CIGNA RELAXING?????????

I wouldn't think so. Exclusions have nothing to do with working with your insurance which is what Obesity Law primarily if not exclusively handles. For WLS, w/ an exclusion in your policy, it is equivalent to you being uninsured. I agree with the last post that you are probably going to have to take out a loan to pay yourself if you choose to have surgery. Medical necessity would not even play a factor in this one, you just don't have the insurance for it...

Therese, Do you have your paper copy of your coverage yet? Or are they verbally telling you it is an exclusion? It is very important to get the written copy of your coverage. My DH 's company told me on the phne that there was an exclusion, I got the hard copy, and they way it was worded allowed a loop hole. Ours was worded that like this...
Coverage Exclusions
1.
2.
3.
4. Any and all procedures done for the purpose of reduction of weight.

BUT my DR coded everything so that we were not reducing weight, we were treating a disease process and the co-morbidities. The insulin resistance, the high BP, the sleep apnea, the elevated cholesterol, etc.
Where there is a will there is a way. Now- the way may be to self pay, BUT you should at least make an attempt to see if you can get around the coverage.

The other option is does your company offer ins? If so- check to see if they cover it. Ask for a copy of the coverage, and tell them that you are considering switching off dh plan and you want to see what they offer.

This is also true.. If it is not in writing it may not be enforceble and they may not be as strict as is sounds....  It may be in how you word it when you ask as well. I do know a few people who states that if you call and ask your insr co what "PROVISSIONS" they have for people who fall in to the catagory of "OBESITY". Or under what cercomstances "WLS" might be consided as a Weight loss option.. I have heard some people have gotten a different answer. I know a few people who have taken the exclussion thing to the mat and some of them with some really good results.

Insurance