Insurance Company Denied Cranial Molding Helmet

[Guest guest]

Hi, I'm new to this and my son who is 6.5 months old just got his helmet from

Hanger. We went through the pre-authorization process and got denied and the

reason was because my plan simply did not cover it. Cigna told me that I needed

to talk to my employer as they were the one that chose the plan. I contacted my

HR department who told me that they would not do any exceptions and that to go

head and go through the appeal process which I have done and haven't heard back

from Cigna. I don't think at this point Cigna will pay for the helmet as they

are using the reason stated above. Hanger went ahead and submitted the claim

even though Cigna denied it, but I'm trying to get them to reconsider their

decision and pay for the helmet. I got my doctor, nurse, and orthotist to write

a letter to Cigna explaining the reasons why my son needs to wear a helmet.

Cigna also said that my plan would cover it after post operation so my son would

have to go through surgery before they would cover the helmet. This just seems

totally backward to me. I'm not gettinga anywhere with this and was wondering

to know if anyone has gone through the same thing I am and know what I can do to

get the insurance company to pay. My next option is to go to the insurance

commissioner as I'm at a lost at this point. The cost of the helmet was $2200

that we had to pay out of pocket for.

Looking forward to hearing from everyone.