The worst timing!

[MissMelo 2]

My employer will be changing from our current insurance, oxford, to a new insurance company, cigna. What the hell am I gonna do! I had no problems with oxford covering the LAP-BAND®, but cigna is saying that they do not cover the surgery! I cannot have my surgery done before my insurance changes because I still have a few more pre op appointments. It is not listed as an exclusion with cigna, but they do have an exclusion for weight loss programs and the rep was saying that this would be classified as a weight loss program!!! That does not make any sense! What should I do guys! This is the worst timing ever! Please HELP!!!

[MissMelo 2]

Bump!!!!!!

[bwhitty 1]

Did you ask your surgeon if he/she might make an exception? Just tell them your insurance is changing and if you don't get it done by a certain date you won't be able to do it. They might look at what you have done and go for it.

[MissMelo 2]

Did you ask your surgeon if he/she might make an exception? Just tell them your insurance is changing and if you don't get it done by a certain date you won't be able to do it. They might look at what you have done and go for it.

I have no other choice. I honestly hope he will be able to squeeze me in before January. Could you imagine going from having everything in place and having the surgery 100% covered, to possibly having to self pay! I am beyond pissed at this point!

[amybethy 0]

My center said they are having some stop covering the surgery and they are willing to help speed the process along so you could still get your surgery. Hoping and praying your place will do the same.

[ape087 1]

Ask your dr for the insurance billing code, then call your insurance and ask them if they cover that specific code. My insurance (tricare) doesnt cover weight loss programs (I.E. nutritionalist visits, weight loss centers etc) but weight loss surgery wasnt under that catagory.

[Nevgal 2]

I have Cigna and they cover weight loss surgery of course the employers sometimes set the parameters for what will be covered. I agree about calling with the CPT code and get a definitive answer and ask the surgeon's staff for help. Good luck. Maybe this is just a minor road block.

[stargate713 0]

My Insurance made it sound like weight loss surgery wasnt covered, but it was. You need to call and ask if your employer has an "exclusion" for WLS. Sometimes you employer will have the exclusion on your particular policy.

[MissMelo 2]

Guys thank you so much for your help! My hr department just got back to me and said that it is a covered benefit!:frown: I was so excited! I'm still wondering why cigna tried to say that it was not covered? I'm also concered that I might have to start my six month diet over. Hopefully not, but I'm still going to try and get most of my pre op apps done before my insurance changes.:mad2: Thanks again guys!

[Cangel76 1]

Guys thank you so much for your help! My hr department just got back to me and said that it is a covered benefit!:frown: I was so excited! I'm still wondering why cigna tried to say that it was not covered? I'm also concered that I might have to start my six month diet over. Hopefully not, but I'm still going to try and get most of my pre op apps done before my insurance changes.:mad2: Thanks again guys!

I worked for CIGNA, I am not going to bash them or anything. However, as a person who had to quote benefits, sometimes things are not just cut and dry in the benefits screen. So as long as your HR confirmed that it was written into the benefits as a covered item, then you shall be fine. We had that problem, poor lady had cancer and we were denying her claims and when I talked to the HR department they said they were supposed to be covered. It took me 3 months and a lot of fighting with higher ups but I got her claims covered and the HR decided to stay with CIGNA because they were going to change insurance companies because of the problem. Keep your head up and your procedure will be here before you know it!