State of TN employees

I am a current state employee.  I had the lap band procedure on 8-17-10.  I have just found out tonight that the state insurance plan  will not cover weight loss surgery of any type next year.  The insurance company I was speaking with is also unsure if lap band fills will be covered next year or anything else associated with weight loss surgery.  This also applies to school employees and others besides just state workers.  Because the insurance companies just administer the plan, they have to find out from the state what will be covered.   The insurance company is supposed to call me back tomorrow and give me more information on this horible news.

I feel like they have hid this information from us, I have been trying since August to find out what will and won't be covered.   Our open enrollment started on September 15, but I haven't been able to get an answer  til tonight.

I was told today that cigna was wrong and the state will cover weight loss surgery.  I am still not certain, I don't think any of them know what will be covered or not.

I am a teacher, and I am signing up for Cigna for next year during open enrollment.  I have been told by Cigna and ParTNers for Health that bariatrics is still covered.  It's the only reason I'm signing up.  It has been so frustrating trying to get information about what will be covered and the type of coverage we will have.

I was also told the Cigna state plan would cover surgery and the fills...crossing my fingers....

I have called both Cigna, BCBS, ParTNers for Health, and the dept that handles insurance at the state (can't remember what that office is called).  They have all told me bariatrics will be covered.  BCBS requires a 10 % weight loss during the medically supervised diet and Cigna does not.  I am so thrilled!  It is an answer to a prayer.  I've already started the medically supervised weight loss w/my dr.  I will have insurance for this in January and January will be my last month with my dr, so I'm hoping by February I will be good to go!!!

I was told by my surgeons insurance coordinator the 2011 insurance plans will cover bariatrics.  However...the State is selling them to us as 'the same' and we just need to look at providers, and decide which one we want.  My surgeon has a $3000 program fee.  My United Healthcare (current ins) pays $1500 of that.  My coordinator called last week to let me know Cigna will pay the program fee 100%, and BCBS pays nothing toward this fee.  So choose carefully and GOOD LUCK.  This lack of ability to provide information seems so unfair.

I was submitted to insurance Friday...so hopefully I can have the surgery this year, and not get wrapped up in all that next year......

Too bad I didn't know this before our enrollment period was up.  If I can't have my surgery before Jan. 1, we'll be paying a substantial amount on our own.  My own PCP (who has several patients who've done WLS) says that he's never had a problem with BCBS authorizing surgery but that Cigna has turned people down.  Interesting.