Doctor appointment on September 24th, 2008

Sep 27, 2008

I had my DR appointment for my yearly inspection, and to talk to my DR about the letter of exclusion I got from Cigna. He told me that if it was excluded then that is what it means. But I could call the insurance and ask if there was a way around the exclusion, if my DR thinks that this surgery would benefit me, since I am diabetic type 2 and also have high blood pressure. I was thinking I had read on here somewhere that i could get my DR to write a letter to this effect and get around the exclusion. I also talked to my primary DR about quit smoking, and I am going to start taking chantix Monday, September 29, 2008. My goal to stop smoking christmas 2008 or before.


The following day I had a DR appointment with the surgeon that done my knee surgery. I told him I had checked into gastric bypass and he wanted to know what I found out about it. I told him it was excluded on my insurance and he offered to write me a letter stating that he recommend I have the surgery for health reason, instead of weight loss. I left his office feeling like there might be a chance I could still get the surgery I need and want.


So I am off to do more research and see if anyone else has had these same problems with their insurance, to see if there are any ideas I haven't thought of.



Insurance letter of Exclusion!

Sep 18, 2008

I finally received the letter from the insurance company (Cigna), stating that gastric bypass/lap-band procedures are excluded under our benefits plan.

Here is what the letter stated: The following services are excluded under the plan: Medical and surgical services, initial and repeat, intended for the treatment or control of obesity, including clinically severe (morbid) obesity, including: medical and surgical services to alter appearances or physical changes that are the result of any surgery performed for the management of obesity or clinically severe (morbid) obesity; and weight loss programs or treatments, whether prescribed or recommended by a physician or under medical supervision are specifically excluded under the plan.

Now to plan my next hoop to jump through. I have a doctor appointment on the 24th of september. We will see how that goes with my primary Doctor and see if he has any ideas. Also to talk to him about my options to quit smoking. :)

Have a GREAT weekend!

September 8, 2008

Sep 08, 2008

We went to talk to the HR person at my husband's work today about the exclusion of surgery for gastric bypass. The HR person called there broker, which in turn will contact the insurance (cigna). The broker called the HR person back and said it shouldn't be a problem to get the letter. We should have the letter by friday or saturday. The HR person said if there was anything come up she would call and let us know.

Think I have joined the circus, taking up jumping through hoops. :)

Obesity Surgery Seminar

Sep 07, 2008

I attended the obesity surgery seminar at Bothwell Regional Health Center in Sedalia, MO. Dr. Phillip M. Hornbostel, M. D., F.A.C.S. lead the seminar. It was very informative and promising. My only downfall is that my husband's insurance is Cigna, and gastric bypass is excluded in there benefits package. Needless to say we will be making a trip to his work and talking to the HR person tomorrow to get the skinny (so to speak) on this exclusion. I am not giving up yet.

After going to the seminar, I know this surgery is for me. :)

About Me
Blairstown, MO
Location
52.1
BMI
Sep 03, 2008
Member Since

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Doctor appointment on September 24th, 2008
Insurance letter of Exclusion!
September 8, 2008
Obesity Surgery Seminar

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