SHOULD I GIVE UP?

After all I've been through i just found out my employer added a written exclusion to our policy not to cover gastric surgery on 5/7/06!!!!!!!!!!!!!!! keep in mind the denial i received was not for an exclusion, cigna stated in-adequte documentation of the 6 month diet history!!! yes I have contacted mr. viscio. I submitted my paper work in and have gone through the denial process...!!!!!! I need some (soilders) in this army to help me(please).. self funded plan....I was not informed by cigna or my employer that the policy would change.. this just happened on the 7th of june!!!!!!thanks you guys!!!!!!!!!!!

Hi Michelle.... Ever heard something like this.... Anything worth having is worth fighting for? Well, if you want this bad fight for it. Let me shed some light here... As long as you submitted for your approval BEFORE the exclusion was in effect BCBS has to allow you all the time necessary for you to fulfill what the originally denied you on. Your employer has the right to modify the wording at anytime but, they do not have the right to say you dont qualify because they dont cover it anymore. Now, Two things to me that need to be done are 1) For whatever reason BCBS denied you for fix it, correct it or supply the info that they need. 2) Under NO cir****tances allow time to run against you because then you may miss out. I would be glad to help you if you need any help with this and feel free to email me off board if you would like. Hang in there... It will be alright... Crece

Unfortunately BCBS CAN and WILL deny you if your coverage has changed. I got my approval from them in early December of 04 and my employer's policy changed in January 05...I had been approved in December...given until Feb to have the surgery THEN 3 days before surgery (on a Friday and surgery was scheduled for Monday morning) I was told that BCBS will not pay for it and my surgery was cancelled. Fortunately for me I kept fighting and made some alternative decisions which allowed me to have the surgery in April 05. Keep fighting!!!!!! Shree 336-pre-op 163-current