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PPO being run like an HMO
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CALIFORNIA -- Since CIGNA took over management of NALC, my health care seems more like an HMO. Referrals for an MRI take an inordinate amount of time, my doctor's decision to order an MRI have been questioned, and the site selected by CIGNA is considered sub-par by two of my doctors. The site chosen for the MRI by CIGNA is a site available to people without insurance in California and the care is considered less than ideal by doctors in my area. Instead of choosing a site from the Preferred Provider List, one must now call into CIGNA/Med Solutions, speak with the person handling your case, and then choose from a list that he/she provides. Then, instead of being able to contact the MRI site (or any other site) myself, I must wait on the line while my "handler" calls the chosen site, speaks with the appointment desk, and then allows me to confirm a time and date for the MRI.

Furthermore, I was transferred 3 times within the CIGNA/Medsolutions labryinth before I actually spoke to the "handler" (my term). I received a letter in the mail today confirming that the MRI would be covered, however, the site mentioned in the letter was not the site where the appointment was made. Also, the MRI ordered by CIGNA was for the thoracic area - not the correct area!! I needed a cervico/lumbar MRI. So now the process must begin again and, needless to say, treatment is being delayed because the diagnostics are being delayed. Can't wait for July when I become eligible for Medicare. I was dreading this transition, but now I'm prepared. It can't get much worse.
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Court on 03/06/2012:
Cigna doesn't order the MRI, your doctors office gives them a CPT code representing your test... So that part was your doctors fault.

Med solutions is a horrible company, can't argue with you on that one. Deal with them daily.
Green Acres on 01/21/2013:
MedSolutions is a terrible company. They are slow to respond and generally say no to more expensive tests. They use the pretext of saving the patient from radiation exposure, but it's really a money thing for them. Check out the lawsuits against them, as well as the Delaware case.
Michael on 10/13/2014:
I don't get these complaints. I just had an MRI authorized right away and the scan was done where and when the doctor ordered it. I have self and family plan. How can it vary so much from one person to another?
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1 out of every 3 prescriptions has to be justified by my doctor before NALC will cover them
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WASHINGTON, DISTRICT OF COLUMBIA -- 1 out of every 3 prescriptions has to be justified by my doctor before NALC will cover them. And when my doctor wants to try different dosages my prescriptions are rejected unless I use Caremark, a mail order company, I do not have time to send in a prescription and wait 10 days to get it filled. I'm currently spending 3-4 hours every 2 weeks on the phone, Faxing letters, and running to my doctors to pick up letters of justification. NALC fights 1/3 of my doctors plans, causes significant delays in my medication. If you have a choice you should NOT choose NALC (CIGNA) for your insurance!
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goduke on 08/12/2009:
I imagine you are using some high dollar RX's, using some newer therapies, or are taking some drugs which have generic or OTC alternatives. You're probably going to be doing this no matter what plan you have. It's what NALC agreed to.
MSCANTBEWRONG on 08/12/2009:
That's unfortunate. You would think if there was a legal prescription, your requests would be justified. Will your Dr give you a justification letter when he prescribes or makes changes to your medication and dosages? It may save you some time.
charlene2 on 10/30/2009:
We are having NALC PPO (government). This is the worst medical insurance we have ever had. Bad choice. High copays on regular routine visit. No routine coverage on vision. No dental coverage. Most of the labs work are not covered even though requested by your primary physicians. When we call for questions about the benefits, we were put on hold for more than 30minutes, then were transferred back & forth to these representatives with attitudes. Bad service. Do not choose NALC PPO unless you want to pay most out of you pocket & have patience dealing with bad attitudes
Wendye in TX on 04/30/2012:
I would like to say that I changed pharmacies because this ins did not include Walgreens, so I went to CVS. I have had nothing but problems with CVS, and would like to go back to Walgreens, with whom I never had a problem. While looking at the list of pharmacies the NALC does business with, there are few in my area...which is central Texas. It seems the list is for those of you in large metro areas in the North-East. We do have Kroger, but they are about the most expensive in our area. I thought Walgreens was everywhere. Why can't NALC make a deal with them, for those of us who used them religiously before signing on with this ins?? I guess they will say that's my problem...
GovtEmployee on 06/21/2013:
I have NALC, and they are terrible to work with. We have a number of bills that should be covered and have not paid and are going into collection despite repeatedly calling them. NALC tells us they are trying to work with the hospital and resend the bill and the hospital says NALC will not respond or call back.
Leon Steczynski on 08/10/2013:
Thank you very much for your comments. I was considering changing to NACL during open season, but your reviews have convinced me to stay put!
sheryl on 08/27/2013:
Do not use NALC insurance we have had major issues with getting our prescriptions. we will be changing companies next year.
Sharon Jepson on 07/29/2014:
NALC has been my worst and is the worst nightmare insurance a patient could ever have. I have lost at least 6 doctors due to their ridiculous letters to my doctor(s). Someone should have filed a lawsuit against what they are doing to patient healthcare. They ar monitoring every single medicine you take and sending that doctor some ridiculous letter for him to fill out and that doctor getsscared and then quits me because he has no time for this ridiculous paperwork. He quits me, I find another, and this starts al over again. Now I cannot find one single doctor who will take me as a patient. I am now blackballed by the doctors due to the deplorable actions of NALC. I cannot find a doctor who will take me at all. This gets worse, Once NALC has targeted you they will not let up. You will continue to be targeted. They are (their words) monitoring you r prescriptions. Ther eis no reason for them to be doing this because there is legitimate reason for myself to be taking these meds but the blatant invasion of privacy and sharing of my record by NALC is placing mine and your life at risk because after a while you will not be able to obtain medical care by any decent doctor. That forces you to go to a doctor who is "questionable" because after a while no decent doctor will take you. This union has to be stopped from what they are doing. Unless someone somewhere files a lawsuit against them they will continue to do what they do. They backed Obama and the Obama care act fully so that should tell you who these scumbags really are. I have no use for NALC. The letters are coming from their legal department so you cannot get in touch with their legal department. They have to get their "story" all ready and made up before they call you back then they give you mumbo jumbo about how they have the right to monitor your scripts and healthcare and on and on. No other insurance is as intrusive as NALC, absolutely none. Someone somewhere please hire attorneys to hire a lawsuit against what NALC is doing to their members???? Since you have to join their union to have their healthcare which is plain stupid. That is UNION for you. Yesterday my gastro doctor received a letter regarding him filling a pain meed for me. He has never ever filled a pain med for me. They want him to fill out paper sand send back to them. He does not have time to do that. Today I hae receivec a letter informing me he is quitting me. He will be the 6th doctor who has quit me as a patient due to these letters NALC has sent out to doctors oitoring you and your health care and your medication. They keep pulling your record and once they have you in their sight they continue sending out letter after letter to every doctor you have, Now after 30 days I will again have no doctor due to NALC and their ridiculous letters. They are breaking the law in every degree every way possible and no one has done one single thing to stop them. U beg anyone who is reading this to please contact me and I can give them story after story of what NALC has done to my healthcare and how they have placed my life in danger. I have no life as I have no doctor with all the thans going to NALC. I beg someone to hire attorneys to file suit against NALC to stop them from destroying any others life. They will continue unless stopped. I have an autoimmune disease and need a doctor but NALC and their ridiculous letters has now prevented me from having any doctor because he does not want to take time out to answer their ridiculous allegations which are all untrue. NALC is controlling your healthcare. Your doctor can do nothing without answering to NALC. My meds are all legit but after I have just lost this., my 6th doctor due to NALC I will no longer have any meds because doctors are refusing to write meds and see me due to those NALC letters. Plain simple fact is that NALC is quietly trying to kill you off. They pretty much have done that to me. they are monitoring everything and everyone you see and sending them letters. You do have the right to see those letters but that is after they have sent them which does not help much. NALC has tried to eliminate me from their record because I have a disability which is autoimmune. Someone somewhere has to stop what NALC is doing because each year is worse than the last and this year is terrible. You hae no idea of what they are doing to you and your prescription meds.They know everything about you, what you take, who you see, what your diagnosis is, what other illnesses you have. They know more about you than you know yourself. Please someone hire attorneys to stop what NALC is doing as invasion to your privacy and healthcare. They go far beyond be a health care provider.I truly think they are part of the NSA. I am trying to find an attorney to file suit against them but it will take a good set of attorneys and other people who have been damaged by them. NALC has destroyed my life, ruined any chance of health care and they will yours too if you do not do something to stop them.
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