Any advice with Cigna POS? Just beginning my journey.

Does anyone have any info that I should arm myself and have ready? I have Cigna POS and hear they are a pain in the rear. I do have out of network and WLS is covered if Med Nesscary & my PCP is fine with it and we're just getting started. First of all I called Cigna to check if WLS is covered which it is only if Med Necessary, ok then I told them that my PCP is advising me of it & that I am looking for a surgeon in my network. The CSR would not tell me which surgeons are participating & said that was up to my PCP to refer me to one. Having been a Med Office Administrator I know my Dr. dosen't know every surgeon, besides they always change & drop & U can't be sure of the provider directories. I asked the CSR how I could find out. She told me to get the listing of General Surgeons that are in-network and call each one that is within a 75 mile range from my home. If I couldn't find a in-network surgeon that if I saw an out of network surgeon & he agreed to whatever Cigna would pay than they would conside it in-network only if I couldn't find a surgeon within 75 miles of me. Now I have a 2 mo old baby I can't travel 60 mi for office visits. Thanks to this site of people who have listed their surgeons I did find one that is in my plan & called the office. Was told that Cigna is very hard & that I would have to have proof that I have been on a supervised diet & exercise program. They gave me info on a dietician so I have that appointment. This is so redundant because my PCP already tried Meridia with me and as far as exercise I have OA and I'm 31, was DX with Rheumatoid Arithritis when I was 5, now my lft knee joint is basically non-existant, no one will do a joint replacement because of my age and diet alone isn't working, if I'm not active how can I loose the weight. Also have 3 herniated discs and asthma. Oh yeah going back to the arithritis, I can remember when I was 16 and arguing with the doctor that no one knows the side effects of these arithritis drugs and look what has happened with Viox (which I have take-wonder what damage if any I may have from it) and also Celebrex (which is another one they should ban)..I'm not keen on taking Embrel will discuss that with my rheumatologist on Monday. Anyway, going back to my question, is there anything that I should prepare myself for when dealing with Cigna? I also have hypothyroid disorder and it wasn't till about 7 years after the surger that I began putting the weight on. My surger in 93 was only a parital thyroidectomy and I was never put on replacement therapy after surgery. Then doctors that I saw told me I was crazy but now I have been under the care of an endo for 4 years and no change. The weight still exists. I feel like I my body has been a prison for the past 7 years and it's time I get a pardon. Thanks for anyones advice.

Hi again My Cigna benefits were also in or out of network. I opted to go out of network and use Dr. Andrei out of St. Barnabus, in Livingston. I had met my deduct and out of pocket maximum so it wasn't that bad of a financial hit for me. I had called over 60 Cigna general surgeons and 95% of them didn't perform the wls and the ones that did, they did not specialize in it. Don't plan on Cigna being muc help in this area. I have lost of stuff from my Cigna journey and would be happy to mail you the info. If you would like it email me and we can chat. Susan

Thanks alot for any advice. If i had any cash I wouod just go out of network, my mom had her surgery with Dr. Rafael Capella 11/2003 she was 5'6" 350 and is now 179...but my company went bankrupt so I am on unemployment with a 2 mo old baby & my husband is working. We already have debt and have knocked it down considerably but was hoping to get out of debt this year. I also think Cigna is going to give me a hard time. When I found out I was pregnant last year I was happy but had a severe case of hyperemesis which had me on bed rest, I had 2 hospial admissions, the one from March 03 was about 28K & the other about 35K and I haven't seen the bill from my delivery in October, so I know Cigna is going to give me a really hard time, not too mention I was on bed rest for 4 months with a pic IV line and had a nurse visit. I was so sick vomiting during my pregnancy I lost 25 lbs but could not even hold down water and had to have a machine constantly pump meds into me 24 hrs a day. But the last 2 1/2 mo of my pregnancy I gain the 25 lbs back which I didn't mind because the ultrasound showed my daughter to be very tiny but when she was born she was healthy 8.6 lbs...then I think I had the post partum depression and gained about 10 lbs from that.But thank God my daughter is healthy & normal & right on target in for her age.. I'm really trying not to worry about things too much and pray & leave things in Gods hands.