Cigna bariatric surgery approval

Gastric band surgery

The most acceptable type of obesity surgery carried out in the western World.  We are pleased to offer the best priced gastric banding cost presented in Europe and a fast recovery time following surgery.

Cigna Pre-approval Requirements* (AVAILABLE IN USA ONLY*)

Unless weight loss surgery is specifically excluded from your policy, surgery is covered if the following criteria are met:
The individual is at least 18 years of age or has reached full expected skeletal growth AND has evidence of EITHER of the following:

  • A (BMI) of 40 or greater. Check here
  • A Body Mass Index between 35 and 40 with at least one significant comorbidity that may include:
    • Type 2 Diabetes
    • High Cholesterol
    • Heart Disease
    • Pulmonary Hypertension
    • Obstructive Sleep Apnea

You must also show that other methods of medically supervised weight loss programs have failed.
The medically supervised weight management program must include monthly documentation of ALL of the following:

  • weight
  • nutritional program
  • exercise program

An evaluation from a bariatric surgeon and your primary care physician with a resulting recommendation for surgery is necessary. A mental health evaluation is required as well as a nutritional evaluation from a physician or registered dietitian.

Types of Weight Loss Surgeries Covered By Cigna

If you’re unsure which procedure is right for you, take our test.

Are lap band fills covered?

Yes, Cigna covers lap band fills as necessary.

Procedures excluded from coverage

  • Gastric bypass combined with a gastric band
  • Biliopancreatic diversion without a duodenal switch
  • Fobi-Pouch
  • Loop gastric bypass
  • Intra-gastric balloons
  • NOTES – natural orifice surgery (Stomaphyx, etc.)

Is a second weight loss surgery covered if lap band doesn’t work?

Yes, it is covered if the first procedure was unsuccessful. An unsuccessful procedure is defined as a failure to lose 50% of excess body weight.

Does Insurance Company Require Center of Excellence?

Cigna does not appear to require a COE designation at this time.

Do I have to use an In-Network Bariatric Surgeon?

While your out-of-pocket expenses may be higher, you do not need to choose an in-network provider. Individual policies may vary.

Cigna’s Contact Info to Inquire About Surgery

For questions on Benefits with Cigna call: 1.800.CIGNA24 (1.800.244.6224) (available 24/7)

please not that CIGNA is a USA Based Medical Insurance Company and not available to UK/EU residents

 

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