cigna - ThinnerTimes

bebop · 05-24-2008, 12:22 PM

my sil is 6'1 and 377. he has had 2 really bad bouts with leg infections and is now at the er getting iv antibiotic. he has cigna but wls is excluded from his company policy. does anyone know if there is a way around this exclusion so he could get the surgery? we are desperate here at this point. he is a truck driver so not the best lifestyle to say the least.

bebop · 05-26-2008, 08:43 AM

huh? what does that have to do with cigna? hehe

Native2u · 05-26-2008, 08:46 AM

Quote:

Originally Posted by bebop

my sil is 6'1 and 377. he has had 2 really bad bouts with leg infections and is now at the er getting iv antibiotic. he has cigna but wls is excluded from his company policy. does anyone know if there is a way around this exclusion so he could get the surgery? we are desperate here at this point. he is a truck driver so not the best lifestyle to say the least.

I'd probably ask the insurance company if they would consider him, due to the fact that he is having those kind of issues with his legs. How often does he see a doctor...like for weight checks and other stuff (where his weight would be taken)?? You might need to hire an attorney, but, it might "can" be done. I'd start by asking you insurance company...what hoops do they need him to jump through, first. I know that you said that Cigna doesn't cover it, but, there has to be something in the fine lines somewhere.

BabyNicole · 05-26-2008, 10:33 AM

Quote:

Originally Posted by bebop

huh? what does that have to do with cigna? hehe

Spambot. I thought the same thing a few days ago.

BabyNicole · 05-26-2008, 10:36 AM

Quote:

Originally Posted by bebop

my sil is 6'1 and 377. he has had 2 really bad bouts with leg infections and is now at the er getting iv antibiotic. he has cigna but wls is excluded from his company policy. does anyone know if there is a way around this exclusion so he could get the surgery? we are desperate here at this point. he is a truck driver so not the best lifestyle to say the least.

I agree with Native. A lot of times there are ways to get around the system. You may also try to find a surgeon who has a great insurance team that helps you with everything you need get approved. My surgeon even has lawyers (for free) on the team to help fight the third denial. Also, when you call Cigna write down everything they say with the person's name, date, and time.

Good luck to you and your family!

Godsblessedme · 05-26-2008, 11:22 AM

usually there is a way around it BUT when the employer writes it in as an exclusion its because they didnt want to pay for the benefit there fore usually there is nothing you can do as its an exclusion and not even underwritten into the policy. thats like the only bad thing is the employer chooses what to allow and not allow it makes their rates cheaper for them. My advice is if theres any way to get him different insurance and make sure WL surgery is written in a policy

bebop · 05-26-2008, 11:26 AM

I am not sure how it is written up but I will get him to look into it maybe tomorrow since today is a holiday. thanks for the replies

Godsblessedme · 05-26-2008, 11:28 AM

and check with the employer HR department because they will know if they excluded it or not

Native2u · 05-27-2008, 05:06 AM

Also, most insurance companies have all of their policies written and placed on their website. I have Aetna and they have all of their policies (do's & don't's) on their website.