I work for an employer that does Cigna healthcare with three tiers, but the costs for all three plans are similar to the three tiers that Blue Cross Blue Shield offers on the open market. I currently have a premium plan with BCBS for ~$1400/month and my employer’s premium plan is also ~$1400/month. How do companies get away with “offering” healthcare insurance that isn’t subsidized at all? This seems very disingenuous

We were uninsured for awhile, and honestly, it wasn't that bad. We had a 94% discount from the hospital we used and had a great experience with them for many years. Fast forward to last year, we officially got insurance. Cigna. We have an HSA account and a high deductible. We spend SO much money, but I view this as paying for peace of mind so if anything horrendous happened we would be covered. Now, I just got word that our hospital is discontinuing service with Cigna and everything is going to be considered out-of-network. This is a blow to our family because 2 out of the 4 of us require specialists. My son is medically complex and the hospital has a children's hospital wing where he sees 5 specialists a year and may need surgery in the coming years. I've spent years finding a medical team that works for our family and they're all at this establishment. It's all being pulled out from under us...it takes effect in 3 weeks. I don't know what to do now....should we go back to being uninsured? How do we shop around for insurance? Should I look into catastrophic insurance? A friend recommended US Health Group but after searching this sub I'm hesitant. Key points: 1) We make too much money for any form of government assistance (however, we are NOT wealthy) 2) We live 2 hours away from the next closest children's hospital and I have yet to find out if they accept Cigna. 3) How do I vet an insurance company? TIA

In the past I never remember paying anything for an annual physical with blood work. I recently received my bill and my blood work/urinalysis was $1206 and after cost reduction I owe $1020.cigna covered nothing and I will have to call them and see exactly what they cover because I will be turning down the blood work for now on if this is what it will cost. General health panel (CPT 80050) $630.99 Blood test lipids (cholesterol and triglycerides) (CPT 80061) $293.80 $20 for the needles and stuff I rarely go to a doctor so maybe I'm out of the loop but everyone I mentioned this too says it doesn't seem right. So I wonder if it's a coding issue or Cigna really just doesn't cover anything until I hit the $1k deductible.

In early 2024 I made an appointment to start seeing a therapist, specifically one that my insurance (Cigna) listed as one accepting EAP. I called the office and confirmed with them they do accept EAP, so I scheduled an appointment. My six EAP covered sessions ran out around September 2024, so I called my insurance, got a new code for six more covered sessions, sent it to the office by both text and email (and also over the phone to confirm it was correct). Come March 2025, I’m on my last of the second round of therapy sessions covered by EAP. I check in at the office for my sessions, and they tell me an owe around $300 for my last several sessions. Confused, I tell them that EAP covers my sessions aside from an establishing bill of like $69 once a year. The office tells me they do not accept EAP and that I’m overdue on my bill. I have never been told, in all the times I physically check in for my appointments (I never do virtual) that I owed anything. This is the first I’m hearing about it, or that they do not accept EAP because I confirmed when I made the very first appointment that they did accept them. Hell, I had called to give codes for each batch of six sessions. Now, if they had told me this sooner, I would’ve stopped going to find someone else. Not a big deal, it’s their business and they are allowed to handle it however they want. But it feels really shady to suddenly spring a mystery bill on me and say I’m overdue for the last six sessions. They had six months to tell me when I came in or email me or call me. I showed them all the proof of me contacting them (I always leave paper trails) about the EAP codes and confirmations it was accepted. The legal advice I’m seeking is, is it legal for a provider to do that, suddenly stop taking EAP and secretly bill you without informing the patient? I’m assuming they will drop my bill once they review my evidence, but if not, can I legally ignore that bill (if it even comes my way at all)?

My company moved from Aetna to Cigna self-funded open access. Every month I submit claims for reimbursement with an out of network provider. The diagnostic codes never change but at least 2-3 a year, they play this game with me where they either lose the claim, claim is pending for weeks or the superbill is "missing" information even though its the same info every month with different dates. Of course, we all know they are just playing a game and trying to weasel out of paying me. Is there any where I can go to escalate these issues? My companies care advocate is useless but it feels like that is my only recourse.