42 − Elevation of the head of the bed for patients who develop heartburn or regurgitation when lying down; or − Avoidance of recumbent position within 2 - 3 hours after a meal; and • Laparoscopic implantation of a magnetic esophageal ring is intended solely as a minimally invasive alternative to surgical treatment. • The individual does not have evidence of: − Barrett’s Esophagus − Esophageal cancer − Motility and/or swallowing issues − Previous bariatric or esophageal surgery − Morbid obesity with a body mas s index > 35 kg/m2 at the time of surgery − Significant hiatal hernia > 3 cm as defined by manometry, upper GI (barium swallow), or endoscopy (one of these measurements should be 3 - cm or less) ; and − Allergy to titanium, stainless stee l, nickel , or iron mater ials Coverage is available for the implantation, replacement, and/or removal of the device, and for the device itself, when the above criteria are met. Coverage Information Charges for treatment of GERD with a laparoscopically implanted magnetic esophageal ring are subject to all limitations as set forth in the Schedule of Benefits and the section on Covered Charge Limits. • Coverage for these services is limited to in - network benefits only. • There is no out - of - network coverage for implantation/removal of a la paroscopically implanted magnetic esophageal ring or for the device itself. • Coverage is available only for use of a laparoscopically implanted magnetic esophageal ring where it is medically appropriate as outlined above. Covered and excluded procedures as well as clinical guidelines are subject to change without notice, as appropriate, in accordance with advances in treatment and changes in industry standards as determined by the Plan or the Claims Administrator. Note: Prior authorization review and approv al is required. Please ask your physician to contact Cigna well in advance of any proposed procedure to implant or remove a laparoscopically implanted magnetic esophageal ring. Mental Health Services The Facility, Practitioner, and Medical Support Charges incurred for the treatment of mental health conditions are covered medical charges under the terms of the Plan, provided the charges meet Mental Health Services definition. No other charges outside this definition incurred for treatment of mental health c onditions are covered medical charges under the terms of the Plan. Benefits for Mental Health Services will be eligible for payment only if the treatment is provided by a Hospital or a Mental Health Residential Treatment Center, or by a physician or a psyc hologist holding a Master or Doctorate in Psychology, or another similarly degreed practitioner legally licensed to provide Mental Health Services or practice psychotherapy by the state in which he or she practices.