Numbers for SHBP members

I promised I would post the phone numbers where I got confirmation of the SHBP covering WLS as of January 1, 2009.

The SHBP DID NOT have the info regarding WLS, I had to call Cigna and UHC directly.

Cigna 1-800-244-6224
UHC 1-877-246-4189

According to the Cigna rep, the information had just been "updated" in the computer as of 9-25-08.  Cigna will cover LapBand and RNY, but not VSG (considered experiemental).  I'm not sure about UHC.

-Elli

So Cigna is NOT going to cover the DS? Thanks! Kimberly

I think they will, this is what their website says:  (and you can search yourself www.cigna.com  on their website is a search engine...put in "obesity surgery" to find their policy statement)

 

-vertical banded gastroplasty
-Roux-en-y gastric bypass
-laproscopic adjustable banding
-biliopancreatic diversion with duodenal switch for individuals with a BMI greater than 50

Hope this helps.

-Elli

how do you start the 6 mo supervised diet with cigna choice fund HRA (new ins choice starting jan 09 for state health benefit plan)?

I noticed you have the VSG scheduled in December. Are you going to change your surgery so that it is covered? Or self-pay for the sleeve? Kimberly

I'm actually in the middle of appealing my denial.  i scheduled that anticipating I would pay out of pocket if my denial wasn't overturned. 

I will not self-pay for the sleeve.  I will cancel that surgery date, unless I actually win on my appeal.  I suspect I will not win the appeal and my surgery (which I anticipate to be RNY) will be in early 2009.

-Elli

I called UHC today -- they were able to tell me that the HDHP and HRA plans will cover 'morbid obesity treatment'. However, no one was able to tell me what types of surgeries they will cover. I called the care coordinator and SHBP (who did not even have the info that UHC would cover the surgeries at all yet!). Frustrating! The lady from UHC I spoke with (very helpful, btw), said they did not have much information yet, but that they should have it by October 10th. Unfortunately, I am scheduled for surgery on the 8th! I am going to call Cigna to see if they pay for the DS as a two step procedure... Kimberly

I knew the SHBP didn't have the info yet.  Not even my benefits manager (of my school district) had it.  It's a brand-spanking-new decision.  Hopefully, by October 10th, we'll be able to see the whole health insurance booklet to compare apples to apples.

Good luck calling Cigna.

-Elli

This is so wonderful to hear.  I almost cried when I heard this news today.