Consumer Complaints and Reviews
I have finally found a glaucoma medicine that keeps my vision pressure in check -- but guess what?? CIGNA has decided to drop this medication from their formulary. I am told by CIGNA (not a doctor) that I need to try a generic eye drop (cost $1.23). Oh yeah, that ought to work real good! Now I must try this new medicine and if I lose my peripheral vision, oh well!! More profit for the CEO, right?
I find they have fraudulent numbers posted, missing providers and they don't cover in a policy year what they claim they WILL for the upcoming year when you go to renew. They also didn't apply my endorsement coverages for dental insurance, vision insurance, and silver sneakers as the policy claims it is covered. I paid an extra premium for this part of the policy and then STOPPED PAYING WHEN THEY DIDN'T ADD IT ON AND THEN APPLY THE COVERAGES to the dentist and/or vision center. Both offices said they have never seen anything like this before!! My prescription drug plan formulary carried my name brand and generic drug so I signed up. After the policy started... I filled it twice that calendar year then I was sent a BOGUS formulary claiming the drugs that Medicare cover are not covered after the year was in progress.
In IL you cannot change the policy terms during the calendar year you have applied those coverages to. Cigna people who answer their phones are not well informed and they claim to have 65 call centers all over the country so each different state doesn't know what to do with you calling from a specific state. I also get audio answering messages claiming KAYAK administers my prescription drug coverage... They are a TRAVEL WEBSITE. I believe these morons have overtaken the customer service number. I also get mail from UNREGISTERED MAIL DROPS that are fraudulent mail denying me coverages and the local pharmacies charge a ridiculous amount of copay. EXAMPLE COPAYS ARE $3.00 or $6.00 for name brand. They charge me $7.92 or $4.31... Don't use CVS pharmacy. I think their employees ** up the coverages all the time... And corrupt the swipe card system. I've seen them do it live at the stores.
Frustrating experience today when I spent 3 hours on calls with Cigna Customer care to figure out how to file a claim for prescription glasses which I purchased from out of network provider. Here are the sequence of events: Note I had first called Cigna on 12th Jan 2015 to confirm benefits coverage of vision and was advised that my plan had the coverage for 1 free checkup every year and up to $150 towards frames and lenses. It was also confirmed that the doctor Monica ** was in network provider and I do not have to pay anything for the checkup.
Coverage was confirmed by the doctor's office and following which I visited the doctor on 15th Jan where my Son was advised prescription glasses. Post the checkup the doctor's office on 15th Jan had Cigna Authorization on the coverage for frame and Lens, however Since the glasses sold by the doctor's office did not fit my son well so I did not order them. I was checking on other options. Visited Visionworks on 19th Jan who also received authorization from Cigna on coverage but again the frames did not fit my son so did not order.
I further visited Walmart on 19th Jan where we did get the frame which fit well. Walmart optician called Cigna to confirm coverage where they were advised that there was coverage. However they were not in network, advised that there is a process to claim up to $96 expenses on frames and Lens and I would have to pay and then claim. I order the same and the expense was within the coverage limit.
To file a claim today it was excruciating painful experience with Cigna customer care as for 3 hours I was getting tossed around from departments to department... Cigna medical to VSP, Vision, EyeMed and back and forth. Where Cigna medical kept pushing me to one of them and the respective departments pushing me back. I was persistent in trying to get an answer where one agent of the many (...Dawn, Sheela, Melissa, Terry) advised that vision was not covered since beginning of the year i.e. 1st Jan 2015 and I should go back to the plan administrator. Nobody seem to be able to answer how and why there were two authorizations and the advise I had received on 12th Jan 2015 on coverage. I'm appalled on how Cigna can misinform me on the coverage which I had particularly verified before availing service and deny me of the claim which I should have been entitled to. Cigna should never have advised me on the coverage being a responsible corporation.
I was in my garden and fell and the next morning I noticed a large floating mass like a curtain in the side of my right eye. I went to an eye specialist who diagnosed a torn retina and sent me to a specialist for emergency surgery. After five surgeries I had lost the vision in my right eye. With no medical or surgical options my eye was now blind. I filed a claim with Cigna under an Arizona life insurance policy that included Death and Dismemberment which is covered by the dismemberment section of this policy. The company Cigna sent a form to me to fill out along with my doctor which has done the form documents that I fell in my backyard and have irreparable and permanent blindness in my right eye.
Since that time six months ago my claims Agent Courtney ** has refused to accept that as proof and has been contacting hospitals, anesthesiologist, other doctors that assisted and anyone else to look for a secondary document (which is not required, it's their procedure only), all these doctors assisted with surgeries etc. but I have never spoken to them in was usual under anesthesia.
Obviously such a record doesn't exist. So she has repeatedly said she doesn't know what to do so I should tell her other names she could get records from making me try to investigate my own claim even though they have a signed affidavit. This company is also on the east coast even though my insurance was in Arizona so contact is impossible as they never answer their phones. It always goes to voicemail 100% of the calls made. This company make up rules and procedures to try not to pay a claim so talking about adding insult to injury. Now I'm Blind in my primary eye and they're calling me a liar as well as calling my doctor a liar and refusing to pay a claim unless my own or some unrelated doctors would have written an unrelated note about me falling in my yard. This insurance is useless and combative bringing a new definition to the term bad faith.
My wife's employer no longer offered CareFirst Blue Cross/Blue Shield (CF BC/BS) as of January 1, 2014, and our only two choices for employer health insurance were Kaiser Permanente or Cigna, so she chose Cigna. The first week in January, I created an account and logged onto the Cigna website to view our vision benefits. It said that this benefit was not part of our plan even though we know it is. My wife spent several days calling Cigna from her job before she was able to contact someone to correct the error on the website. It took her so long because of constantly being on hold for long periods of time. She has a job where she has to answer incoming phone calls so she couldn't stay on hold for very long. On Sunday, January 12th, I called Cigna's main customer care number (the number on the back of my insurance card) to ask a question about something and was on hold 38 minutes and 46 seconds before my call was answered.
On January 14th, I mailed a prescription order form along with two prescriptions. By January 25th, the website was still showing "No Orders" for me. I thought perhaps it had got lost in the mail. So, on that date, I submitted an inquiry via their "Ask a Pharmacist" feature on their website to see if they received my order and inquire about the status of it. On January 31st, I had not received a response to my online inquiry but it was finally showing on their website that they had received my prescription order and it was being processed. This was much longer than what I was used to. I used Walgreens Mail Order Pharmacy when I had CF BC/BS. After mailing a prescription order to them, it would usually be on their website within 3 to 5 days and I also would receive an e-mail advising that they had received it. I did not receive an e-mail from Cigna even though they have my e-mail address. I had to keep checking the website every day.
On January 31st, I also called the pharmacy to ask a question about pharmacy benefits. I couldn't get an answer from the website because every time I clicked on "Pharmacy" under "Review My Coverage," I got two error messages: one said that the web page had not loaded properly and to refresh my browser. I did this to no avail. The second message, right below it, said that their servers were down for maintenance and to try back later. This happened 5 times in January, each and every time I tried to view my pharmacy benefits. I was on hold over 10 minutes before my call was answered only to be told by the lady that she couldn't answer my question. She said the number I had called was for the pharmacy and she could answer only questions regarding prescription orders, and their status. She said I needed to speak with someone in "Pharmacy Member Services." The number I called is the only phone number on the back of their prescription order form and website for anything pharmacy related, and it doesn't say that this number is only for the purposes I was told. There is no separate number on either the form or website for Pharmacy Member Services. There should be, with an explanation for each number is for.
After being on hold for ONE HOUR AND 25 MINUTES, I finally got an answer to my question. But, not directly from anyone in Pharmacy Member Services because no one in that department ever answered the phone. The lady who originally took my call has a friend in that department. They both are members of the professional networking website "LinkedIn." The lady who took my call was logged onto the website and she saw when her friend returned after being out of the office and logged onto the website. So, she sent her a message containing my question, over the Internet, via LinkedIn, to get an answer for me.
I applaud her initiative to get an answer for me the way she did, but seriously, what kind of way is this to run a business? I have no idea how much longer I would have been on hold if she hadn't done what she did, but that also says a lot about the Pharmacy Members Services department. The lady had time to log onto LinkedIn after returning to the office but couldn't answer the phone? The lady gave me a phone number to call about the error messages I kept getting every time I tried to view my pharmacy benefits on the Cigna website. The lady I spoke with said the reason I was getting the error message was because it was showing that my wife has no pharmacy benefits. I told her that my wife does have pharmacy benefits because she has already used them; I wasn't checking on her benefits; I was checking on mine; and I had used my own log in. She said she understood that, but because my wife is the policy holder and it is showing that she has no pharmacy benefits, the servers get confused when I requested to view my pharmacy benefits and it spit out the error message I got.
I asked her why the error message wasn't more specific and I can't recall exactly what she said, but it didn't make any sense. I used to design websites and set up servers over 20 years ago, and I know they can be set up to give a more specific, and correct, error message than I was receiving. Their servers weren't down for maintenance each and every time I clicked on "Pharmacy" and the lady I spoke with said they weren't. I forgot when I was talking to her that when I clicked on "Vision" at the beginning of the month that I got a very specific, albeit incorrect, error message. So, this is the second benefit under our plan that wasn't entered or linked properly to our account which resulted in some kind of error when I tried to view it on their website. Anyway, the lady I spoke with said she would notify the appropriate department to have the error corrected and call me the following week. Yeah, right. I haven't had anyone in any organization who said they would call me back ever do so in YEARS.
On 2/2/14, I finally received a response from the inquiry I submitted on 1/25/14 about my prescription order. The response said, "We are waiting for your physician to respond to our request for clarification concerning your medication." This was only partially helpful because I submitted two prescriptions written by two different doctors. If I knew which doctor they were awaiting a response from, I could call his office and maybe light a fire under them to respond and find out what clarification Cigna needs. Also, this "hold up" in filling my prescription order was not showing up on their website under my prescription order status, like it would have on the Walgreens website. Unfortunately, I cannot go back to CF BC/BS, and the Walgreens Mail Order Pharmacy, unless I go through the government's health care website and purchase insurance on my own. So, for now, I'm stuck with Cigna and my experience with them in such a short period of time has been abysmal.
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Cyril TuohyInsurance Contributing Editor
Cyril Tuohy, has covered the insurance industry for more than 15 years. He is an expert at writing about personal and commercial property-casualty insurance and covers life, annuities and retirement as a staff writer for a top insurance trade magazine aimed at insurance agents and financial advisors.
Cigna, a major U.S. health insurer with a big presence in foreign countries, offers vision plans under its group health plan offerings. A proposed merger with Anthem Blue Cross Blue Shield is pending before the U.S. District Court.
- Providers: Consumers with Cigna vision coverage have access to a network of more than 70,000 providers around the world.
- Cigna Vision Indemnity: Cigna’s Indemnity Vision Care plan lets employees visit any licensed eye care professional whether in or out of network.
- Cigna Network HMO: This vision plan comes with either the HMO or the point of service medical plan.
- Cigna Vision Preferred Provider Organization (PPO): The Cigna Vision PPO plan offers access to vision and eye exam from in-network or out-of-network optometrists and ophthalmologists.
- Best for Employees enrolled under a group health plan.
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