Surgery for State of Illinois Employees

I am a State of Illinois employee who has been denied for the lap- band surgery by Health Alliance and CIGNA because it is considered "experimental," even though I explained that my health is at serious risk and that my daughter has lost over 100 lbs. thanks to this "experimental" surgery. I would like to know if any State of Illinois employees have been approved for and received the surgery, and which insurance company approved it. Thanks for any help anyone can offer.

I work for the state and I had surgery 1-17-05. I have Cigna and once I met their criteria I was approved. I did have to remain diligent with phone calls to make sure things moved in a timely manner but it took me fron nov. 17 when I submitted til 1-17 for my surgery.

It took more than 8 months for me to get approval eventhough I had over 600 pages of medical documentation to support medical necesity. I ended up hiring a lawyer to help and finally won approval on the second appeal. Send me an email if you need more info on lawyer. Start a journal NOW. Takes names of who you talk to, what they said, and the date that you spoke to them. I, too, work for the state. My surgery was April 2, 2004 and it has made a huge improvment in my health. Good luck

I don't have experience with HA or CIGNA - but wanted to tell you that my insurance would not approve Lapband with ANYONE either, but I was approved for open RNY finally. I have Personal Care - is that still an option for State Employees?

Then I would ask for proof the lap band is experimental. And if they prove that, then ask them, what is an accepted WLS that is covered. Research your surgery of choice, find evidence supporting the procedure. Have your Doctor write a letter about the procedure. Keep going, don't stop.