Please respond if you have Cigna and have been denied
I am just trying to compile a list of people who have been denied by Cigna in this past year. Please respond if you have been. i was denied yesterday and I dont intend to give up but after 01/01/04 Cigna will not even cover the surgery as if they are approving anyone lately anway. Thanks for all that sign or comment.
Generally speaking, it's your employer who decides what will be covered or not by the type of policy they purchase through a provider. For example, I have United HealthCare, and so does my boyfriend. I work at one of the nation's largest multi-media corporations and WLS will be covered in 2004. He works for a small company with only four employees and his policy has a specific exclusion that no surgery for a diagnosis of obesity or morbid obesity would be covered, even if having the surgery would prevent or alleviate symptoms of other medical issues.
Be sure and stay in contact with your own HR department, I've read other people on here who have gotten a denial appealed by working through their HR department.
Good luck.
~ T.
I have Cigna PPO. I was denied at first but then approved, very quickly, on first appeal. As a matter of fact Cigna called my PCP and confirmed that I had been on a 26 wk weight loss program. I was immediately approved.
I also know that the employer does have input as to whether WLS will be part of the coverage. However, I question if this practice is discriminatory. Excluding WLS, which is life saving for some and including heart surgery which is life saving for others seems discriminatory to me. Time will tell or the courts will tell.
Maryl
I am have been denied 11/19/03 and am working on my appeal. If you were denied prior to excluding WLS, you should have the right to appeal under the guidelines under the program at the time of the appeal. Even if they change the coverage you should still qualified under the terms of your coverage at the time of the request.
And I also believe each policy will have there own exclusions. What are your plans for this list ? Brenda Messina
I guess for now I basically want to see how many people they are denying and If I get enough, I may get a lawyer that will work with all of our cases at once if anyone wanted to join. Cigna has really made me one very mad person and it is not all over having this surgery, it has alot to do with their clueless cust. serv. reps. I get no answers out of these people and If i do manage to get one I can call right back and get a whole different answer, so i.e. they jerk you around and I have had it.
I also have been denied twice so far and i currently have my PCP fighting my battle with me. FYI its not all of cigna thats not covering WLS. Its certain plans. Fortunely my plan will still cover it next year so i f i need to contunie my battle after the first of the year i can. ANd just to let everyone know if your cigna policy quits covering WLS after the first of the CIGNA WILL NOT GRANDFATHER you in if you get approval. Hope this helps all
Kim in Florida