CIGNA and Sculptra Coverage
Jun 1, 2010
Hello, I have PPO coverage through CIGNA and was wondering of they are now covering this for my facial lipo? I called them and they asked for a diagnosis code. Since I have Medco for my prescription coverage, would I need to appeal to them also, for the actual drug? Thanks for your reply
Response from Dr. Pierone
Hello and thanks for posting.
Historically, very few insurance companies have paid for Sculptra or Radiesse for treatment of HIV-related facial lipoatrophy.
Now that Medicare has agreed to cover this indication it will help push insurance companies to do the same. But there needs to be pressure from patients and doctors to have insurance companies provide coverage. This means submitting claims, filing appeals, and also following up with regulatory agencies. As more people pursue this issue with persistence and vigor, we will start seeing positive change from the insurance companies.
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