I posted this on Facebook a year ago, when I was in the midst of our second appeal to Cigna (my husband’s insurance provider through work) to compensate for services which I was told in advance that we had coverage for:
“My husband fell off of a ladder and sprained his ankle while painting the house on Labor day. I called Cigna before we settled on a facility for emergency care. I tend to be fairly thorough in matters regarding finances and I asked 3 times if a specific location would be covered and what the cost would be. I was assured 3 times that everything would be taken care of with a nominal copay. Later, fine print revealed that services rendered by the location we’d chosen were not covered as I’d been told. The recorded call confirmed what I’d been told by the representative I’d taken the time to call and that I’d been given incorrect information. I explained that I found it unreasonable for a person to be expected to review fine print or to consult a lawyer under the sorts of circumstances that necessitate a trip to an emergency care facility, especially when a representative of the insurance company advises upfront that care will be covered. And I understand that the phone representative was mistaken and that we all make mistakes; however that advice is what motivated me to choose one facility over another. And under the circumstances, I think it’s reasonable for Cigna to own that mistake on behalf of their employee, honor what I was told and pay my bill as I was expecting.
We’ve also had bills we’ve submitted to Samaritan Ministries, a Health Sharing Organization that we use as an alternative to insurance for the rest of the family since adding us to my husband’s insurance would have cost around $1,000 per month. Two recent, substantial sets of medical expenses we’ve accrued are considered “unpublishable” as they are related to pre-existing conditions and have been submitted as “Special Prayer Needs” rather than in the usual way that needs are shared in this program. Pictured is the stack of over 40 cards that accompanied a comparably sized stack of checks sent over the last 3 weeks by Samaritan members – Christians who chose to give above and beyond the monthly shares they have committed to, in order that they might ease the burden of our otherwise unpublishable (“uncovered” would be the insurance term) medical bills.
In the first scenario described above I am arguing with a huge, lucrative company looking for loopholes to justify denying an arguably valid claim. In the second situation, strangers-made-family-through-faith are joyfully, generously and voluntarily pouring out love in the form of cards that are balm to the soul and money for our practical needs. The contrast here is hitting me on so many levels and I don’t think I can come out of this epiphany the same.”
Cigna never did pay that bill and I ended up submitting our expenses to Samaritan Ministries. All of the bills were shared by Samaritan members without so much as a grumble or likely a thought as to what loopholes might legally justify not doing so. In fact, we received cards and letters again, along with the checks! Those cards, once again, were filled with love and prayers that humbled and served as vehicles of healing to hearts wearied by the physical injury as well as by the apathy we’d received from the Insurance Industry.
I absolutely believe that businesses have a right to make money and that in itself is not wrong, in my opinion. I can also see that legally, Cigna had it’s pretext to deny our claim. However I did not and do not feel that our family was regarded as a unit of people with legitimate needs and rights that the company had any pledge to meet or to uphold. I do not feel that we were treated with integrity or compassion and I feel that the drive for profit was put over our family members as human beings. I can’t even say that we experienced regular, old fashioned, good customer service. Cigna satisfied the letter of their complexly written legal documents and yet missed the spirit of caring for the sick and wounded. Perhaps it’s naive to think that spirit was ever a motivating concept for the health insurance industry at large. In any case, our family has found another way in Samaritan Ministries and I don’t think that we’ll ever look back.
*Photograph by Cristina Howell