Insurance

[Guest guest]

Joni, Hang in there. If all else fails, get an attorney to write a letter.

You have a BMI of 62! Who do they think they're dealing with? An uneducated

consumer? No way, they got an educated one right here and you have a right

to this life-saving procedure. What more life-threatening status do they

need? Get an attorney, and let them know you're going to when you speak to

the pre-cert manager. Obesity is a disease. What, less serious than

diabetes? or cancer? Not really, just slower. You fight them, girl. And

keep your spirits way, way up! We're all behind you. Judy

[Guest guest]

Curious whether anyone else has tried to get coverage of the MGB through

Cigna HealthCare of NC. My Primary made my referral to Dr. R. today and I'm

sure the letter from their office will go soon to Cigna to request coverage.

Heard Cigna will cover Bypass if there are medical reasons for it. Hoping I

qualify with my high blood pressure and BMI of 40. Glad for any information.

Donna

[Guest guest]

I have Duke Manage Care and they turned me down flat and sent me a denial letter

which also stated that they would not cover the surgery or any complications of

the surgery should I have it at all. My husband covers me also under his plan

which is Cigna Health Care of N.C. and they approved me once my primary doctor

did what she was suppose to do. They asked for additional records and when I

called and asked Cigna if I had been approved they said no. I asked why and they

told me that they had not received the additional records that they had

requested. Needless to say, I feel apart and call my doctor right away and was

so

upset that I could hardly explain to them what needed. Anyway, she called me

back

and said that she did not know that she had a deadline to get the records in,

but

she would get them out as soon as possible. We were at the beach on vacation and

I call Cigna and they said that they could only talk to the Dr. R or his nurse.

Once again, I just fell apart and I called Barbara and told her what had

happened. Of course, she is so cooooool and told me just to hang loose and she

would call and then call me back. Within 30 minutes she called me back and

bingo, I was approved. They needed a surgery date so she had to give them a

" dummie date " and they approved me. Barbare is sooooo wonderful and is there

for

you and will answer any questions you ask and if she doesn't have the answer,

she

will find out for you. She is a " GEM " !

I had surgery on my knee in June and was told that I had about 4-5 years before

I

would have to have a total knee. I have no cartilage in my knee and this is my

only option. I am hoping with this surgery that, even though I may still have to

have a total knee, may this will prolong it a little longer. I am 48 and would

like to just be able to walk without giving out of breath or being in pain when

trying to do this simple task.

Also, I am scheduled for October 16th. Anyone else out there doing the dance on

th 16th.

Joyce

Chapel Hill, N.C.

willowcrof@... wrote:

> Curious whether anyone else has tried to get coverage of the MGB through

> Cigna HealthCare of NC. My Primary made my referral to Dr. R. today and I'm

> sure the letter from their office will go soon to Cigna to request coverage.

> Heard Cigna will cover Bypass if there are medical reasons for it. Hoping I

> qualify with my high blood pressure and BMI of 40. Glad for any information.

>

> Donna

>

>