Re: Cigna sucks

[Guest guest]

Sorry u r getting the same as me!!! I can not believe that this is so hard.

marg

[Guest guest]

I'm about ready to put United Healthcare on that list too. They denied my

appeal yesterday because, " the MGB procedure has not been proven superior to

the RNY by a peer review board. "

I'm on to the greivance committee now, and then the Fla insurance commission

if that doesn't work. My benefits mgr. for United @ the school board says,

" Dr. R, can't be the only one doing this procedure. I should be able to find

a general surgeon in-network to do the same thing " . I have explained to her

the facts, I don't know if she's slow or just doesn't care and will say

anything to me.

And my care coordinator's wife just had the Lap RNY from Dr. marema last

month, and he his having one in Jan. so he keeps saying, " don't worry

Ruqayya, you can always go to Dr. Marema, he's great. " I'm starting to

wonder if he's passing that message along to be powers @United along with my

appeal letters. I know he means well, and before I found out about the MGB,

I was pretty sure about the RNY, but now it seems unthinkable. I want the

safest and most successful procedure available.

Thanks for letting me vent. I know it's the same ole story.

Ruqayya

[Guest guest]

> I'm about ready to put United Healthcare on that list too. They

denied my

> appeal yesterday because, " the MGB procedure has not been proven

superior to

> the RNY by a peer review board. "

>

> I'm on to the greivance committee now, and then the Fla insurance

commission

> if that doesn't work. My benefits mgr. for United @ the school

board says,

> Thanks for letting me vent. I know it's the same ole story.

>

> Ruqayya

I'm sorry you are having problems with your insurance company too. I

know there are many who are. It seems it would make me feel better

to know I am not the only one fighting an insurance company but it

somehow just makes me angry. It really ticks me off that the

insurance companies have more say over what happens to us than our

own doctors that have known us so long. I have been going to the

same doctor for about 35 years. I think he ought to know better than

people at the insurance company that has never even met me what is

best for me. I can't even get the insurance company to tell me what

they are missing to get the surgery covered under medical necessity.

They just keep telling me to have the doctor call them. When I told

the doctor, he said, " I don't know what else I can tell them. " I'm

really afraid he is not going to play their game and I will be the

one left holding the bag. I am so frustrated!!! I have problems

with depression as it is and I am one that gets more depressed when I

get upset and angry. Instead of the anger giving me the push I need

to fight, I get really down and have to force myself to go to work

and do the daily things I need to do. I just don't have the energy

or the desire to do anything else. I have been fighting that big

time the last couple of weeks. Thankfully I do have people that

knows that about me and has been a help in not allowing me to get

down to far. At this pont I am still functioning. I have some good

friends on this site that keep reminding me why I need to hang in

there and fight. I am trying to do one day at at time right now.

Keep in touch. Let me know how things are going for you. I'll pray

that we all get our turn in God's time.

Rhonda

[Guest guest]

> Sorry u r getting the same as me!!! I can not believe that this is

so hard.

> marg

Thanks Marg. Sorry, I don't have an appeal letter that has worked as

you could probably tell by my post. Cigna has not told me that wls

is excluded in my policy. They are deeming not medically necessary.

When I try to find out what I need to make it medically necessary,

they will not tell me. They just say, if your doctor has any

questions have him call us. So I can't even tell my doctor what they

want. He has told me he has given them everything he can think of.

It is so frustrating, isn't it? It really ticks me off that the

insurnace companies have more control over what happens to us than

our own doctors do. Keep up the fight. I am trying to keep up the

fight also. I know how hard it is. It would be easier to just give

up and be a self-pay even though it would be a lot harder on our

family finances. That is what they want and are hoping we will do.

I will do that if that is my last resort, but I don't think I am

there yet.

Hanging in,

Rhonda