The company I work for is a popular financial technology (FinTech) company, which means they’re politically liberal. It also means they’re incredibly cheap. After years of being insured by United Healthcare, (and satisfied I might add) the CEO of my company decided to save the company money and switch every employee over to Cigna health insurance. I have yet to hear a positive word about them.
In 2018, United Healthcare covered my decompression back surgery in full, no questions asked. A year later in 2019, and about three weeks after my company switched to Cigna, I needed to have a two-level spinal fusion; a much more involved back surgery which required rods and screws to be inserted into my spine. Cigna refused to pay for this and denied my claim. After weeks of fighting and endless paperwork, my surgeon finally convinced them the procedure was necessary and Cigna ultimately paid for it.
My question to Cigna is this, “Who the hell are you to tell me and my doctor what is medically necessary and what isn’t? Do you think my brain surgeon is just handing out surgeries willy-nilly for no reason?” Apparently, Cigna thinks their doctor (who was probably a D student because he works for an insurance company rather than have his own practice) knows more than my neurosurgeon who has physically examined me and has a relationship with me.
In the end, Cigna paid the $90,000 for my surgery after a protracted battle. (That works out to $30,000 an hour for my surgery. Anyone think this figure is inflated just a bit? Perhaps I’ll argue the cost and the relationship between the hospitals and the insurance companies in another post.)
I recovered from my surgery well, but now I’m fighting Cigna over a simple prescription drug. Again, United Healthcare covered it, no problem. Cigna? Huge problem. For three months I have been calling both my doctor and Cigna trying to get this medicine covered. Today, I finally got an honest answer.
The battle went something like this: I called my doctor for my prescription who then called Cigna. A few days later Cigna faxed paperwork over to my doctor to be completed and then faxed back to Cigna. I would call my doctor and ask the status. He told me he faxed everything Cigna. I called Cigna and they said they needed such and such. I would call my doctor back and he said he faxed them such and such. I’d then call Cigna and they said they never received such and such. This endless loop went on for three months with Cigna saying they never received what they needed in terms of paperwork. My doctor told me he sent out all of the paperwork to them ten separate times using Cigna’s five different fax numbers over the course of three months. (Do you see a pattern here?)
Finally, my doctor’s Office Manager got involved and I got the truth, which was simple; Cigna was simply stonewalling in an effort not to pay the $1,200/mo prescription.
My doctor filed an appeal with them which will take 72 hours to begin. Can you imagine if my prescription were heart medicine? I’d be dead already! Again I ask, “Cigna, who the hell are you to tell me and my doctor what is medically necessary and what isn’t? Do you think my 14 year-educated, government-licensed doctor is just randomly doling out prescriptions to anyone who says, “My turn”?
Cigna has no problem taking the premium payments every month, but God forbid they have to pay on a claim! (Um, that’s your problem Cigna. If you don’t like your business, quit. Let an honest broker take you place.)
America, this is what socialized medicine (Medicare for all) looks like. Let the free market compete and provide choices for everyone based on their needs and wants. Don’t just accept the bone the government tosses you. Had I had the choice, I certainly would not have chosen Cigna to insure me and my family.