? for Gary - "experimental"

Hi Gary, Question for you.  How can CIGNA deny one person for the DS saying it is investigational/experimental but yet approve someone else for the same procedure?  Isn't that illegal? If it's an approved procedure for one, shouldn't it be an approved procedure for all?  Thanks, Lyndia

Youre 100% correct.  The problem is they do what they can in the states where they can.  So, if say NY forces them to cover the DS, but in LA the state doesn't, then they use that as an excuse. THeyll say that while it's a National company each State has its own set of rules. I would say though, that it is an argument to use against them, and if sued, no way could they defend two different positions.

Thanks for the response!  My packet is now in the hands of the external appeals company so we'll see how it goes.  I'm hoping it will end with them, but if I have to take it further, I'm ready. Thanks again!! Lyndia