So upset with benefits through employer

[Tvorceskiy 6]

I have cigna and I know they cover the surgery. I've studied their policy inside and out. Just to make sure my plan really did cover the surgery I called them today only to learn that my father's employer (who I am covered under for another year) has chosen to still consider bariatric surgery as "cosmetic".

It sucks because I was so hopeful that I could finally get healthy and feel good. I know the surgery will cost them less in the long run...but is there anyway I could appeal to his employer? Anyway around this other than self pay?

[iggychic 1,405]

the employer can only make changes to their plan off their renewal period if they have made a legal mistake (ie bariatric coverage is required in some states with different conditions per state). Their renewal does not coincide with your plan, so you could speak with the employer and ask them to consider adding this coverage for their next year. (You can also look at your state's legal requirements to be sure they meet the minimum...I've seen many occasions where people don't).

We are self insured and this is the sort of thing we like to hear about from our team. Our goal is to provide the best coverage in the business, both as a benefit to our team's well being and for competitive reasons (helps us get the best people). So when we learn that we are lacking in an area from someone we look at how to make that work in our program. When I had my surgery we saw we were lacking in this area and will make the changes for the next period. We did the same for fertility and adoption benefits after seeing we were low.

Typically employers go with a plan that is sort of standard, then add bits here and there as necessary. It's impossible to sit there and say "how much do we have for this and that" because it's overwhelming, so we get guided by our administrators. Which is where you come in Yes tell his employer. He may or may not make the change, but it's worth a shot.

That said, this probably won't help you during this enrollment period. He can't just add the coverage for you as an appeal.