Self Pay vs CIGNA

I would like to hear from those who made the decision to "self pay" for their WLS, especially if you have been denied by CIGNA. I have submitted the paperwork to CIGNA, but have not heard back yet. Because there is a high probability that I will be denied (after all, it is CIGNA I'm dealing with!), I would like to hear about the expeirence of others who paid out of pocket. Thanks, Janet

Hi Janet, Please be aware that many insurance companies, even though they are obligated to pay under the terms of their policies, will still automatically deny requests for surgery the first time. They are in business to make money, so if they can make it hard for people to get approved, they know that many of them will just walk away and pay for surgery themselves or do without it. For them, it's good business to discourage people. Make them cover if they are supposed to. You can find their guidelines on their website. Check to see if you do qualify and fight to make them pay if you do. Good luck to you.

J H, I'm sure you are right about insurance denial policies. Thanks for your encouragement-- Janet

I just want to let you know that on the Tennessee message board, there was a woman that just got approved by Cigna. It officially took 3 days for her to get approved. Rachael

Rachael, I found the post that you mentioned. Isn't it amazing how every experience is different? My request should be submitted to Cigna by tomorrow so we will see how it goes from there. I have put it in the Lord's hands. Thanks for your help, Janet

Hey Janet, I have Cigna EPO, I haven't submitted everything yet, so I can't give you advise about self pay vs. Cigna. However, have you read over your benefits completely? Do you know if they exclude the surgery? I've read everything I can on the Cigna website about bariatric surgery and there "stand" on the topic. Some plans exclude it, some don't. I wish you the best of luck though. The insurance coordinator at my surgeons office stated that if it is covered on the policy, you have to play their game, but they'll cover it...

Cindy, Thanks for you help. Good luck to you to you as well!!! Janet

Janet, I have Cigna POS in Oklahoma. I was approved within 5 days on my first try and my wife was also. I would be happy to give you more info if you want it. I would say it would be worth going for and fighting them if you have to. I also heard stories of people having to fight with them but I did what they told me to do up front and was approved the first time along with my wife. So far I have been pleased with Cigna. Kendall

Kendall, I am happy to hear about you and your wife. Thank you for your help and your encouragement. Janet

From what I understand it totally depends on your policy. Some Cigna polices just need medical necessity and if you have the criteria you are approved fairly easily. Some Cigna policies have a written exclusion for WLS. I have Cigna and our policy has a written exclusion, unfortunately I have reasearched and it is almost impossible to get approved even with a lawyer. I wish you Luck and hope you are approved!