I was told my doctor was covered, but now my insurance is refusing to cover her.

Hi all!

This is my first time posting in here because I finally got fed up with my insurance. If anyone has any advice, please comment!

I had BCBS Anthem in 2022 and they were really crummy, so I started looking for new insurance starting last November. Someone mentioned that Cigna was good, so I called and spoke to someone about signing up. I asked about whether my PCP was covered under the plan I was signing up on, and the agent confirmed that yes, she was. I really didn’t want to switch doctors since it took me months to find a decent one (iykyk).

Several months pass and I have an appointment lined up with my PCP, but Cigna is declining coverage. I called to find out what was going on and was told, “That doctor is not covered under your plan.” Which makes me do this: 😳 because yes, she is. I specifically confirmed that before signing up.

Fast forward TEN CALLS LATER (because Cigna kept dropping the calls and never returning mine…) and I find out that whoever I spoke to before signing up gave me the wrong information: my doctor IS covered, but only under group plans. I signed up for an individual plan (which could not be confused by the Cigna agent because I am not part of a group and do not receive health insurance through my employer).

Fine, no biggie, people make mistakes. I ask how it can be fixed because I would have chosen another insurance provider if I had known my doctor wasn’t covered. I’m told the doctor can fill out a special form and it will be taken care of. Cool.

I just heard from my doctor today and Cigna is still refusing to cover anything under her. I understand that they have specific doctors and facilities that they cover, but I never would have signed up with them had I gotten the correct information last year. They’re more expensive than my previous insurance and none of these issues were brought to my attention until after open enrollment was over, so it’s not like I can just switch to something else.

In addition, Cigna was one of the companies that was sued for pulling stuff like this in the past (getting people to sign up by telling them their doctors were covered, then refusing coverage after open enrollment was done).

Has anyone ever gone through something like this? Does anyone have advice? I would love to drop Cigna because this feels so scammy and they can’t even cover the one doctor I wanted them to, but going the rest of the year without health insurance is risky.

Thanks so much if you read this far!