Experience with Cigna Health Insurance

November 27, 2024 9:13 PM

What's it like having health insurance through Cigna? Are they better, worse, or the same as other insurers? What has your experience been with getting things covered? Is their customer service accessible and well-trained? Are they friendly?

I am considering switching from health insurance purchased on the private market (Harvard Pilgrim) to an employer plan offered by Cigna. I live in Massachusetts. On paper this looks great, and will save my family a lot of money. But we use a lot of healthcare, including mental health services and obscure conditions (POTS). It is important that we actually be able to use our insurance to pay for our medical needs.

I've looked up our providers and they appear to be in Cigna's network.

Harvard Pilgrim is annoying, and our premiums this year are due to go up 14%. But bottom line, they get the job done. And when I call them, I reach friendly knowledgeable customer service reps on good quality telephones who will answer my questions or call me back if they can't. That's worth a lot.

I've read this FPP, and while it sounds terrible in a "American health insurance is terrible" kind of way, it doesn't feel dispositive to me about this decision.

I'd appreciate comments from anyone who has worked with Cigna, either as a patient or a medical provider. Are they better, worse, or the same as the other insurers you've worked with?

posted by Winnie the Proust to Health & Fitness (9 answers total)

I have had Cigna for a few years. They are totally fine. Much better than, say, United Healthcare, but not fantastic. You can get customer service but I don’t know that they would call you back. Haven’t had any issue with them paying claims.
posted by knobknosher at 9:38 PM on November 27

They are laughably bad and consistently default to rejecting coverage, even when the reason for rejection is against the law. The only way that they have been functional as actual insurance is by appealing every rejection and by using my employer's advocate to push them to actually provide the coverage that I'm paying for.
posted by ajayb at 10:09 PM on November 27 [1 favorite]

It will depend on the specific program within Cigna.

But generally Cigna has been fine for us. Maybe slightly worse than my previous United Healthcare plan from a previous employer, but not in any consequential way. Less bells and whistles but that's probably a reflection of the options made by the employer.
posted by mullacc at 10:35 PM on November 27

I have had a positive experience with a Cigna PPO. I experienced no claims issues with a significant medical event and its aftermath. The service was reasonably helpful.
posted by shw at 4:29 AM on November 28

I am a therapist who started taking Cigna to keep a client whose insurance changed. They pay markedly worse than other companies. This is to say I suspect your choices, if you want a therapist who takes your insurance, may be fewer because a lot of providers may opt out of being on that panel.
posted by less-of-course at 5:09 AM on November 28 [1 favorite]

I've had Cigna for a year and I had Cigna ~8 years ago. I also deal with benefits as part of my job, so 100% of the escalated employee issues have come through me to take back to our Cigna people.

A few things:

- Cigna seems to be MUCH better now than they were years ago.

- They do love denying claims, but almost everything can get resolved with a "peer to peer" where your doctor talks to Cigna's doctor and I assume says some version of "bruh." If you ever have anything denied, ask your doctor to do the peer to peer, it's the fastest path to a solution.

- For our employees (who are spread out over the whole country, mostly remote workers) the network has been mostly fine, but there have been a couple highly specialized therapists, etc who aren't covered. Cigna plays pretty well with exceptions if you follow all the rules. If you find yourself in this situation, the magic words are "network adequacy form." Your doctor will fill that out with all the reasons they're the only ones able to give you the care you need.

- Anecdotally, I think Cigna is fine. Between employees and their families we have 1000ish covered members on my work's plan, which we switched onto back in January after being with Aetna. There were a bunch of initial growing pains just getting everyone aligned onto a new insurance carrier, but since those early (and easily resolved) issues, I think we've had less than 10 real issues that I've had to escalate. And all of them have been resolved.

- Anecdotally, Cigna is great if something very bad happens. My coworker's 29 year old husband was diagnosed with chemo resistant kidney cancer this summer and she found out she's pregnant about a month later, and she told me (unprompted) that Cigna has been wonderful to them. Assigned her a dedicated case worker and everything. So that's good feedback to have.

- The biggest benefit to switching to Cigna is that you're going to be covered on an employer plan. Someone at your work? It's literally their job to make sure employees are able to effectively use the insurance the company is paying (lots and lots of money) for. Ask for help when you need it, let your employer grease the wheels with the client team.
posted by phunniemee at 5:35 AM on November 28 [6 favorites]

Have had Cigna through work (and in Massachusetts) going on 10 years now. In general I would say their reputation has improved over that time. Having said that, I don't have another company to compare them to, so it's hard to know how they rank. In general, I've never had major issues with them.

A few deets:

• My wife has a chronic illness, so from the beginning we've used my company's "Cadillac" plan or whatever the name is for the highest level of coverage. The main benefit of this has been dodging most of the "out of network" claims, this means she can basically use any specialist she wants without too much hassle. The downside is that it's expensive because it's a family plan and we only have one child, and that plan is most efficient for families with multiple children.
• The mental health coverage news isn't great I'm sad to say. But again I don't know how it compares to other company's plans. My wife is also a mental health provider, and she quit taking Cigna about 5 years ago because they kept reducing the amount they pay out. Having said that, she also stopped taking all insurance for the same reason, so...
• As a counterpoint to that, if you do find a therapist who takes Cigna, you're generally in good shape, my experience is you'll seldom have billing headaches.
• In general we've been satisfied with their coverage, and also take full advantage of our "FSA" plan.The FSA helps paper over the occasional billing surprises that pop up.
• Lastly, I would agree with phunniemee 's last point, there is likely someone in your HR dept who can help you navigate the best choices for you. My first two years of work I made the mistake of waiting till the last minute during our enrollment period and doing it all on my own. Then year 3, I took advantage of those help sessions (that I usually ignore) and ended up saving a non-trivial amount of monthly payments.

posted by jeremias at 6:08 AM on November 28

I've had employer plans by Blue Cross Blue Shield, United, Cigna, and Aetna. BCBS was far and away the best of the four in terms of coverage and network size, but the other three were basically indistinguishable.
posted by capricorn at 8:53 AM on November 28 [1 favorite]

I had Cigna once through an employer and I hated it--I complained about it every year on our employee satisfaction survey. Since it sounds like your providers all take Cigna, you might be all set. But my issue was that I had to stop working with some of my providers because they didn't accept Cigna. Oftentimes, providers I was interested in didn't take it. I also had to have my physical therapist talk to Cigna a few times to get them to cover more PT sessions, because they deemed my PT treatments for chronic pain as not really useful after a certain point.

I'm now resolving my pain issue with a provider that doesn't take insurance, so I guess Cigna's lack of customer-friendliness did not really matter in the long run, but I still hated having them as a provider. I've had much better experience with BlueCross BlueShield and Aetna.
posted by dean_deen at 8:57 AM on November 30