WASHINGTON, DISTRICT OF COLUMBIA -- I have had NALC Health Benefit for two years. They are great with office visit and prescription copays. I had to go to an emergency room recently when I was very sick, and in coughing I passed out, hit and cut my face. I was in the ER three hours, had x-rays, CT scan, tetanus shot, 2 IV antibiotics, and blood work. The total bill was over $7000!!! and was billed by many hospital entities.
My COPAY WAS $920!!! for three hours! They did not even address the cut on my nose. The last time I had to go to an ER was nine years ago with chest pains. That hospital kept me for observation for 23 hours, provided IVs, did a EKG and a stress test. My copay was $150!!! For a 23 hour stay with many tests vs. $920 at a different hospital for 3 hours of care. I CANNOT WAIT to switch out of NALC during the next open season. God forbid I get a major illness. I would likely lose everything.
DISTRICT OF COLUMBIA -- I switched from the ACLU health benefit plan to NALC's on 1/1/16. On 1/2/16, I filled out their Health Risk Assessment for which I opted to receive as my reward membership in the CignaPlus Dental Savings Plan. When I didn't get any cards, I began calling NALC, who switched me over to CareAllies, who switched me over to CignaPlus (which had the only helpful customer service of the three). After being told for several weeks that the cards were forthcoming, I was finally told after 4 weeks that I hadn't selected the Dental Savings Plan as my reward, but a CVS gift card.
To begin with, the website for the Health Assessment tells you that, if you have self-only insurance, only the Dental Savings Plan can be selected as your reward. Second, why would I have been calling to find out when my Dental Savings Plan cards would arrive if I had chosen a CVS gift card? Third, if I hadn't received a CVS gift card yet, why couldn't any error on anyone's part been corrected by Customer Service? Can't wait for open season to get away from deceitful practices like this and back with APWU.
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 labyrinth 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.
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!