Question:
HOW CAN CIGNA SAY A SURGERY IS COSMETIC WHEN THE DR SAYS MEDICAL NECESSITY?

   — CHRISTIE S. (posted on May 3, 2004)

May 3, 2004
Hi, you can check out my profile if you like. I had quite a few problems with Cigna. I finally got approved after being denied twice and then making an appointment to go before their medical committee. You're doing the right thing by finding out what others did to get them to pay...don't give up! (30 weeks post lap-rny... pre op 253...now a happy 168lbs!)
   — Kimberly S.

May 13, 2004
Cigna (and most insurance companies) are going to deny you out of hand, citing the request as cosmetic. This is the way they operate. Less than 40% of patients who are denied will go on to appeal. Cigna denied me as well. However, once I sent them my appeal packet, which I faxed and mailed, they approved me in less than 2 weeks. I had panniculectomy and breast lift approved, and paid the dr the difference to upgrade to a full abdominoplasty. Hang in there. AND SEND PHOTOS WITH FRANK, HONEST REMARKS...like an editorial. Good luck!!!
   — lisachris

May 19, 2004
they are in business to make money not help people. each ins. co has its own criteria for medical necessity. and almost any doc will say they feel it is medically necessary even if they think it is just cosmetic. this is why I personally am working as many hours as possible and saving every penny I can to pay for my own surgery.
   — **willow**