Question:
Has anyone had Cigna HMO approve reconstructive surgery?

I have Cigna HMO and am in need of a pani and the bat wings fix as well as a serious breat lift (reduction). My apron doesn't hang terriblly but enough for a few hygiene issues, my batwings I could live with but my breats have gone from a 40D to a 36DD and my shoulders and back are crying for relief. Has anyone been sucessful fighting Cigna to cover any of these surgeries? I had to fight 13 long months to get the WLS approved and was wondering if I'm up against the same type of situation for this too. Thanks in advance :)    — lilmskitty (posted on August 26, 2002)

August 26, 2002
I have Cigna HMO of FL and I submitted for a TT. They denied me; their letter said that they don't cover it because it's considered cosmetic. They told me that in order for it to be considered reconstructive, the medications that they prescribed for rashes needed to fail. I also had to have the dermatologist and my PCP document that counseled me on proper hyegine; and that I was following those instructions~yet they must lead to failure. Also, when/if you get any RX's for rashes, keep the receipts. Document with pictures; both the skin and the rashes. Finally, make sure that all letters that are submitted to Cigna say it is "medically necessary". Oh, and by the way...I too want my arms done, but I know for a fact that they will NOT cover this :0( so I'm self pay for arms. Good Luck and if you find any other valuable info, pass it along!!!
   — Kristin R.

August 26, 2002
I have Cigna HMO and have found them horrendous to deal with. For example, I nearly died of appendicitis earlier this year because they were "dragging their feet" on approving the necessary tests to diagnose the problem. Fortunately, I had the good sense to go to the ER rather than waiting around for Cigna to get their sorry butts in order! I doubt Cigna will approve my reconstructive surgery, so I'm just trying to be patient and am saving money in the meantime!
   — Terissa R.