Cigna declined me

[jdsatx1977]

Alrighty, the deadline for the appeal decision has passed and have not heard a peep. Maybe I might see something next week, and hope it is a positive outcome.

[duke_cicero]

Any news here? I was also declined by Cigna and my doctor doesn't seem to want to help. I don't know what self-pay options are available. I don't have the cash on hand. What can we do?

[duke_cicero]

I was denied by Cigna three times before I was approved (9 months)

Here is what I did - I contacted my HR manager and basically said “how is it that we are supposedly paying for great insurance coverage and getting crappy coverage?” What I found out was that there were other employees in our company that were not getting covered for Specialty Pharmacuetical Drugs - very expensive. They added a lot of these coverages as my HR threatened to look at new insurance coverage from other companies

I would try to get your your HR to be your ally and look at adding additional coverage options… Do not accept no and fight like a mother

I would bring this up to my HR manager but she's a woman and I feel extremely nervous about revealing this sensitive issue to her. I work for a relatively small company right now and I have this awful feeling that, as terrible as this sounds, she may tell someone, or my professional standing at my company may be impugned because I am requesting special dispensation for a procedure related to my penis.

[rdnkbiker]

I know this sounds desperate but i would take a personal loan pay cash its a lot cheaper most docs now wont finance it so just have to do it on your own.... my first got approved through Cigna then 3 days before they said no coverage the hospital and docs office said they can't do that well guess what was handed a 89k dollar bill so yes they can and did i wouldn't trust Cigna at all ......my second i paid cash upfront 24800.00 that covered everything even fallow ups ......they bill insurance so much more then cash if you can find the best doc ask for a cash price total might be worth checking i still owe more on my first implant then the second one cost probably hit the grave before its paid

my 2 cents

[easymoney]

If the HR manager was to reveal any information she could be sued for HIPPA violations both through the company and personally

[wilsonmill]

I really do not think that HR can do anything anyway, the company purchased this type of insurance for their employees and I am sure it was negotiated. Now when they renew they could negotiate a new policy but probably will still go with a lower cost coverage. Insurance keeps going up, even your premiums as well as the deductibles, I agree with rdnkbiker, see what cash can get you, I have seen somewhere doctors that accept cash, I think I saw as low as around 20k, but do your research.

Pulled off the web
Although HR professionals—unlike medical professionals, religious functionaries or attorneys—are not subject to any overarching legally mandated duty of confidentiality, they are required by laws regulating the workplace to ensure and maintain the confidentiality of some types of employee information.

[Wvanative68]

My company uses cigna and has sine I been employed 23 yrs...I got an approval within a week of doctor submission..I wonder if it depends on what state (SC here) and your employer wants to cover...over the last several years I went through the 3 major pills and then injections.

[LastHope]

Cigna and Aetna are the biggest POSs when it comes to penile implant coverage

[JohnHC]

Contact the implant manufacturer. They usually have people who can help get insurance to pay, or at least let you know what you need to submit to insurance for the best results. My insurance told me, the Dr and hospital it was covered, I then needed immediate revision (done 2.5 months later) and of course then got the letter saying no we aren't covering it. Been fighting them over it since Jan and just got word they are going to cover the previous surgeries, I don't know if they are going to cover this revision I need ( both my first implant and the revision failed ) but hopefully I'll be getting more info next week.

[duke_cicero]

Contact the implant manufacturer. They usually have people who can help get insurance to pay, or at least let you know what you need to submit to insurance for the best results. My insurance told me, the Dr and hospital it was covered, I then needed immediate revision (done 2.5 months later) and of course then got the letter saying no we aren't covering it. Been fighting them over it since Jan and just got word they are going to cover the previous surgeries, I don't know if they are going to cover this revision I need ( both my first implant and the revision failed ) but hopefully I'll be getting more info next week.

Not sure if it makes a difference here but I haven't had the procedure yet. Insurance apparently won't cover it. Maybe I'm misunderstanding you.