Everything posted by lilbit08
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Aetna Open Access Plus Plan...Anyone??
Sent u a private message. Thanks!
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Aetna Open Access Plus Plan...Anyone??
Hi there! Thanks for the reply. MY BMI is 49.1 but I am not sure that the policy is going to cover me. I have my consult on 1/6 and I was told that the Dr ofc that I am using is good about trying to get approval, so we will see. How would I know come Jan if my job's policy totally excludes wls?
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Aetna Open Access Plus Plan...Anyone??
:smile2: Ok...So I was so excited because I was scheduled for my consult on 12/4 with my current insurance of Cigna's Open Access Plus Plan. This is my very 1st step in starting the whole weight loss process. A while back when I called them they told me that WLS was excluded unless medically necessary and I have a BMI of 49.1 so I am thinking that I was going to be ok. Well I get to work on Monday to get an email from HR that our insurance as of 1-09' is going to be changed to Aetna's Open Access Plus Plan. I called the Dr's ofc and they moved my consult day to 1/6 because the scheduler stated there was no reason for me to come in on 12/4 and they try to get approval thru Cigna when in January it is changing. Just wondering if anyone has ever used or known anyone to have Aetna's Open Access Plus Plan pay for the lapband? If so, Please let me know the process! Thanks bunches!:wink2:
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3o and thinking...
any other 30's in there that have had the lapband and doing well? any 30's in here that have had the lapband and not doing sooo well? please shed light as i am trying to decide between the lapband and rny....:thumbup:
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Are "fills" paid out of pocket?
Are fills paid out of pocket? If you have insurance does that normally cover the fills if it covered ur procedure? I don't understand the whole fill thing. Also, how many fills do u have to get?:thumbup:
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Why am I so terrified?
Ok in the past I have studied the VSG procedure which was my surgery of choice but I am trying to use my insurance and they dont cover the VSG. I am stuck between the lapband and the RNY..I am sooo scared of the lapband...It is because I have heard sooo many stories about slippage, erosion, revisions, failures etc..that I am not sure that I want to go thru all that. My husband doesn't want me to have any WLS but stated that if I just had to have one then he would rather me go thru with the lapband because the RNY is too complicated...I am so terrified about foods getting stuck, terrified of PB-ing and vomiting....Is this normal??:thumbup::ohmy:
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Cigna Open Access Plan
well i called the ins co and they told me that wls was excluded but that if medically necessary it cld be approved...soooo i have a consult on 12/4 and the dr that i have chosen they say are good with getting u all u need to be approved..we will see
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CIGNA..Pre-Determination of Medical Necessities
thanks for the reply..so let me understand..ihave done weight watchers in the past but not for 6 mnths...the dr that i am using, i have been told that he is pretty good with helping u along the way..i know that u said they make u do a 6 mnth diet first, so how did u get approved in 3 weeks?
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Cigna Open Access Plan
I was told by a Cigna rep that all WLS surgery was excluded unless medically necessary. I currently dont have any health problems except anxiety and depression but I do have a BMI of 48. I also took my 1st step and scheduled my consult for 12/4..I am sooo excited.:smile2::cool2:
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CIGNA..Pre-Determination of Medical Necessities
Thansk for the info! Looking over it right now!
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CIGNA..Pre-Determination of Medical Necessities
Ok I have Cigna Open Access Plan and I called them today and the rep. told me that my policy doesn't say whether it covers WLS or not. He said that whatever Dr. that I choose would need to call them and get Pre-Determination of Medical Necessities paperwork, fill it out and send it back in and then we can go from there....Anyone know what this means? Also, what is the 6 mnth period that most ins co's make u do and what if u loose weight during this time? Does it mean you are no longer eligible for ins to cover u? Someone please advise...
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Cigna...Will they pay?
I recently started a new job and as of 11/14 Cigna is going to be my insurance company. I have heard good and bad about this insurance when it comes to WLS. I have the Open Access Plan and was wondering has anyone ever had Cigna to cover the lapband? I am not at all interested in the Gastric as it seems to be covered by more insurance companies. My in-network is 100% so that is good! Any advice?:biggrin:
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Dallas Doctors
Thanks!:sad:
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Me
Me being me~
- My Idol
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Dallas Doctors
ok thanks..good idea!
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Cigna
well the problem for me getting financed is that my husband and i both dont have any credit and the credit that we do have is just not the best.....soooooo i was hoping that cigna would cover the procedure once the new hire 90 day probation is over.
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Dallas Doctors
wow...didnt think of that..how do u do that???
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Cigna
i was trying to get financed for the vsg procedure and had hell because i dont have any credit. let me know who helps u as i think i have tried all companies possible in america and was denied!
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Cigna
wow..thanks for the info! ur's went well. i dont have any of the insurance info as of yet except that it is cigna and that is all i know...i will try and find out more at work, but i dont want to ask too much to where i am letting them know that i may try to use the insurance for WLS. some companies dont like that from what i hear.
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Dallas Doctors
i had lots of problems getting financed because i didnt have any credit when i was trying a few mnths ago to get financed for the vsg procedure. any ideas?
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Recommendations Needed (Dallas Tx Dr's)
wow...thanks soooo much! hopefully i get more replies also.
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Recommendations Needed (Dallas Tx Dr's)
Can you tell me who u think is a good Dr. In the DFW Area that performs the lapband and why? Also if you know the total cost that would be great as I may have to be a cash pay... Thanks ahead of time!!:thumbup:
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Dallas Doctors
Thanks I'll keep him in mind!
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Dallas Doctors
can someone please shed some light and tell me who some good dr's are in the dallas area that perform the lapband procedure? if you know the cost too, that would be great because i am thinking that i am going to be self pay...:party: