Our daughter was born with half-a-heart.
But instead of providing Jasmine with the treatment she needs, Cigna has put our family through a health insurance nightmare.
Our story begins long before Jasmine was born. We’ve been paying premiums to Cigna Health Insurance for years. Cigna had no problem taking our money. Then, when we needed access to life-saving care, Cigna initiated an insurance paperwork nightmare.
In September 2014, Jasmine was born with Hypoplastic Left Heart and Heterotaxy. Basically, she was born with half-a-heart and her organs flipped. As a result, Jasmine has battled chronic and complex immune challenges. She has been hospitalized many times and received medical procedures far too advanced for any infant. One day, she’ll need a heart transplant.
Jasmine’s condition makes it absolutely critical that she maintain a consistent continuity of care. She needs access to the same specialist physicians, hospitals, surgeons, and cath team that understand her history and the unique circumstances of her case. That’s why we can’t just change insurance providers overnight.
We wish we could, especially after what Cigna has put us through.
Last September, Cigna notified us that they would no longer offer our PPO plan on the individual market. We followed their instructions. We called the 1-800 number and spent an eternity on hold. When we finally got through to a real person, we explained our situation and were enrolled in Cigna’s Bronze PPO at a cost of nearly $1,100 per month.
A customer service representative named Charles gave us a confirmation number and certificate code, but not written confirmation. We asked. Again and again.
After 50 requests for something in writing, Cigna’s legal team told us that we’d been enrolled in the wrong plan with no out-of-network benefits. This was corrected, and through the assistance of the Department of Insurance, a letter was over-nighted stating that our family was enrolled in the Cigna Bronze PPO plan for 2017. However, Cigna still declined to provide any rate or coverage information in writing.
We kept asking for the rate, coverage, and benefits of the plan. Nothing.
In mid-December, we paid Cigna $1,079.73 for our January 2017 premium, even though we didn’t know the policy benefits, coverage, or whether the plan had received regulatory approval. Still no response.
Just in case Cigna’s insurance failed, we purchased a Blue Shield PPO as a back-up, but come to find out that’s only available in Southern California. With no other PPO options to cover Jasmine’s heart surgeon, and only one HMO choice, we additionally purchased a Healthnet HMO policy to cover the heart surgeon at Lucille Packard Children’s Hospital.
All three insurance policies cost us $2,500 – just for January.
We’ve been paying our premiums but Cigna employed all the usual delay and deny insurance tactics. They kept saying that the plan lacked final regulatory approval from the Department of Insurance. They kept giving us that excuse – even when the Department of Insurance confirmed otherwise.
Delays: we’ve experienced them. Five weeks before a trip to Boston, Jasmine’s cardiologist prescribed portable oxygen concentrators for the flight to Boston. It was supposed to be delivered immediately in order to give us time to test and learn how to safely use to the equipment. Cigna delayed the oxygen, placed the order through five different vendors. A wild goose chase that ended a few days before our departure.
Run-around: we know all about it. Four of Jasmine’s doctors have prescribed Synagis, a treatment that that is medically necessary. Cigna won’t provide access. More paperwork.
Then, Cigna used the excuse that we were past due on our premiums – even though we paid our insurance premium on-time. Days before a trip to Boston, Cigna actually cancelled our policy and refunded our premium for the entire 2017 year. Cigna blamed a computer error.
We paid it back, and the policy was corrected for now. Our plan is no longer past due, but they say that the “error” could happen again.
Enough is enough.
If Cigna properly enrolled patients and offered proper documentation, much of this could have been avoided. We are tired of spending all of our energy fighting our insurance company. We don’t need the additional stress from Cigna. Our daughter’s condition is enough stress for anyone to handle.
