Cigna HC?

[mickeysmate65]

For 20+ years we've been covered by some form of CareFirst Blue Cross/Blue Shield health plan. DH's employer is beginning to phase them out in favor of Cigna plans. It looks like one is considered an HMO and the other an in-network type of plan. Does anyone have experience with Cigna?

 

[dex08]

My company has been on Cigna for what seems like forever and they just announced that we're switching over to Blue Cross/Blue Shield! I've been on Cigna for about 15 years.

I've never had a problem with Cigna except when it's been a doctor's office or hospital which has coded a test or diagnosis wrong. Cigna is good about letting them re-submit under a corrected code so that items are covered (or covered differently, rather.).

 

[mickeysmate65]

Thanks for responding Dex08. I think the biggest challenge will be finding a primary care provider. I'll have to wait until Monday to double check but I don't believe our doctor accepts Cigna. I checked the website but couldn't locate his name. DH's employer is doing a phase-out of CareFirst over the next 2 calendar years. I haven't seen the cost for next year yet but I doubt it will be affordable.

 

[sdzman]

We have Great West Health Care (GWH) which merged with Cigna a few years ago. I havent had any issues with them other than a mistake in which a claim was coded wrong. They responded to their mistake and resolved it quickly. I do like their website, a lot of good information there.

 

[dex08]

Thanks for responding Dex08. I think the biggest challenge will be finding a primary care provider. I'll have to wait until Monday to double check but I don't believe our doctor accepts Cigna. I checked the website but couldn't locate his name. DH's employer is doing a phase-out of CareFirst over the next 2 calendar years. I haven't seen the cost for next year yet but I doubt it will be affordable.

My employer is switching to Anthem Blue Cross and I'm fortunate that all of my doctors were listed on their website. We were just advised of the switch about 2 weeks ago and it goes into effect in January, so no 2 year transition for us. We were told our premiums would be increasing but they haven't told us anything else yet. We're supposed to start receiving our healthcare enrollment packets in the mail in about a week.

Finding new healthcare providers that you are comfortable with and trust is no walk on the park and I'm sorry you are going to have to go through this.

 

[southern_redhead]

We have had Cigna POS for a year and it has been FABulous! That said, we are now having to choose between 2 PPO's and I detest PPO's because of the deductible. I went with BCBS because they have more specialists on their list and we do use them with our youngest DS. Other than that I might have stayed with Cigna's PPO.

We have had several other insurances while DH carried us. The only one I truly hate is United Healthcare. Dealing with their claims was a PITA because, no matter what it was, they always told me it was pre-existing and I had to do backflips to prove it wasn't OR they would decide the Dr was now out of network ("Yes ma'am, it does say in network on the site and he HAS been in network for years but not now. Now his clinic is in network but not him personally" was my favorite response.)

 

[sookie]

we have cigna PPO and I LOVE IT!!!
i have the option for BCBS federal and cigna is better by far - price wise and for services. I hope it doesn't change too much this open season!

 

[IndayMichelle]

DBF is a CM and he has Cigna. I am not a fan. Everything requires precertification! Well, not everything. It's a huge network with a lot of options for providers. But they require precertification for imaging which is a big pain in the you-know-what right now. DBF has been having knee problems and we finally got him in to see the ortho. But we've been waiting forever to get approval for an MRI!!!

I know it's not his dr's office that dropped the ball because I tried to get an authorization for an order too. I work in a chiro office.

You'd think the Mouse could provide a little magic to those who help make the magic happen...

 

[luvmarypoppins]

Not all cigna plans are the same.

If you go to their website you could also look under internal medicine etc. to find your doctor.

I have noticed that most of the local doctors here, or should I say the surgeons dont accept cigna.

Here, you must go to the univ. hosp. as they have a blanket coverage plan with all cigna policies - example, POS (Point of service), Oap (open access plus), OAP with care link etc.

My experience with cigna: this would be 7 surgeries last year, coma, radiation, biopsies etc.
Good: They did approve mostly everything

Bad: They denied one of my biopsies. They later approved it after we challenged it saying we didnt have control of where the surgeon sent it etc. So it was considered in network

2. One of my surgeries was considered "outpatient". Nothing like getting a denial letter when you are in the hospital as in inpatient fpr 3 days. Dh got on the phone and said the surgeon was challenging it immediately. They approved it.

3. They dont pay for the best physical therapy places (the hospital out patient ones) with our contract. That is a sub division of our contract with another company.

5. Drugs - they wont pay for certain brand names on the 3 tier plan. I only take a name brand of one drug and they wont pay for it as their is a generic. It is something I chose myself however.

6. They big brother you alot with dh plan. They have some "wellness thing they send when you dont fill your meds etc. This letter is sent to your physician as well. They really push their mail in drug plan which I refuse to participate in.

7. They tried to assign some nurse case manager to me. I told them no thank you twice with 2 different surgeries. Honestly, what is someone thousands of miles away going to do for me on the phone??? I can handle my own care quite nicely thank you. She even called my room when I was in the hospital

Read the policy carefully!! Hope it works out for you.

 

[mickeysmate65]

Wow! Thank you to everyone for responding. While we are all located in different areas it is nice to get other people's perspectives on a company. Most of your experiences could really happen with any plan or company. I expect many of us will see changes to our healthcare options over the next handful of years. Once they send us the open enrollment packet I'll see the details of the plan.

Thanks again!

 

[justAglance]

A few days late, but figured I'd chime in. The company I work for has had Cigna since I started. Currently they are starting to phase it out in favor of other plans. Personally, I don't care for the new plans, I have gotten used to Cigna and IMHO, they are easy to deal with, no hoops, no loopholes. And I do mean easy. For instance, I had to have surgery awhile back and it was surgery that I would need aftercare for. Hearing this, I jumped onto their website, looked for the surgeon I needed (extreme specialist), found him, called him the next day to confirm, called Cigna to confirm, called my parents, explained whats happening and how I needed aftercare, booked my flight and was in the operating room within the week. Talk about easy. No muss, no fuss. As for plans, I doubt they are the same between companies, so I'd stay check into it better and get to know their website. Any questions give em a ring as probe em with questions. I love Cigna and am sad to see it being phased out of where I work.

Here's hoping your plan is just as good as mine is/was.

 

[Mama-san]

I had Cigna with my previous employer and we currently have it now with through my husband's job. We've generally had no problems with them. I really like the ability to view all claims on their website. They do push their mail order drug service though. Can be kind of annoying (they usually send you a form about it whenever you get a prescription filled at a pharmacy but the service is optional).

 

[PatsMom]

I have had Cigna for years and haven't had any major problems. The exception would be paying for my diabetes educator. The first time the hospital submitted the claim, it was always denied. I would call Cigna and they would research the claim and say they had mis-coded something and they would resubmit. Then it would go through.

This year I've had CT scans, ultrasounds, two fairly major surgeries, lots of biopsies and cystoscopies, and now chemo/immunotherapy. They have been good about processing the claims and re-processed some without being asked after I met my out of pocket maximum.

They do have the "Wellaware" program which can be kind of annoying. Nurses call you with health questions. They call me about my diabetes - the last time she called, I said to please take me off her list. I was more worried about the cancer right now. They call my husband about his heart conditions - he looks at the caller Id and lets it go to voicemail!

I don't have Cigna's prescription plan so I can't comment on that.

I haven't had any problems with the precertification process.

 

[TiggerStac]

I have had cigna for the past 4 years with no problems whatso ever. We started on an EPO w/copays and changed over to deductible/coinsurance plan.

I would prefer the copay verison, but hubbys co stopped offering it. I have only had one dr that we have been referred to that did not except it. My youngest has a lot of specialest, etc and never had a problem. I havent had problem others have mentioned w/therapies, I have had pt w/out problem w/tons of options. really haven't had any testing yet that will require auth, but I'm sure I will in dec when I take my son to another specialist..

No problems w/their prescription coverage, I do hate that they just changed to force us to do mail away. we can fill 3 times for maint drugs then you have to do mail order. some of my youngests doses change so frequently, and need to be kept at certain temps. but on the plus side...those meds are overnighted to me.

 

[Gina]

I was with BCBS for a number of years until changing jobs this past May, and am now with Cigna through my new employer. I didn't have any real complaints with BCBS, but I never had any claims other than well-woman visits and such. I haven't had any claims with Cigna yet either, but I was extremely surprised and happy to discover that DS and I could go get our Flumist vaccines at the Take-Care Clinic and they would be covered 100% with no copay or anything. Went and took advantage of that in August, and it was zero hassle and no cost to me at all. Very happy so far!

 

[SandrA9810]

Disney uses Cigna. But they do offer lots of different options. At Disney you could choose the HMO or the PPO plan. Disney practically gives it away free, to make it even more enticing to make sure all CMs have medical coverage. And they partner with WebMD for discounts off your weekly payment, $200 in free FSA account for the basic coverage.

Although I can't say I ever used the medical part, so I don't know how hard it is or what's covered.

 

[Cindy B]

So happy to see pleased Cigna customers. As a stockholder, I'm pleased as well

Been on CIGNA's plans (all variants of them) for over 10 years. No problems, no hassles or anything. I came on after having a baby, no issues, no issues with claims, and such.

Glad you say that customer service was great. DH was part of a customer service team (IT side) for many years. Now he's in a totally different division--so its very different.

The FSA plan is good. Sometimes they 'question' a FSA purchase or submission and all I need to do is quote the FSA list of allowable expenses in thier letter and voila.. it gets paid.

 

[dclfun]

Not all cigna plans are the same.

If you go to their website you could also look under internal medicine etc. to find your doctor.

I have noticed that most of the local doctors here, or should I say the surgeons dont accept cigna.

Here, you must go to the univ. hosp. as they have a blanket coverage plan with all cigna policies - example, POS (Point of service), Oap (open access plus), OAP with care link etc.

My experience with cigna: this would be 7 surgeries last year, coma, radiation, biopsies etc.
Good: They did approve mostly everything

Bad: They denied one of my biopsies. They later approved it after we challenged it saying we didnt have control of where the surgeon sent it etc. So it was considered in network

2. One of my surgeries was considered "outpatient". Nothing like getting a denial letter when you are in the hospital as in inpatient fpr 3 days. Dh got on the phone and said the surgeon was challenging it immediately. They approved it.

3. They dont pay for the best physical therapy places (the hospital out patient ones) with our contract. That is a sub division of our contract with another company.

5. Drugs - they wont pay for certain brand names on the 3 tier plan. I only take a name brand of one drug and they wont pay for it as their is a generic. It is something I chose myself however.

6. They big brother you alot with dh plan. They have some "wellness thing they send when you dont fill your meds etc. This letter is sent to your physician as well. They really push their mail in drug plan which I refuse to participate in.

7. They tried to assign some nurse case manager to me. I told them no thank you twice with 2 different surgeries. Honestly, what is someone thousands of miles away going to do for me on the phone??? I can handle my own care quite nicely thank you. She even called my room when I was in the hospital

Read the policy carefully!! Hope it works out for you.

Just an FYI I've had CIGNA for years and I LOVE their nurse case manager program. You do have to qualify for it ( chronic condition or something that would benefit from that kind of assistance). Both the nurse case managers I've had have been excellent. They've gone to bat for me, researched questions I had, and approved durable medical equipment and sent the approval paperwork to the vendor the SAME DAY my Dr. prescribed it. They cut out alot of red tape, will find a vendor and contact them on your behalf, and do their best to get you the best care possible. I've been very pleased with CIGNA and esp. with this program. Best of all, the nurse case manager program is a benefit with no additional cost.---Kathy