Self funded insurance?
Does anyone know anything about this? I work for a large utility company, we have Cigna EPO for insurance. I was told that our insurance is self funded through the company. Does this mean that we don't need to be pre authorized to have the surgery, or does that make it eaiser to get approved? I read on a couple different profiles that other people had insurance that was self funded through the company, & it looks like it made it easier for them to get approved. I asked the insurance company when I called them yesterday, but they acted like they had no idea what I was talking about.
Self funded insurance means that your company pays your premiums, either through your deducations from your check or from their funds, or a combination of both. Cigna is the "fund administrator," i.e., they take the policy that your company has approved and administer it for the employees. There is very little difference for the patient. You still have to abide by what the policy says. If there is an exclusion for WLS, it's very difficult to overrule that. However, if you have a really great company that cares for its employees, they could overrule, or bend the rules, to help you out. It did n't work for me -- I was denied after two appeals. Had to change jobs to find better (for me) insurance that covers it.
Rose