New Year New Insurance New Nightmare-Yes The System Is Broken
Ok so the New Year brought about a new insurance company through my husbands company. It was cheaper.
We switch insurance frequently the new reality. Rates get too high you switch or your primary insurance holder changes companies and you get a new plan. We know the drill all to well. You have to see if your doctors are in network and your kids doctors, etc. Never any fun.
Something new has happened this time however. Something that has not quite happened before. So my husband had back surgery right after we started the new insurance. We had so much trouble figuring out who was in network, etc. He was actually given the wrong information from the insurance company and the doctor.
So in February a condition I was struggling with led me to a urologist. I went to someone who was recommended by another doctor who I respected. Went to the appointment after the doctors office said they were in network with Cigna our insurance company. At the appointment I had to fill out many forms and one of them was a form saying credit card info needed before treatment. I filled out all the forms and proceeded with my appointment. This month, May, my husband says there is a charge of $285 on the credit card from the urologist. We thought that was high for one appointment. Insurance should have covered it. So on the phone I got with the doctors office. They were rude. They were combatitive. I was mad and I wanted to know why they charged my credit card and why I was never sent a bill and why if the doctor was in network was it not covered? Well they said that it was because our deductible was not met. I decided to contact the insurance company to find out the story there. They said that the doctor was not in network. I was given the wrong information by the doctors office. Oh great. She also said that that doctor does cover some Cigna plans but not ours.
Cigna basically said I was screwed because I should have called them and not taken the word of the doctors office. So I called the doctors office back and asked for the office manager. Well if she was not even ruder than the first person I talked to. She basically said that it was my fault. I should have given them the full information. She proceeded to tell me that Cigna has different plans and not all are covered. I say why did the office staff not ask me this if they knew this to be true. I am a patient with a new insurance company and do not know the inside out workings of insurance companies. I am relying on the people who do this for a living to tell me what they know and ask me the questions that will make a difference in my bill. They did not and I find this unacceptable. They sure were right there to charge my credit card the full amount though weren’t they.
So here is what I have learned in the last few months about my insurance company Cigna. Before you do anything get on the phone with them. If they give you the wrong information you have more recourse. If you go to any doctor or hospital and they want to do tests. Get on the phone with Cigna. The lab they use may not be covered. Then what do you do? Go sick as a dog and start lab shopping? If they want to do a biopsy or X-ray. Call Cigna. They may not be covered? Is anyone who touches that X-ray covered? Call Cigna. So basically what I learned is just how screwed up the insurance system is. So this leads me to the question that if God forbid I am in a bad accident where I am rushed to an emergency room. There will be no time to get on the phone with Cigna. I will be fighting for my life. I cannot imagine the charges that will ensue because we have no time to make all the calls about who is covered and who is not. It is so frustrating that at our most vulnerable of times when we need health care we have to be put through this unnecessary headache. In my mind if you go to a doctor and they are in network then all the people associated with that doctor should be in network.
My story is not anything catastrophic but it does point out that major flaws exist in our system and they do not seem to be getting better. The system is broken. Please remember this when you vote in November.