2005 Denials, Relax and Avoid them.

There have been so many posts and emails about 2005 that a panic is being created. First, every policy is different. BCBS declared an exclusion in 2004 yet they were covering it in most States this year. That is because each policy and then each State are different. Also, self funded plans fall into a different catagory. Second, the plans may renew at different times during the year and 1/1 may not be the renewal date. What you need to do is look at your specific policy, read it, know it and then apply for it. If you are denied, look at the reasons why and the State or Federal Law (if self funded) and determine how to overcome the denial. Most of all, do not panic. 2004 was slated to be another grim year, yet the surgeries continued. Many exclusions were overcome and many were not. Don't lump yourself into someone else's catagory and give up. Fight back and win!!! Best of luck. Gary Viscio www.obesitylawyers.com

RIGHT ON BROTHER GARY!! Gary is right about "DON'T PANIC" but get your act together and get your facts straight before screaming and beating your children up. Donna

Gary, answer me this. I was approved on December 3rd 2004. However, I would not be able to get in till January. (Dr was already booked till then.) The approval letter that Cigna HMO sent me said that my approval date was for 12/31/04 only. So I called Cigna and talked to TWO different reps who stated that my benifit plan was not downloaded yet, so they could not tell me if I had the surgery in January if it would be approved or not and to call my HR partner at work. I did just that. She in return, stayed on the phone with me and call Cigna.. the girl there stated that YES, I would be covered and not to worry about a thing. Well, it's 2005 and the confirmation of the date was being sent in, only to find out that my company did not pay to have the WLS done. So I am being told now that I am no longer approved. Are they able to do this???