Re: does anyone else have a DOC band and Cigna HMO

[Guest guest]

Hi & welcome to our group

First, I'm so happy to hear how well is doing in his band & how

happy you are with it as well! How old is ?

It sounds like Cigna is giving you the " reasonable & customary "

exclusion. $1,200.00 amount THEY feel is what the band should cost.

This is one of those things with ins. that really gets my dander up -

just exactly who are they to say how much the band should cost? What

do they know????? Yet another way insurance dictates the medical

field today.

I know, Gail, mom of twin DOCgrands, has been fighting Cigna in TX for

a year now, her policy has paid nothing of her $6,000.00 band costs.

I am sure you can appeal R & C. So don't stop yet!

Good luck with this - I hope they cover more. Please keep us posted &

keep us posted on 's progress as well.

Debbie Abby's mom DOCGrad

MI

> I am new to this group so I'm not sure if the info is out there

> somewhere already and I just didn't find it. My son, , has been

> wearing a DOC band since the beginning of February. We go to

> Cranial Technologies in Dallas. I had to go through 2 appeal

> processes with Cigna HMO in order for them to approve the band.

> They finally approved it but I just got the EOB and they are only

> paying $1000 of the $3000 that the band costs. They say that pay

> 100% of the $1200 covered amount after the $200 deductible which

> leaves our out of pocket costs at $200 plus the $1800 that is not

> covered. For all the office visits that we go to and the custom

> molding, etc. I can't believe that they think $1200 is adequate to

> cover the costs.

>

> *** Has anyone gotten the insurance companies, particularly Cigna

> HMO, to pay more for the cost of the DOC Band? ***

>

> BTW, is doing very well with his band and it is completely

> worth the money but I would obviously prefer that the insurance

> company paid more. Isn't that why we have insurance?

[Guest guest]

Hi,

Welcome to the group!

I'm sorry I can't help you out w/insurance problems, my ins wouldn't

pay anything. But I'm sure someone here will be able to help you! I

just wanted to welcome you to the group! How old is your son? It's

good to hear that he is doing well in his band. I've heard great

things about the Dallas CT!

Please keep us posted.

> I am new to this group so I'm not sure if the info is out there

> somewhere already and I just didn't find it. My son, , has

been

> wearing a DOC band since the beginning of February. We go to

> Cranial Technologies in Dallas. I had to go through 2 appeal

> processes with Cigna HMO in order for them to approve the band.

> They finally approved it but I just got the EOB and they are only

> paying $1000 of the $3000 that the band costs. They say that pay

> 100% of the $1200 covered amount after the $200 deductible which

> leaves our out of pocket costs at $200 plus the $1800 that is not

> covered. For all the office visits that we go to and the custom

> molding, etc. I can't believe that they think $1200 is adequate to

> cover the costs.

>

> *** Has anyone gotten the insurance companies, particularly Cigna

> HMO, to pay more for the cost of the DOC Band? ***

>

> BTW, is doing very well with his band and it is completely

> worth the money but I would obviously prefer that the insurance

> company paid more. Isn't that why we have insurance?