I got Cigna at the start of this year as my job switched insurance companies. My surgeons office was preparing me with steps toward surgery when I got a call today saying that bariactic surgery isn't covered under my plan. I feel so disappointed. Now what? How can I get coverage? Anyone experienced this?

On 3/5/2023 at 8:50 PM, Bandedbut said:

This is something you would need to talk to your HR dept about. My understanding (and I could be wrong) is that each company negotiates their rates with the insurance company, and there are things they can choose to not cover in order to keep the costs down for ALL employees. They can't just add it for one person. Bariatric surgery is getting more common, so maybe your employer might choose to add it durning the next open enrollment period, or, to cut rising costs, eliminate services. Unless you have a life event (like loosing your job, marriage, birth of a child etc) your husband can only add you to his plan during open enrollment. And your company's plan can't change until the next open enrollment. Most companies that wouldn't be effective until Jan 1 2024 (but not all, my company has open enrollment in the spring) Find out first if your husbands plan even covers it, and what the deductible/co-pay would be. You could start all the presurgery requirements now, as that usually takes about 6 months. Sounds like IF, everything works out, the soonest you could have the surgery under insurance (and a lot of things could go wrong to not align) would be Jan 2024. Or, do self pay and you could be recovering in a matter of weeks. There are low to 0 interest medical financing plans, and you can even pay those bills with an HSA or FSA card. It all depends on your financial situation and patience.

I totally understand your disappointment, I felt the same way when I found out it wasn't covered under my insurance. I had determined the VSG was the right path for me and had my hopes up, and was crushed. I didn't want to wait any longer, and self pay was the best option.

Thank you a lot