roux-en-Y (pronounced “roo-en-why”) gastric bypass is a form of gastric bypass surgery.

How is this surgery done?

  • Laparoscopic surgery is a type of minimally invasive surgery. To guide the surgery, the doctor makes multiple small cuts and utilizes small equipment and a camera. This form of surgery allows you to recuperate faster. You’re also less likely to experience discomfort or complications following surgery.

What’s usually involved?

It’s a major step to have weight-loss surgery. You’ll need to make new, lifelong changes to your eating and drinking habits after surgery.

You’ll work with a team of professionals who have been trained to assist you in losing weight and making healthy lifestyle choices. They’ll be there to assist you in getting ready for surgery. Before your operation, inquire about how your team will assist you in preparing for life after surgery as you adjust to new food habits and physical changes.

  • Before surgery, a medical doctor or nurse will assist you in managing your care and scheduling testing.
  • A licensed dietician can assist you in meal planning and dietary modifications.
  • A therapist or counselor who can help you understand why you overeat and educate you how to cope with stress and emotions.

How well does weight-loss surgery work?

Most patients lose at least a third of their excess weight after surgery, depending on the type of surgery. Some people are able to lose nearly all of their excess weight. The amount of weight lost depends on the type of surgery. It also relies on how thoroughly people adhere to their doctor’s lifestyle adjustments, check-up appointments, and counseling advice.

Banding was shown to have lower surgical risks than gastric bypass in a research comparing the two procedures. People who had gastric banding, on the other hand, lost less weight. They also dropped weight at a slower rate than those who underwent gastric bypass surgery.

The most weight loss was seen in people who had gastric sleeve surgery or a gastric bypass. Gastric sleeve surgery is less effective than gastric bypass surgery, however it comes with fewer side effects.

What are the risks of weight-loss surgeries?

People who are extremely overweight are more prone than others to experience complications following surgery. And, following any type of weight-loss surgery:

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 insurance cover 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.

How long does it take for insurance to cover gastric sleeve?

A growing number of states have approved legislation requiring insurance companies to provide weight-loss surgery for people who fulfill the NIH surgical requirements. While weight-loss surgery is commonly covered by insurance, the approval process can be lengthy and confusing. Working with your surgeon and other professionals gives you the best chance of getting insurance coverage approved.

Steps to obtain insurance coverage for bariatric surgery:

  • Most insurance companies are aware of the health risks associated with obesity and will cover the costs of surgical weight loss in qualified patients. Every insurance plan, however, is unique.
  • We begin the process of obtaining insurance authorization once you have completed our preparatory program, satisfied all of your insurance company’s requirements, and the surgeon has cleared you for surgery. We start by submitting your medical records to your insurance company, requesting that they fund the procedure. The insurance company may take two to four weeks to react with a decision.
  • Once we obtain permission or refusal from the insurance carrier, we will contact you. If the coverage is accepted, the patient is given a surgery date and a pre-op appointment. If coverage is refused, we investigate the cause for the decision and file an appeal with the insurance carrier.

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.

What is VSG weight loss?

The vertical sleeve gastrectomy is a weight-loss procedure. A substantial piece of your stomach is removed by the surgeon. The new stomach, which is about the size of a banana, is much smaller. It restricts the amount of food you can consume by making you feel full after a little meal.

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.

Does Cigna pay for dietitian?

CIGNA, like other major insurance companies, should be invoiced in units, which represent the total amount of time spent in session with your client. 1 unit equals 15 minutes for most billing codes with a single client. A 60-minute session, for example, will be invoiced as four units.