VERIZON-Cigna Change in benefits 2008

I just learned today that Verizon-Cigna has decided to no longer cover bariatric surgery starting 2008.  It says some mumbojumbo about it covering anyone who has already started the "1year prequalification process" may still be covered.  I was told it was a 6 month diet, not a 1 year, so I am confused and wondering since the memo was regarding all the insurance plans that maybe they are just referring to the HMOs that the 1 year thing would apply.  I have open access with Cigna, they said it was 6 months, 2 of which I have completed.   I am so upset right now.  I don't know what this all means.   

If your employer is the owner of the insurance policy with CIGNA, then contact the benefits administrator for your employer.  The benefits department is the only one that should be answering your questions.  If there is no benefits department, then contact HR.

the benefits center said I need to talk to Cigna.  .....

That's the plan, they open at 8am.  The thing that upsets me is that I called Cigna and was given totally different info and NOBODY at Cigna told me that the benefits they were reading off to me might not actually be the benefits that Verizon is saying I can have.  I even printed out a sheet that Cigna told me to take to my Dr., only to find this out now.

I am aware of the information you received. My partner works with Verizon Wireless, and I am covered under his plan, and we just received open-enrollment information. Your benefits administrator is Hewitt, but it will not have plan-specific information about changes to Cigna.

The packets that the vice president sent out really were just overview packets communicating that bariatric surgery would no longer be covered under any of the Cigna plans. The main piece of information to focus on is that Cigna will continue to cover those who started the process for bariatric surgery in 2007, which is the "continuation of coverage" that the benefits manual is referring to. For those who will have not started the process before 2008, bariatric surgery will no longer be covered. So, in reality, it does not make a diffeerence whether Cigna required a six-month or five-year supervised diet plan. As long as you have already started the process, you should be fine (barring no exigent issues).

Also, be mindful that there are some ambulatory-surgery co-pay changes to Cigna's plan as well, nothing significant though.

I hope I was able to answer your question.

Thank you for your reply, however now I am even more confused.  I just got the call back from the benefit center that unless I am actually APPROVED by Cigna before the end of the year, I will not be able to have the surgery covered.  I asked them to specifically check on this for me and the benefit specialist  talked to some contact at Verizon and said that she was "sorry" she had bad news for me that although I had seen the surgeon and was in month 2 of the supervised diet, I wouldn't be able to have the surgery covered. Where exactly did you get your info from?  I wish I knew who had the right info...lol..Ok I'm not really lol at all right now. If I go ahead with what is required, I will be spending over $500 on tests and surgeon fees that are non-refundable.  I don't know what the heck to do.

I am sorry for the confusion swirling around for you. I contacted Hewitt, our benefits administrator, this morning to get clarification, and I was told that there is a lot of employee confusion regarding the matter, so Hewitt is waiting on clarification from Verizon Wireless and should receive that clarification today.  He did confirm that transition-of-care benefits would be offered but could not solidify any other information.  I will contact Hewitt tomorrow to follow up. I, then, contacted Cigna for information.  Transition-of-care benefits will be offered, but whether one is eligible for them or not will be based on the date of approval of pre-certification for bariatric surgery.  Just in case you are not familiar with the term, "pre-certification", it is a request sent to the insurance company by the medical office for pre-approval o render a procedure (in this case, bariatric surgery) as well as for payment after the procedure has been rendered.  What is unclear is whether the medically supervised diet plan is included in the pre-certification process or not.  Some insurance companies require a pre-certification from the start while others require that the medically supervised plan be completed before pre-certification is requested.  The three representatives at Aetna could not clarify that for me either. So, at this juncture, I will contact Hewitt tomorrow to get the appropriate information for you.  I will also have my partner talk with his human resources department today to get clarification from them.  Human resources doesn't typically answer benefits questions, but it should be able to provide some insight since you are not the only one with questions regarding this mess of a situation. I will follow up with you.

WOW, you have really helped me out a LOT.  You have no idea how much I truly appreciate this info.  PLEASE keep me advised as to what you hear.  I could not get clarification either.   THANK YOU :)

All right, I contacted Hewitt again today to get a status update on what Verizon Wireless' definition of continuation-of-care coverage was, and I was told that those who started the pre-surgical weight-management plan would be covered for bariatric surgery into 2008, of course, as long as the procedure was deemed medically necessary. I, then, called Cigna to get more information on the pre-certification process for bariatric treatment and was told by a representative and a supervisor that the pre-certification submitted by the doctor is done before a patient starts the medically supervised weight-management plan.  So, as long as the pre-certification is approved and the date of submission and approval is before 2008, then any patient covered under it will be eligible for continuation-of-care benefits.  Anyone starting treatment after 2008 will not be eligible. So, it seems that my original assessment was correct in that you should be fine in continuing the treatment and having it covered.  However, just to ensure that there is no miscommunication, go to your human resources and tell them about the disjointed information you've received from Hewitt as well as from Cigna, and let them know that you want them to check into the matter definitively to ensure that you are receiving the right information.  To make the point, print out this thread and share it with them so that they can see how much back-and-forth nonsense you and I have had to go through just to secure what we HOPE is the right information. Also, from my understanding, Verizon Wireless is going through an employee-appreciation phase these days and is doing everything that it can to ensure that employees are content with the company and all the perquisites that it is offering, so it might be willing to go that "extra mile" for you to ensure that you have the definitive information to make an educated decision about whether to continue with the process. I hope I was able to assist you in some way.  Feel free to message me if you have any additional questions.

I just got the same info you did.  I talked to someone at the benefits center (who incidently confided in me she had had the surgery herself) and I was told that they are actually in the works right now to release a new statement.  She said what she THINKS is going to happen is that if there is anyone who was already on their supervised diet etc, BEFORE this statement about no coverage for 2008 was released, they may be grandfathered in to have the surgery in 2008.  I AM HOLDING ON FOR DEAR LIFE...lol...I actually started my supervised diet Sept 5, so by the grace of God I may have this suregery afterall! I have to say, I am VERY impressed with Verizon for caring enough to listen to their employees about this.  I hope this works out, we should know for sure in the next few days.  She said to keep all my dr appts and not to cancel anything.  She also said she could see that I had been in for weight management appts since Sept 5 and would collect my info because they are actually putting together a claim for all the employees who already started the qualification process. Lets just hope....and pray... Thanks for your help, it has been great!