Cigna Health Insurance

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Kimberlie of Willow Spring , NC August 14, 2009

This is my Second time complaining. My husband has reoccurring Pyoderma Gangrenosum. He has been fighting it for nearly 2 years. This is in direct relation to his "complicated Crohns disease". He also has vascular disease and a massive DVT in the same leg. He has been out on STD 4 times in the past year. Always a battle with Cigna. In June he wound up in the hospital in fear of bone infection. This time Cigna gave no hassle. Mike went back to work after his 2 round of HBO therapy. 3 days later the wound started to open again. After 8 days we notified Cigna he would be going back out on disability. His Dr. advised long term. This was on July 27.

Cigna has spoke with the Dr.,recieved a note from the Dr. and medical records. They are still refusing to make a determination. It is never enough and they will never ask for all that they need at one time.

I would like to quote the Dr.'s note "Giving the difficulty that Mr. F has had in healing the pyoderma gangrenosum and its impact on his ability to work, he should be considered for total disability. I expect that even in this regard his ability to use this leg is in jeopardy and he should not be subjected to the risk of loss his lover extremity."

She also made me aware today that they are not useing his other illnesses in there judgement. Pyoderma is a direct relation to Crohn's. The DVT started when a dr. gave improper wound care instrutions for the Pyoderma. And the vascular disease is directly related to the fact that the Pyoderma wont heal. I am tired of fighting these people. I am tired of the run around. I am tired of the lies. I have dealt with "complaint" department in the past all that proved to me is that they truly are a bunch of liars. Even going as far as to make up conversations that were never had.

Aundra of Houston, TX August 14, 2009

My son has Cigna HMO coverage on his job, FEDEX. Last November he fell victim to a stroke. He is currently living in a nursing home and is completely dependent for care. He has a wheel chair that Cigna paid for. Because of his condition, he needs some alterations to his chair. When "Rehab Specialist requested authorization to order the parts, they were told that they would be covered 100%; however, after the parts arrived at Rehab Specialist's location, Cigna had changed the planned and denied payment. We were told we, the family, would have to pay 1000 to get the alterations done. They changed the plan without any authorization from my son, the patient. Because of this we cannot get the much needed alterations done to his chair.

My son's head is not supported on the right side as it should be causing more attrophy of his muscles on the right side where the stroke is concentrated. We need the tray on his chair so he can have a place to rest his hands and support his remote control and other devises we use to communicate with him as he can not speak. His left arm and hand did not completely recover from a previous stroke and the right arm is completely immobile.

Jack of Killeen, TX August 5, 2009

My son suffered 3 ruptured discs in his spine in December 2008. Cigna started paying short term disability. The money Had to be approved weekly by a hostile rep. The requirement was he had to travel 350 miles one way from Killeen, Texas to Corpus Christy, Texas for medical exams and treatment. They told him if he missed any appointment he would lose all benefits. They refused to authorize surgery but demanded he have injections to see if that would work. When the injections failed they authorized surgery but still require the 350 mile one way trip (700 miles round trip) for treastment, they refuse to authorize care in the Killeen, Texas area. Final results to delay is loss of home, loss of car, loss of all money because they keep sending the checks late. Now they will only send money once a month. New forms clearly specify that the Social Security disability money if he is approved will be taken by the insurance company. All state agencies refuse food stamps or housing or medical assistance because the insurance company says he is being paid. He has lost his family, and now can't make the trip they demand he make to keep the medical appointments. They require all trips and yet refuse to pay the cost.

Tyra of Lebanon, OH July 31, 2009

I have a 4 year old daughter Maggie that has a tracking defect with her eyes. They don't track at the same time. She had surgery when she was 2 years old to help correct the problem. Maggie still goes to Children's Hospital every 3 to 4 months for examination of her eyes. They are considering a 2nd surgery which is typical with the type of problem she has. CIGNA repeatedly denies the part of the claim for the refraction stating their policy only allows for a one time of year routine refraction eye exam.

I continually tell them this is a medical condition and in order for them to determine the best medically for her eyes moving forward, she has to have an eye exam each time. Children's Hospital will not code it any differently because they tell me it's medical. In other words CIGNA Health Insurance repeatedly is denying a medical health claim. Maggie's condition is all on record at Children's Hospital. I've done all I can think of and they still continue to deny the claim. I feel I pay a lot of money a month to have health insurance and what good is it if they won't pay for medical treatment?

Can they get away with just taking your money and not paying? My husband's company does not offer health insurance and I feel I have no other options. I've looked up complaints on-line and it does appear the CIGNA recieves many complaints. Is there anything that can be done? To me this is the same as saying your only allowed one xray a year no matter how many bones your break. I truly believe they are just finding loop holes to deny payment. Please Help.

Donna of Battle Ground, WA April 18, 2009

I am a retiree of a large corporation since 2000. We have had CIGNA health insurance for many years and have always been satisfied. Three years ago, my husband became disabled with gouty arthritis, immediately followed by colon cancer. CIGNA, up until the beginning of 2009, has been great. Now, CIGNA has backed off of paying for the continuing medical tests and problems my husband has had since his cancer. They are saying that he became eligible for Medicare when he went on disability, and, therefore, they are no longer the primary insurance.

They have paid a few dollars from the claims, but we are paying a whopping 250 a month for full coverage for him. They say it's our fault we didn't apply for Medicare when it became available to us. In a letter from the Social Security Administration dated February 6, 2008, it states, You may enroll for Medicare medical insurance at any time you are covered under a group health plan.

However, you may wait and enroll durng the 8-month period that begins when the work ends or your coverage under the plan ends, whichever occurs first. So, we elected to stay with CIGNA, since we had been so satisfied, even though their premium had jumped so drastically in January 2009. I have called and written letters to CIGNA trying to get 2500 in medical bills paid, but they are rude and non-responsive to our problem. I finally got someone to promise to mail me an Appeal form, but I haven't received it yet.

They were even rude enough to return a several-page document with cover letter that I sent them asking for a review. CIGNA's stand is that we were required to go on Medicare when it became available, but why didn't they tell us that? Why did our bills have to pile up before they finally told us their policy? Why have they collected the high premium but not provided the services? It's frustrating when you try to do everything right and make the contacts to correct problems...only to be told It's your fault. Deal with it.

My husband needs some more diagnostic work done, but now we can't afford it. He has some new medical problems that need attention, but we can't afford the doctor visits. His health has been put on hold until July, when he will start receiving Medicare benefits. Does CIGNA care? NO!

Genalyn of Saginaw, TX April 1, 2009

I filed a claim for short term compansation for surgery. They accepted the clain set the amount to be paid per week. Now I have recieved one payment(late) and any have recieved no more. There are no updates on my claim on thier web page. They do not answer or return my calls. I have paid my dues every week from my check. is it to much to ask to recieve the aggreed upon claim amout in a timely manner. These times are tuff and the loss of income is devastating to our family. please help us.

James Derek Adair of Richmond, TX March 20, 2009

The cost of the Cigna plan increased by 1500 to over 5000 annually. The benefits decreased to the point where healthcare and prescriptions are no longer affordable. A quarterly check up with the Texas Liver Institute was 80 co-pay, as of '09 it is over 920! Duane Rykan of Tel-Drug quoted a price of 126.77 for a 90 day supply of one of my meds, yet when I tried to sign up, the price increased to over 380.00, despite the quoted price. This is one of nine prescriptions I require.

I suppose I can no longer afford to stay alive due to Cigna's new for '09 price increases.

Diane of Half Moon Bay, CA February 20, 2009

After fourteen years of long term disability benefits from Cigna. They denied my claim. My health has not changed. My doctor still states that I am disabled and should not return to work. Fibromyalgia/Chronic Fatigue Syndrome is the diagnosis. Cigna had a Doctor review my case and he was paid almost 700. (they accidentally mailed me a reciept). He reviewed the paperwork they supplied him. He specializes in occuptional lung disease. I have no idea what that has to do with Fibromyalgia.

He didn't see me or talk to me. Oh and there was the Private Investigator that followed me around for four days. He got ten minutes of video. He saw me getting in a taxi and carrying in 8 pound bag of pet food into the house. The report the PI wrote didnot coinside with the video. I mailed an appeal on my own (I did it in 1997 when Cigna denied me). But I hear things are getting bad for them so they are doing this to a lot of people. Hoping people will just give up.

I may have to go to the ERISA level if this appeal doesn't work. They say it can take up to 180 days for them to make a decision. Another ploy in hoping people will go back to work disabled or not. And then it is all over. I will not be eligible for benefits from them again. This policy was one through my employer. I didn't even know I had this plan until after I got sick and the Human Relations dept. informed me.(thank goodness for them) Cigna also tried to get my MD of ten years to turn against me. They sent her the video and had the Dr. call her. It didn't work I hope. I can tell that our relationship has changed. I think she is sick of dealing with CIGNA. The policy I have states that I can choose any doctor I want to and they will in no way interfere. oops!

The stress alone has made the symptoms of my disease worse. My family doesn't want to hear about it and I can't blame them. It is like a spiraling nightmare. I have no idea how I am going to live finacially. At my age 53 it would be a sad situation if I have to move in with my 80 year old mother. My kids worry about me so I don't want them to know about it. Cigna is just tearing me apart piece by piece with no mercy.

Kathy of Duncan, SC January 15, 2009

I am a registered nurse. I have several health problems so I was on Intermittant FMLA. In Dec 07 I was told by Cigna that I had over 300 hours to use. I had to stop working 2-6-08. In March I was told that I had no hours left so they were terminating me. I was told by Cigna and a person in Cola who deals with FMLA tell me that its not against the law to give out incorrect information. At this time I was terminated from the hosp. I told them that I had a verbal warning for being out and a written warning. According to their policy the 3rd time an employee gets a suspension, not fired. Darla said she's have to talk to her boss and when she called back said that I was right and extended my time for 30 days. I recieved a certified letter in april 08 that said I was terminated in Feb. No letter was recieved about the change of date.

I also had an ongoing complaint re: harrassment in the work place due to my FMLA. I sent a long grievance letter to Ms Sinclair. I had not heard anything about the grievance and I had been very sick, so it was a momth or so that I tried to get info on grievance.I was told that they had sent me a letter -certified mail re: their response. I told Ms Sinclair that the only letter I recived (certified mail) was where they fired me. I asked what the letter said and she said she couldn't remember but she would send the letter again. I recieved it in june. Nothing was done period. My doctors put me out of work due to several health issues. I have had to get a lawyer to fight for my short term and long term disability. The last full day of work for me was 1-29-08/I worked 3 hours on 2-6-08.

I have had 4 surgeries from 4/08 to 12/08. I had bilateral cervical fusion, gallbladder surgery, and 2 surgeries (10/08 and 12/08) at MUSC in Chas to help me to breathe. I still have apnea. Can not use a cpap or bipap. I have chronic migraines and nausea, arthritis in my back, slight scoliosis, back pain. carpal tunnel in both hands- wear braces on them. I have fibromyalgia, severe depression and stress, chronic pain, High blood pressure, high cholesterol, hyperthyroidism, trouble sleeping, trouble with concentration and memory to name a few. I take pain meds everyday. I have not had a paycheck since feb 08.

Cigna keeps saying that I was a sedentary nurse, I'm only 46 and was educated. My job was triaging patients on the phone. Most people, even in the hosp, did not know the extent of our job was. I did work on the computer 10 hours a day. I had to have a sc multistate license and a penn state license. I have had to get a lawyer but according to them I have been turned down 2x already. They are filing an appeal. I think it is so rediculous that when a person truely needs help and has documented health problems that they can't get the help the need or deserve.

My medical bills are rediculous. And I'm getting very frustrated. I do have a laywer who is trying to help me with the STD/LTD and social security disabilty. This has been going on now for a year. I just want to know why this is so hard. My family is living paycheck to paycheck and I have son that graduates highschool this year. Cigna has drawn this out so long. Now I understand why people who are sick/disabled have to file for bancruptcy.

Jean of South Haven, MI December 29, 2008

On Saturday, June 28, 2008 I took my 10 y.o. daughter in the local emergency dept with a chief complaint of nausea, vomiting and diarrhea. A mass was found in her lower abdomen and it appeared to have ruptured. South Haven Community Hospital has only 40 beds and has no emergency surgery or pediatric services available. Within 15 mins of this diagnosis we were in an ambulance being transported to The Children's Hospital at Bronson Methodist in Kalamazoo, Mi. Once there we met with the Chief of Pediatric Surgery, and the diagnosis was confirmed there was a mass and it appeared to have ruptured. Surgery was scheduled immediately. They removed a tumor the size of a large grapefruit and my daughters right ovary. Shortly after surgery the surgeon informed me of a hospital appointment with an pediatric hematologist and oncologist.

To make an extremely long story short my daughter had an extremely rare form of juvenile ovaian cancer. We were informed that since both hospital visits were emergency Cigna would cover both at 80%. This would not be the case. First we were told that because we didnt call for prior authorization the coverage wouldnt be decreased. (It was Saturday and the call centers were not open) Then it was the fact the hospitals were not in network. Emergent or not. Then that aruptured tumor was not emergent. Finally the bill at South Haven Community was paid at 80% after a battle. Things like the ct had to be pre-authorized etc. Any excuse not to pay.

Then Bronson wasnt part of the network, so they would only pay at 60% Then the oncologist wasnt in network, they would authorize to see a geriatric oncologist but not a pediatric oncologist. And since I have found the oncologist office did apply for network years ago. but cigna only authorizes one name in the entire office. They all bill under the same tax I.D. why aren't they all listed? Bronson applied and became part of Cigna's network October 1, 2008. They had no choice the other pediatric provider for the area discontinued pediatric services June 5th, 2008.

We go back to Bronson for testing every 3 monthes but as of yet cannot get Cigna to pay what they should. And every time you call they agree that it should be covered and then they dont pay. The reasons are numerous and will vary from operator to operator. The latest is no visits to the oncologist are covered because the dedectable hasnt been met! An Emergency room visit, the ambulance transfer to a children's hospital with an inpatient stay, and her deductible hasnt been met. It's unbelieveable. How they determine what to pay at 80% and what to pay at 60% I don't know. The anesthesiologist at Bronson was paid at 80% but the pathologist wasn't. The hospital wasn't and the oncologist wasn't (even though she is supposed to be in network). It's unbelievable.

The bills that have been left behind are becoming staggering. Over 5,000 dollars to Bronson for the June bill alone. And since then we have been back. She has to have Abdominal CT's every 3 monthes and the last time they did blood work and a bone survey. But since they say she hasn't met her deductible..... you get the picture. It was not my choice for my daughter to get cancer. But so far so good. At least she hasn't had to have Chemo. I wonder if she did, would Cigna deem that unnecessary also?

I am on the verge of being sent to collections and am trying to make payment, but I feel that Cigna should pay their fair share. I even applied for Childrens' Special Health care, which is a privately funded program with Michigan's Medicaid to help with the bills. But CSHCS won't pay until the insurance has paid the full amount of 80%. What do I do? I urge everyone and anyone DO NOT GET THIS INSURANCE! They are either truely incompetent or the policies to duck payment signal a coming collapse in the system. Then what happens to all who have previous exhisting conditions?

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