Medford, Massachusetts
Not resolved

My name is Rick and I have just recently starting having issues with our health insurance provider – CIGNA.

Let me begin with our brief story.

My wife and I have twin 10 – year old boys.

The eldest (by 2 minutes) is relatively healthy and has no issues.

On the other spectrum is Sam. He is a full quadriplegic with Cerebral Palsy from birth.

He is non-verbal. He has gross – motor and fine motor issues which cause his muscles to "tighten" at all times. He is blind.

He lives his life from a wheelchair or from his cot in the hall near our kitchen.

He is a very happy kid. He has no thought of his condition and he does not know that he could have had a different life.

As you could guess we have many bills. Some of which can be very large. Wheelchairs and shower chairs and hospital beds are just a beginning. There are monthly expenses also which could cause us much headaches. (drugs and diapers and other expenses)

We have a secondary insurance which covers many other things that our primary insurance does not cover. One of them is the co-pay that is on Sam's prescription drugs.

CIGNA has a rule that states that a customer MUST use their mail – order prescription drug program after 3 months of getting drugs through their local pharmacy.

We do not have an issue with this requirement.

The problem comes when the mail – order pharmacy cannot bill a secondary insurance. If they could, I would not be sending this.

We went back to CIGNA to get an "exception" for SAM for his prescription drugs to be able to fill them at our local pharmacy because our local pharmacy knows how and can bill the secondary insurance.

This is all we would like. Just an exception to get our prescription drugs for SAM from the local pharmacy.

We tried this by having our pediatrician sending a letter (or calling) cannot remember which the CIGNA health-care and they subsequently denied our request for exception.

We have had many different health-care insurances. ALL and I repeat ALL have allowed the exception from the mail-order mandate by seeing our need and allowing us to fill these prescriptions locally.

CIGNA has continued to discriminate against SAM and his condition by not allowing this exception.

CIGNA will ask why is that we just pay the co-pay and then submit a claim from the secondary insurance.

We have many things that take our time in relation to SAM's problems. We do not believe that a large company could stoop so low to say that we have to take time away from the care of our son to do something that they should provide. (As all other health insurances have done.)

Thank you for listening.


Product or Service Mentioned: Cigna Health Insurance.

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