Cigna Cares

[dave29]

I just received a letter from Cigna promoting their new "Well Informed" program in which they scan your claims and come up with helpful tips to share with your doctor. While throwing up in my mouth, I continued to read that their helpful suggestion to me was that they had noticed I may have high blood pressure (I call it HCR-HBP: Health Care Related High Blood Pressure), and that they just happened to notice I had not had a blood creatinine check in over a year.

Here is my well thought out response:

Dear Cigna:

Fuck you! Stop trying to interfere with my relationship with my doctor. We get along just fine. Yes, he is aware of my high blood pressure, which spiked earlier this year when you guys paid out $80 on a claim for a routine Urine Drug Test, and passed along the remaining cost of the bill from the lab to me -- at over $1700. While this whole thing is under investigation by the Texas Medical Board I just want to pass along my disgust that you would recommend treatments to a person who is now paying out of pocket a $4500 deductible for the rest of the year because you guys paid out this claim -- which in turn dried up my HRA funds (a paltry $1500 allowance that costs more than we pay into it, and when counting the employee match, is actually assuring you a $1500 profit before I am forced into the $4500 deductible arrangement).

So I want to thank you for your well informed program, it is well, informing to say the least. It tells me you are willing to sink so low as to think you know better than my doctor, milk me for as much money as possible, and are so bureaucratically bloated that you didn't bother to check and see why I might not have already had this test. Not to mention the creep factor of scanning my claims. Which reminds me: Why couldn't you, or the lab, or the pain doctor that ordered my urine test ever explain to me the charges in that explanation of benefits??? I guess that's for the Texas Medical Board to determine.

Fuck you, again, and again.

dave29

[HowHasItComeToThis]

1. AND ADVERTISING ON TV FOR PRESCRIPTION MEDS IS UN-ETHICAL

[dave29]

2. kick

the health insurance companies in the @ss

[dflprincess]

3. I feel your pain - I have the misfortune of having Cigna as well

though this year we just have a crappy policy - next year my employer is opting for the "don't even think about needing medical care this year" policy - despite evidence that policies like these increase everyone's cost. (The irony being, I work for a "wellness" company.)

What really irks me is, if Congress & Obama have their way, this is what I'll be forced to keep because my employer is too large to qualify for the "public option".

BTW - you do know that HR3200 has large out of pocket expenses (in addition to your premium costs) if you exceed the income limit? (The out of pocket will be $5k for a single making $43K or more) If you make less than the limit, the amount you pay out of pockt increases as your income goes up until you hit the limits. Supposedly, your premium won't be more than 11% of your income but that could be over $400/month at $43K though, hopefully, your employer will pick up a chunk of that.

We are so screwed.

[bvar22]

7. I was going to point this out, but you did a better job.

People still screaming for the "Public Option" do NOT know what they are supporting.

This is another "3-Card Monty" Scam.

[grantcart]

4. kick

[damntexdem]

5. Cigna cares ... about profits.

And not at all about enrollees' health.

[GreenPartyVoter]

6. Your response is a thing of beauty! *hugs*

[LiberalFighter]

8. I would see about getting this incident out more in public so that Cigna would get bad publicity.

[iamjoy]

9. Stop Blaming Cigna!

If you have an employer based plan, stop blaming Cigna.

Your employer negotiated the plan design with Cigna. They went to Cigna and worked out a deal so they could pay lower premiums and brag about how they're keeping costs low. The deal they worked out was a High Deductible Health Plan. Some promote these HDHPs by talking about how they "empower people to make more informed health care decisions by making the costs of medical care more visible to the patient." The company then throws you a bone by making a contribution on your behalf to a Health Savings Account.

Do not blame Cigna. People with employer based health care need to stop blaming the health insurance carrier. In many cases what the plan covers is designed (or at least approved) by the employer. For many plans, all the insurance company does is adjudicate claims and that is in accordance with their contract with the employer. Since the employer often incurs the actual cost of the claim, they have say in what gets covered and what doesn't. Even if it is a plan in which the employer has negotiated a flat per person rate and the insurance company is responsible for the claims cost, the employer still has influence.

AS for the letter you got, that's what they call a wellness program to help reduce costs and promote healthier lifestyles. I bet your employer approved that too.

The insurance companies suck too. I know they screw over their individual policy holders. But if you are part of a group health plan, don't let your employer off of the hook.

[dave29]

10. Cigna remained unresponsive to both us

and my wife's employer on this issue until it became clear we would take the matter not only to the Texas Medical Board but also the Texas Insurance Board. We are well aware of how the HRA (not an HSA by the way) plan works, and my wife's employer's "hand" in this. Like we are going to go rocking the boat at her job. We did that as much as we felt we responsibly could without jeopardizing it. Cigna processed the claim in accordance with the plan, but still, to date, NO ONE, not the doctor, the lab, Cigna nor my wife's employer has been able to explain how this claim was processed, specifically. Cigna gladly sets up plans like this because they look great on everyone's paper, and they make the same claims about the plans efficacy, proudly.

My rant was aimed at one turd in a very large toilet bowl. My real ire is aimed at the doctor and the lab. You want to see what I have to say about them, it's a whole hell of of a lot worse. Who bills $1806 for a urinalysis?

Cigna just plain sucked to deal with. Period.

I say to you: stop telling me Cigna is off the hook here. They did not advocate, assist or even take us seriously until we began making threats.

In regards to the "wellness program," there is NO PLACE for the insurance company in making medical recommendations. What's to stop them from marking me as "unhealthy," and a "risk" because I do not follow their recommendations merely because I cannot afford it? My doctor, ALONE should be telling me how to keep well -- and he has. He is the only person I trust in that regard. Do not tell me my wife's employer carries all the water, Cigna makes out like a bandit as well. And they do it with a smile.

My doctor recommended tests at the beginning of the year (including this blood test). I put them off because the best plan I had available to me only allowed $1500 towards any medical expenses all year, and an overzealous lab charged $1806 for a urinalysis throwing everything to hell and a hand-basket. Is Cigna to blame for that? Sure. They played their part.

Besides, any plan we got through them on our own would have been far more expensive.

Our case proves that the entire SYSTEM is broken. Not just the insurance provider, so thank you for at least pointing that out.

P.S. With exercise, my BP is now well in the normal range. Crazy, my doctor and I's wellness plan worked! At least for now.

[iamjoy]

13. Cigna Is Not Off The Hook

and I never said they were. They share the blame too. The thing is, when a claim is denied or people have a lot of out of pocket expenses, they blame the carrier (insurance company) and forget the role their own employer plays in the coverage they have. The employer looks for the cheapest coverage, not necessarily the best.

I don't think it's a good thing at all.

The problem with high deductible health plans is EXACTLY what you encountered. A doctor recommends procedures and you put off doing it because of high out-of-pocket costs. It makes one scratch his head and wonder what the point of having insurance is.

Then there are the providers who bill a certain way - maybe it's deliberate to try to milk the system maybe it's just human error by a clerk who is overworked. They code something wrong, the insurance company doesn't pay what they should. Then the patient goes back and forth fighting with the two to get the claim covered.

With our current system, we must thoroughly understand our plan - what it will cover and what it won't. We must carefully review each Explanation of Benefits from the insurance company and match it with plan documents to make sure the insurance company is paying the claim correctly. We then have to compare that against the provider bill to make sure we are being charged correctly. Doing that is time consuming and often frustrating.

Perhaps I should have said "Don't only blame Cigna." There's plenty of blame to share. The whole system is sick.

I still think wellness programs are a good idea. One way we can reduce medical costs in this country without compromising care is to encourage healthy habits and preventive medicine. Group health plans can't discriminate based on age or medical condition (yet). But, an insurance company sending you a recommendation for something they won't pay for isn't my idea of preventive medicine. It's insulting.

[Laelth]

11. Righteous rant, appropriately directed to the culpable party. Well done. n/t

:dem:

-Laelth

[Fumesucker]

12. You really shouldn't stifle your feelings like that..

It can raise your blood pressure, don'tcha know.. :)