Cigna VS UHC

It's open enrollment with the State of GA and I am wondering which to pick Cigna or UHC.  Please share expeirences.  Also, I have a thyroid problem.  Anyone have problems losing the weight because of it?  I'm tryingt odecide what surgery t ogo with because of that.  I was looking at Lap Band, but am concenred with the thyroid, that I woln't take it all off.  I need to get down 115 lbs.  Will the lap band do that?  I am at 283.

I just got approved today by UHC but every policy is different. My criteria was just basically a diagnosis of morbid obesity (bmi over 40) and some clinicals that I had to get done like psych eval, nutritional counseling and TSH test. It only took a few days to get it approved once it was all in.

I'm having RNY, and don't know enough about the Lapband to comment. Do lots and lots of research. Obviously the surgery type you choose is a critical decision.

All the benefits and pre-op requirements for cigna and uhc shbp are about the same.   I got my approval in less than 3 hours with Cigna, not sure how long uhc takes.

If you know which pcp you want and which hospital you want to have your surgery at that could be a deciding factor because not all hospitals are on each insurance.


TYes you can lose 115 with lapband, but it may take longer and it may take more will power, since you won't have any alabsorption, just restriction.  There are a lot of things you can trick into slipping through a band, ice cream, smoothies, cheesecake, well chewed chips...  Since you won't malabsorb, you would retain all those calories.  I have met people who have lost 100+ pounds in a year and MANY MORE people who have only lost 50-60 in a year.  The 100+ people were really diligent in sticking with the doctor's plan.  If you don't have the willpower and be honest with yourself, you may opt for rny.

  Also if the state ever stopped covering wls, you may have to self pay for fills and maintenance issues???


On the other hand, the rny is more invasive, you'll potentially dump,  and you may have more vitamin deficiencies.


ALL wls have positives and negatives. You have to evaluate your own situation, lifestyle, eating habits, etc to see which you can live with.


Try to make as many support group meetings and meet n greets to meet post ops and see what they have to go through.  watch what they eat and how much. Ask them what side effects they had post op.   That is the best way to get a good idea of what to expect.


The thyroid issues should be discussed with a wls surgeon. They will want to rule out any medical reasons you can't lose weight and try to treat that before they operate.  Insurance may also consider that a factore in giving approval.

Thanks for all of your info.  I attended my first support group today.  It was very interesting.  They had a vendors fair.  
I am thinking of leaning more towards the RNY.  Cigna requires that I have a 50 BMI and I am at a 41.  The RNY results seem to be more long term. 
My thyroid levels are good.  My PCP checks them often so I don't think that it should be a problem, cross your fingers.  I met a lady today that had her surgery June 10, 2009.  She had the DS and has lost 120 pounds.  Another had the RNY in August 2009 and was down 50 lbs.  That was really encouraging.  I want to use Dr. Smith but I have to wait for him to get on with Wellstar, They said it might take a few months which is good for me because my insurance won't kick in until January. 
DO you know the success rate of the sleeve?

I was at the support group meeting/vendor fair this morning.  I also work for the State.  My understanding is that the policies through the State do NOT cover bariatric surgery.  A coworker, who was also there this morning, went with either the high deductible plan or the HSA(?) in order to have them pay towards the Sleeve she had in January with Dr. Smith.

I strongly urge you to contact HR and then CIgna and UHC to find out from them if bariatric surgery is covered.  At my old job 2.5 years ago, Cigna paid only for the RNY.  Another person from Dr. SMith's Thursday night support group had a policy with UHC that paid for his DS.  Each policy is different and unless the State decided to include bariatric surgery this year, its not covered under their PPO-type policies.

Sorry!
Sue

I am a state of ga employee and our insurance has covered wls since January 1, 2009.


It covers rny, ds, lap band, realize band, and vbg.   You need to select the HRA or High Deductible plans during open enrollment which starts this week.   These are the only 2 plans that will cover wls..

Your bmi does not have to be 50 for cigna to cover the rny.   It does have to be 50+ for the DS.

For rny or the band, it can be 35 with co-morbidities or 40 without.  You are at a fine bmi for them to approve your surgery.

If your bmi os only 41, DS wouldn't be a good option for you anyway. You'd lose too much weight. DS is better for heavyweights.  I have lost 70 pounds in a little over 2 months, if that gives you an idea of how rapid the loss is with DS.


I also wanted Dr. Smith for my DS. They told me last November they would be covered in April, In April they said July....

I advise getting a back up plan,  I t seems getting in network isn't a big deal for Dr. Smith.  shbp will not cover out of network wls under any condition. I tried and was unsucesful in getting them to approve Dr. Smith.