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.
PORTLAND, OREGON -- I got Cigna through my husband's work. This is the first time I have Cigna. The coverage said that they cover acupuncture. Since my cancer treatment, I had many pains on my body. I had tried physical therapy many times, but it doesn't seem to work. Since my Cigna insurance cover acupuncture, I decided to try it with my doctor permission. I picked an acupuncture doctor through the network, cause I don't want to have any problem on denial of my treatments. After a few treatments, I felt better. My neck was able to move better and shoulder not so tight. My back pain was almost gone. I felt so much better emotionally and physically.
Then, my acupuncture doctor told me that Cigna was not paying him. When I called, they told me, they denied the coverage, cause I didn't call them for permission to go see an acupuncture. In my entire life, I have never experienced this before. If my insurance coverage said they will cover acupuncture with my family doctor's permission, then, this should be covered. I even picked a doctor under their network, hopefully this way will have no problem, but Cigna, just finds ways to not pay their coverages. What kind of insurance company is this?
My husband paid for our insurance coverage every month through his paycheck, so we won't have to worry about paying so much when we need to go see a doctor. Cigna has fail to do that for their clients. Because Cigna had rejected to pay for my acupuncture bills, now I had to stop my treatments. My neck, shoulder and back pain have come back.
Due to this experience, we will not buy Cigna again next year. I will encourage whoever out there trying to look for a health insurance coverage, make sure you do not pick Cigna Corporation. You do not want to deal this kind of situation like me. P.S. I will research this kind of practice about Cigna. I believe, this kind of company practice is totally wrong. Maybe a big cost of lawsuit will get them understand the basic moral of human nature.
HOUSTON, TEXAS -- My first experience with Cigna has thus far created three problems. Upon receiving 5 prescriptions from my doctor they first canceled the order because they "could not reach my doctor for verification". I was not notified by them and continued to wait for my prescriptions in the mail. It was only when I looked on-line that I found out that the order was canceled. When I called them they said were unable to reach my doctor and get approval. I told them to try again and they called back to tell me they had received approval.
After waiting another 2 weeks for my mail order prescriptions I checked on-line again. Only the cancellation was shown. When I called them they said they could not fill one of the prescriptions because my illness (CFS) was not among those listed for this medicine. The medicine is an antiviral drug, and what I have is a virus, but Tel-drug determined it was therefore an experimental drug and "they do not cover experimental drugs". This drug has been around for about 100 years and I have been taking it for 20 years. I don't know of ANY medication specifically for CFS.
The written notification said that they would not fill that prescription because they were "unable to obtain authorization to fill my prescription". However, it was not my doctor who refused authorization, it was a pharmacist at Tel-drug. I asked if it was common practice for them to cancel all of a person's prescriptions because one could not be filled. The Tel-Drug representative had no answer. After five phone calls four of the five medications were delivered.
During this pharmaceutical hell, they had asked for how I would pay for the drugs. I gave them credit card information and my statement showed the payment to Tel-Drug on August 11. I then received a statement from Tel-drug dated September 3 showing the amount as unpaid. When I called today and told them the charge had been made nearly a month earlier on my credit card, they said they had no record of receiving payment and I need to mail the credit card statement to them. So thanks to I do not have my main medicine and they do not show payment for the others so grudgingly filled.
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!
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?
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.
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.
Ever since my husband's company changed their insurance healthcare plan to Cigna, it has been nothing more than problems with this healthcare insurance company. I am forever calling our Health Advocate for help paying the claims. This is always after several times of talking to Cigna's customer service reps. This is not an HMO Plan but their Open Access Plus Plan where the company pays $1500 monthly for this insurance. One would think, $1500 a month would give you some decent service. Not the case with Cigna.
I will be pushing to have the company change insurances at the next renewal and hopefully Healthcare reform will do something about companies like Cigna who seem to care about nothing more than their bottom line. We were happy with Great-West Healthcare, our prior insurance company now acquired by Cigna. I understand now how this was feasible. What a shame for our healthcare services in America today!