NEW JERSEY -- On 11/24/2009 I had a medical procedure that amounted to $10,779.00. I was informed that this procedure was covered my Cigna insurance. On 01/27/2009, the service provider sent me a letter that was addressed to an incorrect mailing address. The letter stated the Cigna send a notice to the provider on 12/18/09 that they are not obligated to pay any portion of the claim because of the provider's waiver of co-insurance and deductible. For years, this provider had wave co-insurance and deductibles and was notified of the Cigna change after my service were provided.
About 2 months ago, I was contacted by a collection agency demanding payment of $10,779.00. I called Cigna on 6/23/12 and was informed that it appeared that the claim was denied incorrectly and was scheduled to be re-opened and to call back in about 15 days. On 7/5/12, I did a follow-up call and was informed that the claim was being reviewed. On 7/23/12, I called again and was informed that claim was active and call back in 15 days. On 8/8/12 I placed another call and was informed that a service representative call and informed me that I would have to file an appeal due to the claim is now over 2 years old. I am now appealing the claim and awaiting disposition.
Meanwhile, debt collection company is now calling and for payment. I am trying to hold the off because I am on fixed income and no means to repay $10,779.00 to repay this amount. Now they are possible reporting this on my credit file and at 68 I may have to file bankruptcy to get out of the debt.
LOCKHEED MARTIN CORPORATION -- Where to even begin? I have been fighting Cigna for 4 long years regarding my short and long term disability insurance. Like others who have testified on this site, my benefits were abruptly shut off and then I experienced a continual denial on each appeal for various different reasons starting with "We don't doubt that you have suffered from various medical problems, but believe they do not constitute total disability" to that of a "preexisting condition". Cigna utilizes an in-house nurse to rubber stamp rejections as their supposed medical review process.
I suffer from Interstitial Cystitis, Fibromyalgia, Depression, IBS, Degenerative Back Disease, Vulvodynia, and Migraine Headaches. My medical records contain letters from 4 different urologists that state I must undergo long term narcotic therapy for chronic pain due to an incurable disease which causes intractable pain. My pain management doctor has attested to my inability in maintaining employment due to both physical and psychological limitations.
Like others on this site have stated prior to my review, Cigna ignored my doctors reports and medical records which declared me disabled. They also ignored the fact that the Social Security declared me disabled and incapable of any performing any occupation. In addition, Cigna has never even requested a physical examination performed on me by a doctor of their choice.
I appealed Cigna's denial decision to the State Medical Board. The State Medical Board required Cigna to have an "outside" (Cigna paid) medical doctor review my case. Cigna's doctor reviewed my medical records. There is no surprise that he denied my claim. The doctor was blatantly unfamiliar with my primary disease (IC), and he could not even read my diagnosis reports. The State Medical Board could not require Cigna to pay my claim, and they suggested that I hire a lawyer and take legal action against Cigna.
I hired an attorney who works on a 40% retainer with $400 down. At this point, Cigna came through with a chump change settlement offer which I declined. Cigna only offered to pay my entire claim/policy off for just 2 years of payments which would constitute the lookback period of whether I can work "any occupation". The case is now in court awaiting the judges decision.
According to the policy, the question to the court now is not whether I am disabled, but whether Cigna's administrator was "arbitrary and capricious" in making their denial decision. Of course they were "arbitrary and capricious" in their decision. but this is huge hurdle to prove and really irrelevant, I am disabled and deserve my money.
From reading comments made on the reviews posted, the majority of people do not understand their employers disability policies or ERISA law. You cannot sue for or collect punitive damages (pain, suffering, mental anguish) against the insurance company. You may only collect what is due to you under the policy adjusted for cost of living and interest. That includes the fact that I cannot recoup my doctor and prescription costs which I paid out of pocket during the 4 years that my insurance and prescription benefits were also denied. With all this being so, there is absolutely NO incentive for Cigna to pay ANY claim.
WARNING: Therefore, it is best NOT to pay for disability insurance through your employer (which falls under ERISA laws), but protect yourself and family by buying outside independent insurance. Paying through your employer is just flushing good money down the drain. DON'T DO IT.
At this time, I am hoping for a favorable ruling from the court. If so, as I state above I will be out 40% to the lawyer and will not recoup any out of pocket doctor's office or prescription expenses occurred over the past 4 years. My lawyer has informed me that if we Win the case he expects Cigna to appeal. My lawyer has also told me that if Cigna appeals he will not continue to work the case on a contingency basis but need upfront payment.
This entire process of dealing with Cigna has been a nightmare. I have exhausted my 401K in medical bills and living expenses. FYI-God forbid that you should ever find yourself in a similar situation. If so, my best advice is to ask for a copy and review your disability file from Cigna regularly. Make this request in writing sent certified. You will find that Cigna purposely omits information that bolsters you case, and Cigna purposely inserts information that makes you appear unavailable and unresponsive to their requests.
This employer insurance is a SHAM and need serious reform. I am at a loss as to why this is not covered in detail by the media and news programs. Someone somewhere is making BIG money and must be paying others to keep hush. You have now been warned. Consider yourself lucky and protect yourself and your family appropriately.
EDEN PRAIRIE, MINNESOTA -- I am not aware if CIGNA provides FSA management for other companies, but as a CIGNA employee spouse I am appalled at the lack of communication and the frustration of processing a request for reimbursement from my Flexible Spending Account.
I had $2500 from my FSA for 2013, my son had orthodontia on 12/31/13. This is a qualifying expense for the year 2013. I waited for the processing of my dual dental coverage, but there continued to processing issues. I could no longer wait to file my request for reimbursement as the deadline for submission had approached. I submitted the information I had indicating payment to the Orthodontist of $2475 and an EOB from a dental insurer indicating treatment began in December 2013.
CIGNA's explanation of eligible orthodontia services being reimbursable clearly indicates that “reimbursement can be made once charges have been billed. This can be a one-time fee less any amount paid.” The total billed for orthodontia is approximately $6000, I have paid a portion and dental insurance will eventually pay the rest. NOWHERE does it indicate that FSA will be reimbursed to the member / client / customer based on date paid.
Per the IRS Orthodontia is an eligible medical expense and “distributions from a health FSA must be paid only to reimburse you for qualified medical expenses you incurred during the period of coverage.” The period of coverage for my service was 2013.
STOP WITHHOLDING MY MONEY!! The FSA has a use-it-or-lose-it policy and a dollar limit, so that people don't shelter income tax-free. The other advantage people have to use a FSA is access to the money for qualified expenses during the plan year before they have contributed all the earmarked funds. BUT CIGNA is not accountable – I am accountable to the IRS, so GIVE ME MY MONEY!
ORTHODONTIA is not special – it may be paid differently when processing it as a dental claim – BUT CIGNA YOU ARE NOT PROCESSING A CLAIM FOR PAYMENT TO A PROVIDER! This is my money; this was my qualified medical expense during my qualified plan year. There is nothing more to process.
WESTON -- This medical management and Medicare affiliate company offers many nice amenities, free exercise work-out facility access, transportation to medical-dental appointments and a small monthly allowance for OTC (over-the-counter) medications and left-over dollars roll-over each month. This all sounds good and looks good on an advertisement. This is a good draw for retired and disabled persons living on fixed incomes of just a thousand dollars or less per month. We manage but there's not much left over for extras.
The problem is, mainly with transportation and customer services' ability to resolve an issue. We need transportation to get to and from appointments. No-shows and being late is a consummate problem. Customer service personnel are surly, argumentative. Many, disrespectfully, presume first names when addressing their patrons. They hang-up on you. They make a relatively, easy encounter stressful. My daughter, uses a wheelchair, was refused transportation because she, allegedly, had used up her transport quota.
Our agent was incredulous to explain this misinformation. He made a call to customer service said we would get a call. I got a voice-mail. We returned the call. We left a message with a live person but never heard from this person. Our agent followed-up to see what happened? We told him we were filing a grievance. On a call to customer service, I recognized her voice and her name but she, totally, denied any knowledge of having tried to contact me. It was her. Go figure. Right? We mailed a grievance around June 2013. One person left a voice-mail, 09/04 @ 9:20 am. Nine days later after (4) return calls to her voice-mail we've received no further response.
OTC? About 8:30 am, 09-11-2013, I was hung-up on (3) times on (3) separate calls by (3) separate clerks before, on the 4th attempt I got a clerk capable and willing to dispense week later I called to inquire, as my meds had not arrived. The insurance clerk gave me a postal tracking number and told me to call my local post office. I did. They told me the package was there and it would be delivered in a few days. About, 08/15/2013, a clerk told me it was their (Cigna) responsibility to track the order and she did telling me the items were at the post office and would arrive, shortly. I left for vacation from 8/21-8/28.
The meds had not arrived. On, 08 /29 I called again asking for a supervisor. This person apologized for the confusion. My item arrived about, 09/03. I called (Cigna) and, actually, got the same guy who, originally, placed the order. He tried to give me the track number again. I refused telling him that was his job not mine. I suggested that he cancel the order and submit a new order, as the delivery time had surpassed its allotted time. I asked, why, who at Cigna had diverted the original order from UPS to the local post office? And, why, were their personnel instructing clients to track packages?
P.O. BOX 696018, TEXAS -- BEWARE SENIORS OR ELIGIBLE MEDICARE RECIPIENTS!!!! Check Medicare vs. Advantage replacement plans before you sign up!!! They will offer you "fluffs", and you will pay more out of pocket than original Medicare!!! Cigna's Medicare Access Plan (PFFS) 2010 does not pay for some medications that have to be administered by a physician in their office. Cigna states that the medication (medical Botox) has to go through their Part B; they gave me the run-around. I have been told more than 4++ (I lost count) different excuses from Cigna.
Here is their latest "Mumbo Jumble" that was stated by a company representative (SUPERVISOR) in Arizona: "Yes, we do cover the ADMINISTRATION of medically necessary medications MEDICARE PART B-but, you must meet your $3,000 deductible; any and all the co-payments that you have made throughout the year do not count." I reminded that their contract stated that an individual on their plan is only responsible for a $20.00 co-payment for a specialist MAXIMUM. Then, ** stated that Part B was separate from a regular office visit for the administration of the drug.
CIGNA insisted that I had to get this drug from their pharmacy (covered under "Argis-I am guessing their preferred drug company ‘Medco' uses this pharmacy.”). First, Cigna's Part D called and told me I would have to pay $241.00 out of pocket. Then, they called back and stated that the cost would be $999.60 out of pocket.
Again, Cigna called and stated that the drug would cost $940.00 out of pocket. ** called and stated that she could get the drug for $760.00, but... I still did not meet my $3,000 out of pocket for the neurologist, so, I would have to pay for the drug and an out-of-pocket expense for the doctor to administer it (they told the Botox Assistance Programs that they were going to pay for it). I called Medicare; they told me that if I had regular Medicare after I met Part B deductible, that my cost would only be 20%. Medicare stated that these replacement, access, etc. could make up their own rules without government regulations.
Now, I had to reschedule my appointment for December 21st, 2010 until after the January 1st, 2011, when regular Medicare kicks in. I am in so much pain that it is difficult lying in bed to type this. My neck, face, jaw, and eyelids are in painful spasms. I have had surgeries, pain management without any relief. I am a disabled RN due to a patient assault. I thought Cigna was a good company; I should have googled them instead of trusting them prior to signing up with them (I was ill when I signed up with them, and I was not thinking properly due to serotonin toxicity).
As a nurse (although disabled), I believe it is my duty to warn our senior population and disabled individuals, so that they do not end up paying more out of pocket expenses that regular Medicare (Please note: I paid CIGNA $95.00 monthly + Medicare Part B premiums + co-payments; this equals-MORE than REGULAR MEDICARE).
11095 VIKING DR., SUITE 350, EDEN PRAIRIE, MINNESOTA -- I am dropping Cigna as soon as I can because its service has been appalling. I have been submitting claims since February 2010 and never once have I received the amount of reimbursement that I was promised (70% of Reasonable and Customary for an LCSW in 20912=105 out of 150); it was solely on the basis of that promise that I chose Cigna. I could not make up the nightmare this company has been. I have met every possible roadblock: one claim was denied based on my mistake of copying the diagnosis code incorrectly from my provider's itemized bill to my itemized bill—BOTH itemizations were included with the claim, however.
I have been repeatedly denied full reimbursement (70% of reasonable and customary for out of network) because initially my provider was in an affiliated network, without knowing that that was still active (or that that affiliation with Cigna even existed). He has since TWICE provided documentation that his association with that affiliated network was ended AS OF 1 March 2010, and still, as of this date, I am being told that Cigna has no record of this change having been made. I have had to call twice monthly and each time explain the entire situation because apparently no record is made of my calls.
I am convinced that Cigna is deliberately blocking my access to reimbursement, and thus to ongoing health care provision, in order to frustrate me out of pursuing my claim. I will not only not renew my policy with Cigna, but I will tell all my family and friends and everyone else I meet that Cigna is just a typical Insurance company whose SOLE concern is its own profit, and who is willing to sacrifice anyone's health and well-being to its bottom line. I will also continue advocating for socialized medicine and the abolition of all such companies as Cigna.
The only recourse the U.S. has to such abuses is to nationalize health care and place limits on the unprincipled actions of those who believe that capitalism is an ethical system entitling them to exploit and abuse those who have physical and mental illnesses.
EDEN PRAIRIE, MINNESOTA -- I'm have been on Cigna as insurance for 8 months. I have been with the same therapist for many years, using the insurance plans offered through the companies I've worked for. I suffer from mild depression and working with a therapist has helped my quality of life immensely. I recently received something in the mail from Cigna.
A letter that begins: "Have you recently experienced trouble concentrating or sleeping? Are you feeling overwhelmed, anxious or withdrawn, or having difficulty adjusting to a major life change? Did you know there's a free service through your medical benefits that can help you manage your symptoms? Recently, a claim we received from either your doctor or pharmacy, or information from a health assessment you completed, has helped us identify you as someone who may benefit from this program."
I am feeling completely violated by this. I have never had an insurance company feel they were entitled to step in and comment on my private health information or assume they were qualified to inject one of their staff into my life to comment on personal health issues. It's like a new level of intrusion. How could this possibly be in compliance with HIPAA?
My expectation is that an insurance company can approve or deny claims, not that they can administer care or provide health care advice. Cigna has taken my health care information--either privileged information that I share with my doctor or specifics of medications that I have been prescribed, and run it through a marketing program that would identify me as someone they could put into a bucket for solicitation about a mental health "coaching product" they offer.
I'll be taking this up with my doctor as well as the attorney general about privacy and legality. I can't just let this end with Cigna pushing the envelope with methods that are intended to intimidate patients into ending medical care that is of a highly private nature. I'm sure it would be quite convenient if Cigna could get me to end my therapy with a qualified physician with whom I've been working for years, and call their free "phone coach" for therapy instead, but this is totally unacceptable to me.
I don't want Cigna to monitor my private health care and diagnoses and offer me tailored marketing based on their business objectives. I pay my premiums, percentages and copays and am entitled to proper medical care. So I have two choices: 1. End my care so that they no longer have access to my private health care information and diagnoses, or 2. Fight back and tell Cigna that I don't want them using my private health care information and diagnoses for anything other than a yes/no vote in their claims system. Knowing that my disapproval with their policy won't be enough to bring about change, I have no choice but to bring this issue to a wider audience.
I am a current recipient of disability benefits from Cigna. I received a call today from my representative at Cigna informing me of a policy change. I was supposedly to have received prior notification of said change -- but, of course, did not. My case is under review -- I had Cancer surgery 2 years ago and currently am being treated by a pain management specialist for chronic visceral abdominal pain syndrome. I also have systemic lupus erythematosus, and recurrent bladder cancer. I have one kidney and have had 5 other cancer-related surgeries (three abdominal, one testicular, and one for parathyroid cancer).
I am on so much pain medication that I can barely type this message and have severe short term memory loss. Yet I am under review again. Social Security still carries me a permanently disabled and I receive a 20% service connected disability payment for service in Vietnam. I am well educated and have worked in government scientific research since 1974. Again, Cigna gave no prior notice of a review nor was information regarding the nature of the policy change forwarded. I still don't know what exactly that change is - but I would guess they are divorcing themselves of Social Security determinations.
We have lost over half of our 401K and I cannot interest any reputable company in refinancing our VA loan -despite the low interest rates and the streamline procedure mandated by the VA. By the way my combined credit score is 787. Now I am to lose my only other source of income - due to a "policy change". I have had one physician refuse to treat me because according to him I am so ill that I belong in a tertiary (hospital) treatment setting. What are we to do? I just returned from a grocery store that cheated me out of $10.00 worth of their own coupons -- due to "system failure".
What recourse do we have - is America finished?? Beware -- those who served their country -- it will probably dance on your grave after starving you to death when you are physically unable to work -- by the way I was exposed to Agent Orange - and what has been done about that - a lot of verbiage and still no support for veterans who are now dying by the score due to cancer and other premature illnesses.
I was recently employed with this company and was also a customer. As soon as they found out I had been diagnosed with and was in active treatment for PTSD, they engaged in such severe discrimination that I was eventually forced out of the company. I have been asked why I don't sue. I know the EEOC is an option, and though I am going to the EEOC, this company has almost unlimited resources and I double the EEOC will pose much of a problem for them. They also have mandatory binding arbitration which one must agree to as a condition of employment. Long story short, they can freely engage in discrimination and get away with it.
MOOSIC, PENNSYLVANIA -- I left Cigna on 9/7/13 (gave 2 week notice) they sent my last check to me. However on Monday 12/2/13 I received a letter stating they overpaid me by almost 800.00 in PTO days... they want payment in full by 12/12/13. I am so furious that it took them 3 months to figure out that they overpaid me which I request proof of my PTO days that I took and what I was allowed and it will take 7-10 business days. How dare they do this to me. Is there anything I can do about this if I do owe them the money?