Tuesday, Mar 11, 2014
Cigna Change Leaves SIH Out-of-Network
PITTSBURG -- A new healthcare arrangement has left many state workers and retirees in a bind. Cigna has changed its coverage, essentially making Southern Illinois Healthcare an out-of-network provider.
It's because Cigna no longer wanted to partner with HealthLink, an insurance company that loaned out its network of physicians and hospitals, which includes the largest healthcare network in our region.
The change affects state retirees like Pittsburg resident Katherine Packard. Medical issues like rheumatoid arthritis have plagued her for the past decade, and she says it's her doctors that have gotten her through it.
"My rheumatoid arthritis doctor has been established with me from the beginning. He knows my daily routines, he knows my issues," explains Packard.
So you can imagine her surprise when she went to Herrin Hospital Friday for a routine exam and was told her doctors were no longer in-network with her Cigna coverage. She says she was shocked.
"I wasn't master of my own fate. I had something that was taken away from me without my knowledge or without my acceptance."
Packard isn't the only one. In a statement, Cigna spokesperson Amy Turkington said:
"We believe our clients and customers would be better served for Cigna to have a direct contract with health care professionals and facilities in our network. This allows us to work directly with health care professionals and customers in the area for our quality and consumer engagement programs - for example, our online cost and quality information tools that provide individuals with real-time information, specific to their plan, about the quality and the actual costs of health care."
"Cigna is in active negotiations with Southern Illinois Healthcare and it is our hope that we will soon reach mutually-acceptable terms on a direct contract that is in the best interests of our clients and customers and that would be retroactive to January 1, 2014. This situation impacts all individuals who are covered by a Cigna plan through the state's health benefits plan."
But until a contract is made, patients like Packard will have an important decision to make: leave their doctors or pay hundreds, if not thousands, of dollars more in out-of-network costs.
"I'm sort of in limbo about it," says Packard. "I don't want to change anybody if I don't have to. So, you asked me if I would wait it out, I don't know how long I can."
Certain patients covered by Cigna who are in the middle of critical care will still be able to receive services. You can call Cigna to see if you qualify: 1-800-442-1300
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