cigna ppo{oap}

I have cigna ppo {oap} and they have an iron-clad exclusion in my policy. I was wondering if anyone out there has this same insurance and have gotten approved? My consult with surgeon is april 2nd and just trying to get some info. When i talked to two different reps at cigna got two different answers: one said "yep, it's excluded, but if it's deemed medically nessesary than they would approve it. The other rep said ' NO WAY!!

Yes, it is self insured. I have the summary of benifits in front of me, and it reads: " Medical and surgical seviced initial and repeat, intended for the treatment or control of obesity, including clinically severe (morbid) obesity, including: medical and surgical sevices to alter appearences or physical changes that are the result of any surgery performed for the managment of obesity or clinically severe (morbid) obesity; and weight loss programs or treatments, wheather prescibed or recommended by a physician or under medical supervision."  What do you think?

Thank you, Paul!! That was very helpful. I definetly look into those areas and i will read your profile. Rhea Hernandez

Hi, I have CIGNA PPO and was just approved.  I have posted on the insurance board regarding my experience and have also posted on my profile.  I don't know if my infomation will help you any or not.  According to my plan it must be deemed medically necessary per co-morbidities and a BMI of over 40 for the past year.  And getting the coverage postion is also very helpful I got a copy of it for myself and took a copy to the surgeons office for their records. Jenny