BLOOMFIELD, CONNECTICUT -- For the last 3 months I have been battling this horrible company to approve my short term disability claim. I was taken out of work by my Dr. due to a back injury that is chronic in nature. I also am diagnosed with depression which can be very severe in episodes and very debilitating. On 8/21/13 I took this leave and since returned to work on 10/21 because my claims were denied. I had no other choice... go back to work or lose my home despite the circumstances. I was shuffled from person to person at Cigna and all they basically did was bury me in paperwork and never once did they actually speak to my Dr.
I appealed the decision only to find out today it had been denied as well. The company's motto is: "To help the people we serve improve their health, well-being and security." This couldn't be any further from the truth. I would advise anyone looking into this company for insurance to RUN away as fast as you can. Statistically speaking, Cigna denies 1/3 of their claims and seems to be more concerned about their bottom line than the individual. I filed a complaint with the Washington State Insurance Commissioner with the hopes of at least sending this organization a message.
For as much as we all pay for insurance in this country, it would be nice to know you can count on it when you need it. I'm just utterly disgusted by the way Cigna has treated me and others. I hope this company gets a big wake up call and finally realizes that it can't go on treating people like this.
LOS ANGELES, CALIFORNIA -- I have now been a member of Cigna for a few months and have found out that the sales representative lied to me about 2 different items. I signed up for a health and dental plan. The sales representative told me that I would pay 15$ for generic prescriptions and 30$ for name brand. The reality is that generics were in fact low priced but the name brands would cost me full price and Cigna won't cover any of it. That's a pretty big lie in my book.
Then I found out yesterday that having dental insurance doesn't mean squat. I had a filling pop out and could not eat or drink anything because of the pain. I made an emergency appointment with my dentist only to find out that Cigna doesn't cover emergencies until after 6 months or 12 months. In my mind I have insurance exactly for the reason of emergencies. Again, this is where the sales representative lied to me. I fully understand not covering elective procedures but to not cover emergency procedures, that is absurd. This is a huge lie by the sales representative.
I then called customer service to try to deal with the dental situation and was given the run around and told that the only way I could attempt to get Cigna to cover the procedure was to write an appeal. So let me get this straight, your company lies to me, sells me a bag of goods, and then tells me it's my problem and my responsibility to fix? Does this sound like a scam to anyone else? I will be cancelling my policy with Cigna and finding a company that is honest, knows what customer service actually is, and actually provides the services that you pay for.
MARIETTA, GEORGIA -- Cigna denied my sinus infection antibiotic treatment prescribed by my ENT, and this medication has been compounded and used by me for years prior to Cigna coverage. I have increasing kidney failure probably from multiple antibiotics from constant sinus infections caused by Common Variable Immunodeficiency Disease. My kidneys and immunodeficiency will not get better but sometimes am prescribed nasal infusions to put most of the medicine where the problem is and help spare my kidneys.
This is an acute condition yet they denied it based on diagnosis and "safety". They are denying medication prescribed by my doctor because they think he practices unsafe medicine or does not know the best prescription for my particular problem?
EAST SYRACUSE, NEW YORK -- I am a survivor of labor law discrimination retaliation & personal permanent injuries resulted from the retaliation including property damage, death threats & vicious acts of hate, resulted from my NY State Workers Compensation Board Cases WCB69709892 OGC 08-230 traveling with WCB69711246.
Cigna was the administrator for my husband's employee elected benefits for medical for him & me, Cigna HMO breached the medical contract/denied medical & removed our PCP physician from the contract & added a physician they had the conflict of interest with to deny medical care. After I was assaulted in June 1999 Cigna contacted the PCP requesting the assault go under NY State Workers Comp. Case WCB69709892, the PCP was concerned & wrote it in my medical record. Their Legal Dept in the State of Connecticut have the record on it.
L.A., CALIFORNIA -- I was still declined with imaging center and my family dr. presenting all supporting doc. Unfair. cause I would pay big portion, probably the whole amount to satisfy my deductible, Dummy dahhhh.
they gave several reasons, which showing none of reason holding water, " Multiple choices " - too many sayings.
1. no previous treatment for cough, pain in chest -
I said there was pain both my chest on and off more than 1 yr, which I don't like to take pain pill of much side effects.
x ray was clear, no need for ct scan.
ct scan and x ray are both diagnostic test, ct may see detail tissue for tumor. if x ray showed positive, I would be terminally ill to die. purpose of ct scan is to detect tumor early to prolong life. idiot!!
family dr. prescribed ct scan.
I don't think dr. would lie for me to risk his license - bread and butter.
Recently by error a bank payment of $1908 was transmitted to CIGNA for a monthly payment on a life insurance policy. The amount due was $19.08. Soon as the error was discovered their customer service was contacted and said that they could not send it back. Even the bank representative could not get them to send it back to correct. I ask for a supervisor and was told there was none available. I ask for one to call me.
Hours later I received a call and was told they could not return the amount. They said they could send me a form to fill out and request that it be returned and they would review and let me know what could be done. I said not acceptable. I owe them no money and they are holding nearly $2,000 of my money. They have had it for a week and if I waited for a form and followed their suggestion it could be weeks if ever before that money could be returned. Until and unless this $2000 is returned my home budget is in the red that amount.
I have no idea what they plan to do with the money but they won't return it. Now I must pay a lawyer to sue for me to try to get some of it back. With their unethical business procedure I question how reliable their product is. Shame on CIGNA.
TEXAS -- In June 2009 a Bariatric Surgeon's office staff, on my behalf, called Cigna customer service to find out if Bariatric Surgery was a covered benefit. The representative verified coverage, stating that Cigna would cover Gastric Bypass or Lapband, but not Gastric sleeve. She told the office lady that I had to wait six months, and in that time I had to complete several steps, which included attending a monthly information "class" on diet, nutrition, behavior modification and exercise. I had to have a psychiatric evaluation done. An EDG(?), upper GI was done as well as a sleep study where it was determined that I had Sleep Apnea and needed to sleep with a CPAP machine.
All of the claims for all of these tests and procedures were paid by Cigna. That have spent over $7000 and my copays amount to over $500. I completed every requirement, jumped through every hoop. Last week I received a call from the doctor's office representative. She stated that she had called Cigna to submit all of my information in order to get the final approval and pre-certification and was told that my plan did not now nor had they ever covered any bariatric treatment. They showed record of the call in June, but it did not state one way or the other whether their representative verified coverage or not.
The new representative "apologize" for the error and said she did not know why the previous rep would have verified coverage... so I am out all of my copays and Cigna has spent all of that money for me to have a procedure that they will not pay for. Why would they pay a Bariatric Surgeon for classes on weight loss etc if they do not cover any type of weight loss treatment? Why would they pay claims for tests ordered, not by my primary physician, but by a Bariatric Surgeon?
Anyone have any experience with this sort of thing? Any advice? Would it be worth talking to an attorney? Any way to force their hand? Can I request that they listen to the tapes of that original call to see that the representative verified coverage (in case it is the doctor's office mistake, which I doubt, because Cigna did pay the claims)? Any help is appreciated!
KANSAS CITY, MISSOURI -- I am so glad I found this site! I am ready to spit nails I am so mad at this insurance company!! I do not claim to fully understand insurance companies, and rarely go to the doctor, but never have I had such a poor experience with an insurance company!
This week, I made an appointment to see a doctor for an outpatient procedure/diagnosis at a local hospital. I went to the first appointment and everything was fine, scheduled to return the following day for medications and treatment options. Well, I return the next day and the financial office representative comes to speak with me on payment options!! I explain to her that I have insurance through my husband's place of work, and his employer pays a percentage of the deductible before it ever reaches the insurance. Well, the representative looks into it, and can't find any such info, so I am stuck paying 1450.00 out-of-pocket, when I am supposed to be INSURED!!!
My husband was told and he is trying to make sense of it through his employer, and told me not to worry. I then go to fill my prescription, and am told that they need the Dr.'s authorization to use the generic form instead of the name brand. It was only for a 30 day supply, and nowhere on our info does it mandate that we MUST have the generic, or nothing at all!! Needless to say, a medicine I was supposed to begin today, can't be picked until maybe next Tuesday at the EARLIEST!!! I am soooo upset!! This company is a JOKE!!!
I and my doctor's office called CIGNA and CIGNA Telepharmacy over a period of two days and were told the following by various associates: 1) My daughter had not been covered for prescriptions since August 2009; 2) My daughter was covered for prescriptions and still is, but the injectable medication is not considered a prescription (although you need a prescription to get it); 3) The injectable medication could be covered under "Medical" but only if purchased through CIGNA TelePharmacy.
4) The injectable medication would have a co-pay of $20.00 through CIGNA TelePharmacy as for a prescription even though the terms of the policy indicate it is not a prescription. No deductible would apply; 5) The injectable medication would be covered under "Medical" and the associate did not know if a deductible would apply or if copay would apply.
6) Last answer - If the injectable medication is delivered to my home by CIGNA TelePharmacy there is no coverage under CIGNA. However, if the injectable medication is delivered to the doctor's office, then the doctor's office could bill CIGNA and the deductible would be waived. Who knows what the truth is, except my daughter does have prescription coverage, for all the good it does her in this situation!
PHILADELPHIA, PENNSYLVANIA -- I was at one time a participant in a CIGNA HMO, and the experience was a nightmare. I was referred by my family physician for surgery, and the procedure was approved by the CIGNA office in my area. I took three days off from my job, hired a driver/companion, since I was having anesthesia, and booked two hotel rooms at the hospital three hours away. I arrived at the surgical suite at 6:00am, since I was first on the schedule, and the attendant informed me that CIGNA had cancelled my operation, because they had "made an error" in authorizing it. I then guaranteed personal payment, and I was added to the end of the day's schedule, which caused a 9-hour wait.
Upon my return home, I filed a complaint and a lawsuit, and settled, but it was insufficient compensation for the stress and interference that CIGNA employees delivered. From that point, I paid all of my medical expenses out of pocket, until an enrollment period when I could change to another company. I was afraid CIGNA would continue to make errors and cause problems. Interestingly, I never received an explanation or apology.
I always recommend to colleagues that they stay as far away from this company as possible, unless it's the only thing available. If that is the case, I advise them to prepare for confrontation, to record all conversations, and to keep records of names, phone numbers, and all correspondence. Most have thanked me later.