Michelle Smiles

Teaching my children to question authority, except mine.

A rant because I can

November23

p1010210Tessa expressing her joy that Daddy took this week off to hang out at home with his girls.

I don’t use my little corner of the internet to rant very often anymore but today I will.

We pay over $500 a month for health insurance with Cigna.  It isn’t top tier insurance but I would say it is pretty good (until Jan 1st when it changes and will cost us the same for significantly less coverage).  This year, Steve’s employer opted to save money by requiring all ongoing prescriptions (anything lasting more than 2 months) be filled by Cigna Tel-Drug home delivery pharmacy.  They deliver all drugs in 3 month supplies.  It irritates me because I have to be on top of things to trigger my refill a week or 2 before I need it to allow processing and mailing time and requires I pay 3 months worth of drug co-pays all at once but otherwise it isn’t wasn’t a big deal.

I don’t talk about my health issues on my blog – my choice.  Suffice it to say, I require 1 particular drug each month.  Without it, I could suffer life altering (or ending depending on the severity) consequences.

A little back story – after covering us for the previous two years, a few months ago Steve’s employer required more documentation than the IRS does to prove that we are his dependents.  (Seriously, I had less trouble passing the background check from the Secret Service the time I met Hillary Clinton.)  We faxed our marriage license, Tessa’s birth certificate (they payed for her freaking birth), and Sabrina’s adoption decree.  Out of irritation, I might have sent them the Spanish version – I’ll never tell.  Steve gets an email later stating that the only one accepted as a dependent was Sabrina.  We call.  We fax further documentation.  We are told it is all taken care of.

Over 2 weeks ago, I call to re-order my prescription.  I am given a confirmation number and told it will be mailed soon.  I wait.  And wait.  And wait.  I am now out of this drug that I require.  Last Tuesday, I call the mail order pharmacy to ask where the f*ck my drug is and am told that my order was canceled because my coverage was terminated at the end of September.  After berating the representative for the company not notifying me that they canceled my order (they claim they sent a letter – one was not received and later it is confirmed that one was never sent), I call my husband in hysterics and ask him to fix it.  He calls HR.  They tell him all 3 dependents are active.  HR and Steve call Cigna.  They say all 3 dependents are active.  HR, Steve, and Cigna call Cigna Tel-Drug.  They fix things in their system and re-order my refill stating it will take 2-3 days to process and then be overnighted.  I’m not thrilled with the time line but glad it is straightened out.

Saturday evening, after the last UPS, FexEx, and UPSP truck has rumbled by our house without stopping, I call Cigna Tel-Drug again.  A very nice but powerless man tells me that my order was canceled because my coverage was terminated in September.  My head promptly explodes.  I ask why this company would continue to cancel life saving drug orders without notifying the recipient.  He states that they don’t notify recipients (meaning they lied about the letter) because when the system says terminated it is “almost never wrong” and the people know they have been terminated.  He is sympathetic but says there is nothing he can do and tells me to call Cigna.  I asked if he wasn’t in fact Cigna.  He said yes but not the right department.  We call Cigna.  There is nothing they can do because their system is down.  The woman says she will escalate it to an account manager on Monday morning.  Meanwhile, I have been without this very necessary drug for a week.

This morning, Steve calls all of the parties again.  Four separate people assure him that it is now fixed.  They tell him they will process my order and send it overnight on Wednesday.  My head explodes again.  I offer to call back but Steve wisely feels he should make the call.  I tell him to communicate that is completely unacceptable because it means I won’t get the drug until Friday which is another 4 days away.  I demand that I either be able to go to the pharmacy down the street or that it arrives on my doorstep tomorrow.  He calls back and they agree to expedite it and have it on my doorstep tomorrow.

Moral of the story the first: Cigna sucks.

Moral of the story the second: Cigna Tel-Drug really sucks.

Moral of the story the third:  Steve’s employer kind of sucks for starting this whole cluster by holding us to a higher standard than the IRS to prove that we deserve the privilege of paying $500+ a month for health coverage.

Moral of the story the fourth: I’m not entirely sure how I feel about the proposed national health plan but I have to wonder if the government can really do much worse than some of the private insurance companies are doing now.

Moral of the story the fifth: You really have to be your own advocate so don’t be shy.

UPDATE: My drug did finally arrive this (Tuesday) afternoon. Thanks for all of the well wishes.

posted under Uncategorized
21 Comments to

“A rant because I can”

  1. On November 23rd, 2009 at 11:49 am debbie Says:

    Yep, that sucks. So sorry you have to endure that stress.
    Hope it’s on your doorstep at the agreed upon time.
    I’d hate to see what happens if it’s not.
    And I hope you are ok without your medication.
    Don’t get me started on health care and insurance in general. I could go on for hours………and it wouldn’t be pretty.

  2. On November 23rd, 2009 at 12:17 pm amy2boys Says:

    I hope you get it ASAP!! This is crazy! We have Cigna too and have never (knock on wood!) had problems with them.

    IMO, the gov’t will take things like this from isolated issues to SOP.

  3. On November 23rd, 2009 at 12:18 pm Julie P Says:

    OMG what a nightmare. Hope the meds come tomorrow. No one deserves this fiasco, especially the momma of a 3 year old, and especially not when your hubby was away last week – AHHH I can only imagine the stress you were feeling.

  4. On November 23rd, 2009 at 12:41 pm Anne Says:

    Oh boy, my blood pressure went up just reading your post. Terrible. Hope you get your meds tomorrow!

  5. On November 23rd, 2009 at 1:01 pm Diane Says:

    Michelle,
    I have had an almost exact situation with my employer AND my insurance company .. not Cigna but United Healthcare. I pay a bundle each month and every year I pay more for less coverage. I have had to PROVE my dependents and recently been told I have no choice but to switch to mail order. The mail order doesn’t offer generics for all our monthly meds so we are now paying more for them also. I think your husband’s HR is pretty great to help him. I can’t even get someone on the phone. I work for a well know publishing company in NYC and have been here for 15 years. I can’t get HR on the phone. Ever. I can open a ticket and have someone across the globe call me back with the sole purpose of closing the ticket – not wanting to help or to solve the problem. Bad is the new Good, or something like that. I brought my daughter home from Guatemala at 10 mos and I kept getting letters from the insurance company saying I had to prove she had no other insurance. You know cause she was working on the side. LOL. I kept telling them, You prove it. I have a job.
    Signed – Praying for HC reform.
    Diane

  6. On November 23rd, 2009 at 1:30 pm jane Says:

    I had a very similar altercation/confrontation with my mail order pharmacy 2 years ago…and it was Aetna. I say, “Bring on the healthcare reform!” By the way, best healthcare plan I ever had? US Army. And that is pretty much socialized medicine. Encountered just TWO in 30 years that I wouldn’t go back to today if I could.

  7. On November 23rd, 2009 at 1:47 pm Ruthie Says:

    Just for the record…when Blue Cross Blue Shield asked for the same documentation…I DID send the Spanish version of Joshua’s adoption decree! heh, heh!

  8. On November 23rd, 2009 at 5:22 pm Alleen Says:

    ugh… I hope and pray your meds are here tomorrow because it sounds scary that you’ve been without for this long already. And sadly, it scares me to think about how many more beaurocratic layers there would be with government-run healthcare.

    Our coverage is nearing the $500 a month mark too after the 1st of the year(for one less person). Can’t wait to see how high it goes if the bill goes through.

  9. On November 23rd, 2009 at 7:31 pm Andrea Says:

    So, how can people read this and not be for healthcare reform??? While the government certainly has its share of problems, it wouldn’t be trying to profit from people’s illnesses the way these private companies are. It couldn’t be worse than the current situation.

  10. On November 23rd, 2009 at 7:57 pm Melany Says:

    Absolutely absurd. I have Cigna too… and while I haven’t had an issue THAT major – I have had my share of headaches. And don’t get me started on how much I have to pay for one of my monthly meds for 6 months a year because my “coverage” maxes out by about June every year. Yeah… I have no problem with the government stepping in and trying to reform some of this system. Mainly because I know that in the scheme of things… you and I both actually have it GREAT.

  11. On November 23rd, 2009 at 9:34 pm Sonia in MO (FTC) Says:

    Ugh… that is just nuts!!! I sure hope it all works out for you and you get your prescription ASAP – all the hoops they had you jumping through to do something they were SUPPOSED to do right to begin with!! No wonder you were stressing – I’d have been screaming like a maniac into the phone!

  12. On November 24th, 2009 at 12:23 am Linda Says:

    We had to do the whole thing like you did with sending in our proofs of who we all were for the insurance my husband gets for us via his job. After we finally went through that whole process (and the process of submitting one more form they were requested), a month or so later they wanted further proof our 19 year old daughter was still (two months later) a full time student. (even after the first time they got documentation she was) Am glad to at least know from your post and all the comments we were not alone in the whole “prove who you and yours are” thing this year.

    Sorry for your troubles, hope the meds come Tuesday first thing.

  13. On November 24th, 2009 at 7:05 am karen Says:

    My insurance carrier offers mail order prescriptions as an option. While there are none that I take on a continual basis, I am quite sure I wouldn’t trust them to fulfill that obligation without screwing up. Good luck.

  14. On November 24th, 2009 at 9:16 am Bobbi Says:

    I think you should have called. It would have made for more excitement in the post:>) My blood pressure is up reading this. How can they risk people’s lives, and yes, require so much proof about dependents!?!??! Is it ok that I found it remotely humorous that Sabrina was the only accepted dependent?? Someone must have been able to read Spanish better than English!!!! Hope you get your meds!! This is awful

    On another note, you met Hillary Clinton??!??? Do tell more!!!

  15. On November 24th, 2009 at 9:25 am Shannon Says:

    I’m very fortunate that I have excellent health insurance that is provided free through my employer. It’s a HUGE benefit and one of the reasons I’m gone 11-12 hours a day to work 8 hours. I also carry the secondary health insurance on my step son as the decree states his mother will carry insurance on him, but it covers next to nothing. So after my insurance paid for my entire pregnancy, labor, delivery, and hospital stay, I had to take my daughter to a specialist for a hip click. They denied the claim. When I called to inquire why, they asked if my step son’s mother’s insurance maybe shouldn’t pay it. I’m like WTF. The lady reading the question said I have no idea who put that, but it makes no sense and we’ll get that off of there and take care of it. You think? You paid for my pregnancy, etc.

  16. On November 24th, 2009 at 10:05 am Burgh Baby Says:

    Ugh. That sucks, sucks, sucks, sucks, sucks. It’s the kind of battle that is time-consuming, exhausting, and insanely stressful. I hope it really is fixed this time.

    And to your #4–Yes, that. Definitely that. Bring on the reform. I personally would like to see a public option, but even without it, there is a mountain of mess that the reform can and should address. I think people miss that the reform is as much about making insurance companies behave appropriately as it is making sure that all Americans are insured.

  17. On November 24th, 2009 at 12:06 pm Lindsay Says:

    Hi Michelle,

    I am with CIGNA and am very sorry to read that you seem to be having difficulties with your prescription. We cannot reach out to you directly as we need your last name and customer ID number to find you in our system, so please call 800-835-3784, and ask for Laura on the Account Management Team. She will be happy to make sure your account is accurate and up-to-date, and assist you with any other pharmacy related questions.

    Because you are concerned that you might forget to re-order your prescription, you should also ask Laura to sign you up for CoachRx so you can get reminders via email, text messages, or phone calls (whichever way you choose) to let you know it’s time to refill your prescription. It’s your refill reminder, your way…delivered right to your door.

    We want your experience to be a good one with CIGNA, so please contact Laura as soon you can so we can straighten this out as quickly as possible.

    Thanks,

    lindsay

  18. On November 24th, 2009 at 10:41 pm dana Says:

    So sorry to hear you’re without your medicine. That SUCKS SUCKS SUCKS! Life has become increasingly difficult and NO ONE is competent in their job anymore. Don’t get me started on phone calls, prompts and being on hold for 20 minutes at at time. I can’t for the life of me understand it. It took me 4 hours and a wild goose chase to wire money to make a car payment plus a total of 1 hour and 15 minutes on hold total between my 5 phone calls to get things straightened out. I was close to pulling my hair out and wishing there was another planet I could move to so I could get away from the insanity. I hope you’ll let us know when you do get your drug.

  19. On November 25th, 2009 at 4:22 pm Kelly Michaud Says:

    Michelle I feel your pain. I am so glad your prescription finally arrived. We also have CIGNA and I second that they totally suck. We had such problems getting OT covered for our little Guat-tot that we finally gave up using an out of network provider. Then we gave up OT all together because they were apparently using a dart board to determine how much would be covered each time. Good for your for advocating for yourself- it pays to speak up!!

  20. On November 28th, 2009 at 7:32 am Merlot Says:

    I have the mail order prescriptions (we have Medco) and, yes, it’s kind of a pain becuase it has to be planned out an you have to ask your doctor writed scripts with the appriapriate number of refills. I don’t know about yours, but ours is cheaper than going to the local drugstore though and getting 3 months a time is prettty nice.

  21. On December 21st, 2009 at 1:19 pm Michelle Smiles » Blog Archive » Things that happened when I wasn’t blogging Says:

    […] my whole insurance coverage fiasco? It still wasn’t resolved.? I went to the doctor last week (specialist) and she advised that […]

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