Mike Date Rated: 1/12/2015 7:21:31 PM
I converted to Cigna-Healthspring during the 2014 open enrollment and it went into effect on 1/1/2015. Today (1/12/2015) was my first opportunity to use it when I went refill a prescription. When I got to the pharmacy (for info. it is one of their "preferred" pharmacies) I was told the drug was not covered. Mind you, prior to converting to Cigna I had checked ALL my medications on their formulary and confirmed ALL were covered, including this one.
The pharmacist indicated that she could provide a 30-day "transitional" prescription, but that I needed to get further authorization before they could provide any more of this medication.
When I got back home, I called Cigna customer service and after 20 or 25 minutes on the phone, I was told the drug WAS covered and they couldn't understand why the pharmacy told me it was not covered. I called back the pharmacy who told me that Cigna had not approved it and that I needed to contact a Cigna supervisor and give them the actual prescription number, rather than just the drug name.
I again called Cigna. This time (again after another 30 minutes on the phone) I was told that they do see on my account that the prescription was rejected, but they couldn't understand why because the drug is covered. They said they would have to connect to another department and could I please continue holding. After another 10 minutes and three attempts on their part to try and contact the other department, I told them I had been holding for 30 or 40 minutes already and asked if they could just call me back when they have an answer. They said could I please hold while they got permission to call me back. C'mon, are you kidding?????
The rep finally came back on the phone to tell me they had gotten approval to call me back. It is now 7:30 at night, and still no call back. I am getting quite suspicious that no return call will be forthcoming and I will have to call them again before I get an answer.
It is pretty ridiculous in this day and age that the consumer is placed between the pharmacy and the insurer - one telling me the drug is covered, and the other telling me it isn't. And if today is any example of Cigna's typical customer service, I can assure you I will be switching to another plan as soon as the next open enrollment period occurs.
Disgruntled Customer in NJ