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Horrible Company
Posted by JoelHughes30 on 11/06/2013
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.

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Posted by Mandm048 on 09/12/2013
WESTON -- 09/12/2013

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 wheel-chair, was refused transportation because she, allegedly, had used up her transport quota.

Our agent was incredulous to explain this mis-information. 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?
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Cigna lied about what was included in my policy
Posted by on 08/10/2012
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 perscriptions 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. Thats 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 emergency's until after 6 months or 12 months. In my mind I have insurance exactly for the reason of emergency's. 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 and 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 its 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.

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Posted by leet60 on 2012-08-11:
As for your dental insurance, the waiting period is fairly typical and it is likely they consider the issue to be a preexisting condition.

For your prescriptions, I cannot be sure about your area but the Walmart pharmacy in my area will fill generics for a payment of $4.00. It may be an option for you to try.
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Denied $10, 779.00 for covered services.
Posted by Houzeman on 08/08/2012
Letter From Service Provider
Letter From Service Provider
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 provide send me a latter tat 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 wavier 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 schedule 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.

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Posted by madconsumer on 2012-08-08:
some procedures require pre-approval. this is one aspect of cigna that is annoying. i understand if there is no pre-approval, they can deny and not pay the claim.
Posted by Kris10 on 2012-08-08:
send a letter to the debt collection agency asking telling them to stop contacting you. Also, send a letter to your state's insurance commission/department and ask for resolution to this. At the very least, it will light a fire under Cigna's butt to get a move on with your appeal.
Posted by trmn8r on 2012-08-08:
I can't follow all the lingo in the letter, but hopefully Cigna will get this resolved. It's too bad you have to deal with the collection agency in the meantime.
Posted by CowboyFan on 2012-08-08:
What was obviously happening was that out-of-network doctors were charging patients more, then waiving the co-insurance and deductible on that amount, so that in effect CIGNA paid the entire cost of the bill, e.g. $10,000 normal cost of procedure-patient to pay 20% ($2,000): instead doctor inflates bill to $12,500-waives the 20% from patient ($2,500) and then collects $10,000 from CIGNA. Doctor gets paid full amount, patient pays nothing, CIGNA gets stuck paying an extra $2,000 it should not have to.

Now CIGNA says that patients must pay their share of the total, or none of the bill is to be paid by CIGNA. Since the bill will be paid if the patient pays his deductible/co-pay, the solution would seem to be for the OP to go back to the doctor, pay her doctor the co-pay and deductible amounts, and then have the doctor resubmit it showing that these have not been waived. Then CIGNA would pay their portion of the bill which the patient has not paid. The op paying part of the bill would be cheaper than paying all of the bill.
Posted by Anonymous on 2012-08-08:
Why did the provider wait so long to do anything? If they had done all this 2 and a half years ago, then maybe Cigna could have done something. Insurance companies usually have a time frame for re-considerations for claims.
Posted by olie on 2012-08-09:
Cowboy Fan, you explained this well.
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Denied medication for sinus infection needed from compounding pharmacy
Posted by Rob.pat.henry on 07/10/2012
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?
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Posted by CIGNAQuestions on 2012-07-11:
Hello, I can look into your account to see what else can be done for you. If you would like my assistance, please email me at LetUsHelpU@cigna.com. Thank you.
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Conflict Of Interest Involving Labor Law Discrimination Retaliation
Posted by Bridgetwills99 on 06/06/2012
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 N Y State Workers Compensation Board Cases WCB69709892 OGC 08-230 traveling with WCB69711246.

Cigna was the administrator for my husbands 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.
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Posted by clutzycook on 2012-06-07:
So, what exactly happened and what does your WC claim have to do with Cigna, or what does Cigna have to do with your WC claim?
Posted by bridgetwills99 on 2012-06-07:
Hi clutzycoook: Cigna HMO was located in East Syracuse,NY ( I live in Liverpool,NY,I Used E,Syracuse because I thought it would post on that address)

Now to answer your question how NY State Workers Comp.Board is involved,Most of the info,I got thru the Medicare Investigation Project Investigations & NYS WCIA Susan Bently @ AG Office./Lawyers Ethics, GSA Waste & Abuse .I was declared disabled due to a head injury I sustained in June 1989 @ my long time employer;Nationwide Insurance Co.They fired me upon my return to work.They needed a Social Security Administration (SSA) Disability Decision( SSD) decision to keep paying me my Benefits. SSA Office Syracuse,NY. completed my paperwork for Nationwide Ins.Co.& denied me SSD. Nationwide Ins.then had the power to cancel all my Benefits based on: " SSA Denied me SSD." I was then ref.by Orthopedist surgeon to a program called; N Y State Education Dept. Vocational Education Services for People
with Disabilities (VESID) According to Susan Bentley,N Y State Workers Comp.Internal Advocate for NY State Attorney General's Office , It was a mystery that NY State VESID had me in the program thru BOCES when SSA denied me SSD claiming I was NOT disabled.Medicate Investigations Project Investigations also agreed. BOCES ( ONONDAGA COUNTY) PLACED ME IN EMPLOYMENT @ a Syracuse,NY Local Hospital as a Unit Receptionist working week ends only. BOCES (ONONDAGA COUNTY) Counselor wrote a letter to NYS VESID that my wages were way more than I was making, I wrote up a safety concern report for the Hospital involving I did not want to do patient care & patient transportation including taking off doctors orders.(long story) the hospital fired me resulted in NYS WCB69711246.
I then searched for work on my own to stay away from the State Agency's. Retaliation took over.
State University Of New York,(SUNY)Physical Medicine Rehabilitation were also involved because my PT/Spine rehab was thru them. NYS VESID got involved again & placed me at Health Services Assoc,(PHP working as a mail room clerk (full time as mim.wage) I was pushed head first in to a metal filing unit by a medicare coordinator of benefits when I was bent over filing I sustained a severe permanent injury on July 22,1997,ref; NYS WC Claim WCB69709892.I was AWARDED SSD AFTER THIS INJURY. lONG AFTER IT WAS BROUGHT TO MY ATTENTION THE MEDICARE COORDINATOR OF BENEFITS WAS A FORMER NATIONWIDE INSURANCE EMPLOYEE INVOLVED IN WCB69709892.
Cigna HMO were my husbands employee benefits Administerators for his elected employee medical benefits which were contracts for him and myself for medical. Cigna breached the contract,removed North Medical Family Practice (DR FIACCO PCP)& applied Family Practice Assoc Dr,Fazio to the contract. all medical was denied. At this point Fraud was spreading involving the labor law,Hippa violations
death threats related to labor law,property damage and ethnic acts of hate.According to Medicare Inv.Proj/MSPRC lisa LaChapelle,Supervisor for CIGNA in my case ( located in the State of New Hampshire for subrogation on what they paid out)
ref,it to Cigna Legal Dept.in Connecticut)
NY State Dept.of Health Office of Certificate & Surveillance (Albany NY) did an investigation on it also ref;( 98-11-30010) they denied Freedom of Information on it ( FOIL) Cigna then cancelled my husbands HMO & Aetna took over & REFUSED to insure me. AETNA lawyer in the state of Connecticut even denied to Medicare Investigator that they insured my Husband. Later an Aetna employee 'CONFIRMED TO INVESTIGATOR THEY INSURED MY HUSBAND & REFUSED TO INSURE ME BECAUSE NYS WCB ..
Posted by bridgetwills99 on 2012-07-15:
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Posted by Joeykelley on 05/10/2012
I have had back surgery and have been out of work for about 6 weeks. I have received one check for my short time disability so far. I have made several attempts and number of hours one the phone and still getting the runaround by Cigna. They take your money every check but don't pay out.
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Posted by Alain on 2012-05-12:
I'm going on the assumption you're in Alabama since that's what's on your review. Contact the Alabama Department of Insurance at (335) 269-3550 and/or file a complaint via http://www.aldoi.gov/Consumers/FileComplaint.aspx
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Was declined chest CT scan prescribed by family dr. by irrational reason
Posted by Simonshijr06 on 08/03/2011
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.

2. 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!!

3. family dr. prescribed ct scan.
i don't think dr. would lie for me to risk his license - bread and butter.

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Posted by Anonymous on 2011-08-03:
Just because the dr ordered a ct doesn't mean your insurance company has to approve it. If they don't find it medically necessary, they won't approve the test
Posted by BEJ on 2011-08-03:
LS is right on the money. Just because a test/procedure/treatment is ordered by your physician does not mean it is automatically paid for even if your insurance is a PPO. There must be a medical necessity for the test. I think reasons 1 and 2 are reasonable responses.
Posted by Anonymous on 2011-08-03:
Great review, very informative, I would keep at the insurance company to payup. Don't let them off the hook with that rationalization that it wasn't a medical necessity. Goodluck!
Posted by madconsumer on 2011-08-03:
often times insurance companies fight payment to save money. AFR is spot on, keep at em until they succumb to pay.
Posted by Anonymous on 2011-08-03:
Radiation treatments, such as CT's, are often ordered un-neccesarily. Why should the insurance company pay for a test that isn't needed? The X-Ray report was clear enough. What was a CT going to show that the X-Ray didn't? Too much exposure to radiation is harmful anyways
Posted by Anonymous on 2011-08-03:
Insurance companies are greedy bottom line.
Posted by Anonymous on 2011-08-03:
Oops too late to edit. That should say 'radiation tests' not 'radiation treatments.' Big difference
Posted by Anonymous on 2011-08-03:
Very astute madconsumer!! Also these claim representatives are trained to keep the payment process going real slow. I hope the OP gives us a followup and maybe we'll have another review "resolved".
Posted by Anonymous on 2011-08-03:
No we're taught to know what should or shouldn't be paid, according to the plan benefits
Posted by Anonymous on 2011-08-03:
I would suggest perhaps in the future when is this is settled, to seek out another insurance company like empire etc. There's plenty of them out there that would welcome your business.
Posted by Anonymous on 2011-08-03:
I hate to say it (not because little said it, but because it is true) that some radiation tests are not a covered plan benefit on many insurances and those that cover it make you jump through so many hoops that its not even funny. I say keep fighting until you exhaust all resources. I have had to fight tooth and nail to get some of my cardiac test covered. Not sure what it was called but its the one that they inject you with radiation and then do the scan.
Posted by Anonymous on 2011-08-03:
Oh, and I'd have to agree with Wally. Insurance companies have shareholders to report to for earnings. Too bad they aren't all non-profit.
Posted by Vinnie11 on 2011-08-03:
I'm sorry, I don't understand this. If you have a high deductible and you have to pay for the service anyway because your deductible hasn't been met, what is the issue at hand?
Posted by CrazyRedHead on 2011-08-04:
My husband has BCBS through his employer and he pays a high premium so we don't have a copay when going to the dr, but if the deductible isn't met then we have to pay out of pocket for part of it until it has been met. I thought this was standard for all health insurance companies?
Posted by Skye on 2011-08-04:
Doesn't Cigna require prior authorization from them, before you have any medical procedures done?

What does your policy say about prior authorizations for CT scans?
Posted by Anonymous on 2011-08-04:
The company I work for requires a pre-auth for radiology or we will deny the claim. The ordering physician can send us medical records after we deny the claim. But it sill doesn't mean it will get paid.
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CIGNA Tel Drug Users Beware
Posted by Anti Cigna Tel Drug on 03/31/2011
Our family has been using CIGNA health insurance for the past 8 years and have nothing but compliments on their service, prompt payments, etc. However, their related company CIGNA Tel Drug is HORRIBLE. My twin boys were scheduled to have a specialty drug injected once a month during the first flu season of their lives. One night, after never receiving a bill, they called at 9:00 pm indicating that I needed to pay $997 over the phone to process the next months dosage that needed to ship next day. I went ahead and gave them credit card while I filed the secondary insurance to expediate the process. When my credit card statement came, they had charged me $1440 and had no explanation for the change in authorization amounts. In addition, I had manufacturer coupons up to $500 a month that I wished to use. The associated told me that I would need to speak to a supervisor to use, but I was transferred to no avail to the supervisor's voicemail. I have left 4 messages in the last three months for a supervisor or manager to return my call regarding the change in authorization amount and my coupon cards, but still have not heard back. Thus, we have continued to pay the copay without the reduction of $500 each month for twins....$5,000. Today was the newest issue. They did not ship our monthly drug that has to be administered within a five day window. This Company is a joke with horrible customer service. The only reason why they are still in business is because you have to use them through CIGNA in most cases or for a reduced rate. CIGNA has been great, they should lose this loser subsidiary and go with Walgreens!
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Child with epilepsy Cigna won't pay for medication
Posted by Eriknwill on 03/10/2011
I couldn't believe it when my niece called me today crying because CIGNA won't pay for her son's Epilepsy medication.

She can't afford the medication for her 11 year old son called Trilept. I can't believe a large company like CIGNA thinks it's o. k. for a child to have seizures while setting in class or in the middle of the night banging his head on the floor. Sine see has insurance she can't get any help paying for the medication because if you have insurance drug companies won't give him the Trilept or discount the price.

My niece is afraid to take him to see his gran-father who's dying from cancer because she doesn't want him to see Erik have a seizure.

I could understand if they denied an old person like myself that's already lived a long life but I don't understand how they could do this to a 11 year old that also has Asperger.
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Posted by leet60 on 2011-03-10:
I am not certain why your niece is being told this, I have Cigna and the medication you are referring to is known as "Trileptal", an anti-seizure medication. It is not only on the approved drug list for Cigna coverage it is listed as a preferred brand in suspension form and also available in tablet form.

If she is getting this information it is not covered from the pharmacist she may want to try another pharmacy.

Good luck.
Posted by Anonymous on 2011-03-10:
Trileptal is used to control partial onset seizures, so any headbanging is more likely to do with a characteristic of the mild autism. If not, the child should have a comprehensive med reevaluation, as headbanging during seizures is a sign of a different type of seizure that would best be managed with different medication.
Posted by Venice09 on 2011-03-10:
Is your insurance also refusing to pay for the generic version of Trileptal? You might want to ask about that.
Posted by jktshff1 on 2011-03-10:
I would check with the child's Dr. May be the diagnose that is causing the problem.
Good luck
Posted by Venice09 on 2011-03-10:
My son took Trileptal for off-label reasons, and when the generic became available, the insurance company refused to continue paying for the brand. Most generics are good enough, but in the case of Trileptal, the brand works better. Despite the prescription for Trileptal and the doctor's recommendation not to use generic, they flatly refused to pay for the brand.
Posted by spiderman2 on 2011-03-10:
I imagine that the reference to the child banging his head on the floor is a refernce to falling during a seizure and/or thrashing around during a seizure. I would take leet60s advice and check with another pharmacy and have your daughter call Cigna and found out exactly what is going on. I have a son with Asperger's Our insurance that we pay a small fortune every month for covers very little of his therapy costs. It is not personal, if we had a large company, it would all be covered, but because we are a small business we do not qualify for autism services coverage. I don't know what state you are in, but your daughter can check out what her state offers in the way or progams to help pay for her son's epilepsy and autism issues.
Posted by Anonymous on 2011-03-10:
spiderman, "falling" and "thrashing" (convulsive) seizures are atypical of partial onset seizures, they are characteristic of other type seizures which are controlled by varying degree by other seizure medications. It really sounds like the child suffers from more than one type of seizure, which is quite common, if headbanging is involved, , and needs to be managed by more than one medication, if not a different medication altogether. Also, Op she may qualify for state assistance also, being a special needs child, despite the fact she has insurance, in which case the state may cover it.
Posted by danny54 on 2011-03-10:
Would your niece's doctor be able to provide some samples of the medication until this situation is resolved?

Maybe I missed it, but has she called and talked to someone at CIGNA?
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