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does your policy say that bariatric surgery is "an exclusion"? Do you have comorbidities that make it. Medically necessary? What is your BMI?
Afternoon
I feel so defeated as i write this 
.
My employer is switching to Cigna, and Cigna doesn't cover BARIATRIC SURGERY. I have done my nutrition assessments, all the testing the last was to have my A1C1 retested in January I need a 10, for surgery. Now this, it deems * Services that aren't medically necessary as whats not covered as well as *Bariatric Surgery.
Has anyone that has/ had CIGNA and have bariatiric surgery listed as a non covered; had it covered. Either by your surgeon listied your other diagnosis... IDK.
Im so upset I continue to cry because I have come so close and fought so hard for this and I really can not just stand her and watch it slip away.
If it helps Im in New York and my Surgeon is Gregory Dakin from Weil- Cornell.
Same insurance here in CA and looks like we have to pay a lot of ouf pocket becasue we havent met our deductible.....just switched to Aetna this week :(
Getting this rolling hasnt been easy. My wife and I just switched over to Aetna and attended our seminar this week here in San Diego. Come to find out becasue if our policy we are going to have to pay 2500 out of pocket for the Surgery either bypass or the sleeve......frustrated
This is in response to your inquiry regarding the status of the
authorization for surgery under case number xxxxx
A determination has been made and a letter was mailed to you on
11/25/2014 advising after reviewing all the information provided and
based on our Clinical Policy Bulletin 157; Obesity Surgery, the repeat
bariatric surgery is denied because the documentation submitted shows
you did not have adequate success (defined as loss of more than 50% of
excess body weight), 2 years following the primary bariatric surgery
even though you were compliant with a prescribed nutrition and exercise
program following the initial procedure.
The letter includes information on how to appeal this decision.
So, any idea's what to write back?
I paid for the mini sleeve only lost about 20 pounds.
Then got cancer and stuck at home gain weight back...also the mini sleeve was only a research operations.
Any help would be great!
Ruth, not sure what you are asking, can you re-phrase your question please?
great. You will get. Waymore infor/ replies now,if you start posting on the VSG forum,look under forums in the blue bar above.
thanks so much for posting this!!! this is great information and I didn't know this, I see so many posts for different insurance companies and questions, I now realize that those questions are moot. I am going to get my document and check I was going to look into mexico but now I am going to check my benefits.
Hockeymom87 · 0 replies · 630 views
