Received letter from Cigna PPO 4 PS, Need Help

This is a letter I received from Cigna PPO after submitting for Abdominoplasty, and thigh plaster. Please note I had 4 doctor letters and 6-10 months of doc for medical Ness. plus pictures of body and rashes. I would be one of those WLS patients that is a extreme case when it comes the the excess skin, so you can just imagine the pictures that were sent. I have lost 198 lbs, now current weight being 188 lbs at 5'9 "Dear DR.XXX We recently received your request for a voluntary predetermination of coverage for the service nambed above. Unfortunately, benefits are not avaailable for this service because lipectomy and the associated services are not covered under the memeber's medical Plan. The terms of the benefit plan do not require advance approval for the requested services. We are providing this voluntarly predetermination of coverage as a courtesy. This voluntary predetermination of coverage decision is not a treatment decision, a medical consultation, or a claim denial. If the requested service/prodecure is provided, you may submit a claim and we will make a coverage decision based on the information submitted with the claim without regard to this voluntary predetermination of coverage decision. If the claim is subsequently denied in whole or part you will have the opportunity to appeal the decision at that time, but not now. Details on the appeal process will be provided in the claim determination notice." This to me is not BLACK or WHITE...Its grey. Its not a yes or a no. They have left me hanging. The codes that were used are: 15830 belt lipectomy, 15847 abdominoplasty, 15832-50 medial thigh lift. I know some of you were covered by Cigna PPO, how did you get it covered? Were you approved? Did you receive a letter like this? My husbands insurance is top notch, I was approved for WLS within 24 hours, no questions asked. He works for Cisico Systems here in N. California. Any help would be great on where to go now. If they had just denied me, I could appeal.

I have Cigna PPO too, and am pre-op.  I am in the middle of my 6 month dr diet.  I wish I had an answer for you, but just wanted to know if you can keep me posted on your endevor.  I am so proud of you that you have lost almost 200 POUNDS!!!   Now to get the silly skin issues over with! Was Cigna your insurance for your WLS?   I am a bit nervous that I may end up self pay.  My bmi is around 36 w/ 3 co-morbs.   I am SO tired of dieting..... I hope the best for you, and go ahead and call them so you can find out what the double talk is all about.  That is what I would do....call them myself and ask for concise specific answers. Again, keep me posted as to what happens to you.  I care.

Getting CIGNA to approve plastics is a lot harder than getting approval for gastric surgery of any type. This states that benefits are not available under your plan. The rest of the note (paragraph 2) is just boilerplate so it sounds like they are saying it is not part of your plan. You can review your plan and see if there is an exception for plastics for medical necessity, but some plans do rule it out completely.