Question:
Tummy Tuck and Arm Lift...Cigna HMO...approval prodedures?

I have Cigna HMO (I live in FL). I'm nearly 7 months post-op and I have lost 150 lbs. I'm about 35 away from my personal goal. I am currently looking into a tummy tuck and arm lift. The only plastic surgeon I have gone to see (so far) told me that insurance companies do not cover either procedure (which I know is wrong...because I've heard of other people whos ins. paid for the tummy). He told me to self-pay, have surgery, submit to the ins. company and IF I get $500 reimbursement, I'll be lucky. This just doesn't sound quite right. I told him I knew I'd have to pay for the arms...but the tummy? They won't even submit to the ins. company. I need some info on procedures for approval, especially if you have Cigna. Also, if you could throw some Dr's names out here, I can see if they're covered under my plan. ANY info and responses are greatly appreciated!    — Kristin R. (posted on April 12, 2002)

April 12, 2002
Go to the Cigna website and find plastic surgeons in your medical group. My surgeon also told me insurance would not cover the abdominoplasty. I had a nasty battle with Cigna HMO, and went through three appeals, but in the end they paid. I ended up paying for my surgery up front, and then getting reimbursed, even though it was an HMO. The critical issue to my approval was that I had documented multiple visits to the doctor for the problems the pannus caused, as well as tried various other means of dealing with the problems. I would encourage you to wait another 6 months at least for any reconstructive surgery to allow your weight loss to stabilize and your skin to settle in. You really don't want to have to go through the pain of these surgeries only to have the results affected by additional weight loss. -Kate-
   — kateseidel

April 12, 2002
Thanks for your answers! I just wanted to point out that although I'm looking NOW for a surgeon...I really wouldn't be able to consider having it until fall. Also, I went to the cigna website...found some local doctors...contacted some and have already heard back from a few. I have consults (free!), so that I can learn who I like, how much it's going to cost, etc...so that I can plan ahead. Thank you so much, both of you!
   — Kristin R.