CIGNA policy change at end of December 2004

Has anyone else run into this? Just had my appt with Surgeon and his team yesterday.(12/9/04) After going over the information, my research, comorbidities and BMI etc. we went to schedule everything. Apparently CIGNA sent an e-mail out the day before stating after 12/31/04 they are NOT covering bariatric surgeries. Quelle surprise.... Needless to say, I was very disappointed and am looking for a different insurance carrier

Tara, Is there any way they can schedule everything right away and get it done. I have Dr.Lautz (he's great) and I know he is on vacation the last week of december. I would call Eileen and see if this is possible. I hope they can finagle this for you. Good Luck,Joan F.

joan, thanks for your response! Unfortunately, CIGNA requires 30-45 days to get their act together- Actually, Dr. Lautz and Eileen were troopers and tried to find a way to schedule early but we wouldn't be able to meet this 30 day thing. I'll be making calls on Monday for changing ins. carriers-prefer Harvard Pilgrim. I know some ins. co.'s have initial waiting periods for certain procedures- just don't know if this is one of them. (Adj. Lap Band) thanks again for being there!! Tara

Just an update: I called and asked CIGNA why they are NOTcovering this procedure after 12/31/04. The only response any one could give me was that their guidelines have changed. So I have decided to terminate my coverage with CIGNA as of 12/31/04 and take my health and my business elsewhere. Happy Holidays! Tara

Hi, Tara....I'm a former Massachusetts resident, now back in Minnesota...but every once in awhile I get nostalgic, so I log onto the MA board to see what's going on. It is so unfortunate that CIGNA has decided not to cover bariatric surgeries any longer.....however, the question that would come to my mind first is - is this an employer plan where you get your coverage through work? If so, is that insurance "self-funded" by the company you work for (meaning that the company ends up paying all claims up to a certain dollar amount, over which the actual insurance kicks in.) Something you may not realize is that if the coverage is self funded, it is very likely your employer decided to eliminate the surgery from their plan, due to cost...and it wasn't CIGNA's decision. If the plan you're in is NOT self funded by your employer, but is what they call "risk based" or "fully insured", that's a different story. It may be that the insurer is eliminating coverage for the surgery because they'd have to increase premiums to their customers too much in order to continue to be profitable....and then, they'd no longer be competitive in the marketplace. It's wrong and it shouldn't happen....but it does. Now...if you had an individual policy, none of this even applies. You may want to check out BCBS. I have coverae through them and am hoping to get approval for RNY surgery right after the new plan year begins for me in January! Good luck....and hang in there. MJ

hi tara just call the insurance company they might still pay for the gastric bypass. sometime they will say if you have tryed everythere dieted they will cover it maureen from ma