Question:
will have the choice to choose between hmo or ppo for CIGNA, which one will
I have less trouble with? My current PCP takes Cigna as well as the Surgeon I will be seeing. So as far as have in-network doctors go, that is not a problem. My PCP is willing to refer my too. So it all comes down to which one will approve me quicker?? Any Suggestions would be great!!!! — Tammy O. (posted on October 1, 2002)
October 1, 2002
Tammy, a lot of times an HMO will not cover the surgery. I would check this
out first. Nancy Poe
— NANCY P.
October 1, 2002
I currently have Cigna EPP (glorified HMO) and had my surgery 8/15/2002.
It was a battle to get approved. So when our open enrollment happens this
year, I'm choose to move to Cigna PPO, so I'll have more choices. But
Cigna is still Cigna. Most bureaucratic company I've ever worked with.
— Cathy S.
October 1, 2002
I would say go with PPO, that is what I have, I did not have to go through
all the referal processes that HMO requires.
You can also choose any Doctor you want to see and not worry if they are
considered in Network or not.
From the day my papers were filed with Cigna to my approval it was 6 days,
it really was very easy.
Good Luck
— Jeri P.
October 1, 2002
I must say that I have CIGNA HMO and have not had any problems. I have
heard horror stories about both. I would check each policy thoroughly
before making your decision. I guess it depends on your plan. Good Luck!
— Beffy W.
October 1, 2002
I must say that I have CIGNA HMO and have not had any problems. I have
heard horror stories about both. I would check each policy thoroughly
before making your decision. I guess it depends on your plan. Good Luck!
— Beffy W.
October 1, 2002
I must say that I have CIGNA HMO and have not had any problems. I have
heard horror stories about both. I would check each policy thoroughly
before making your decision. I guess it depends on your plan. Good Luck!
— Beffy W.
October 1, 2002
I would begin by checking w/both the HMO and the PPO and ask if WLS is a
covered benefit, if it is, then I would make sure your PCP and surgeon are
part of the HMO NETWORK - not just part of CIGNA, be specific when you ask
and don't ask the doctor's office, call CIGNA and verify that they are part
of the CIGNA HMO NETWORK. I've had employees ask the doctors only
"are you part of CIGNA" and the doctor will say yes - but not
specify if they are HMO or PPO. Anyway - As much as I HATE HMO's, by going
the HMO route, you'd have much less out of pocket expenses than w/a PPO -
much, much less. Again, make sure that your providers are part of the HMO
network, otherwise, it would backfire and you'll have no coverage!
— Rosario T.
October 1, 2002
I would also check to find out what the percentage is that the insurance
covers PPO vs. HMO. It is possible that one will cover 80% while the other
covers 90%. You might also check on the deductibles for each. Be sure
that you will pay your full deductible and then ins. will kick in. Just
some things to think about. I have Cigna PPO and was approved first go
around. I personally like the PPO since I don't have to have referrals for
anything -- but that's just my preference.
— Jenni K.
October 1, 2002
I have Cigna HMO and it is covered 100 percent.. my employer also offers it
PPO and it's 90/10 in your favor.. but that means if it costs 30 grand.. u
have to have 3 grand up front... no thanks...lol.. I havent been approved
yet.. but it is covered by my job.. and I will be fighting to the death to
get this done... you should call your member services number on the back of
your card and see if it is excluded or not.. Good Luck
— chris S.
October 1, 2002
I have Cigna POS. I dont know the difference between HMO/POS except i have
to get referred by my primart care physcian to another doctor. And Cigna
POS approved me within 2-4 days after my paper work was sent to them. My
policy states that whatever i need to have done"has to be Medically
Necessary". And I dont have a deductible, it pays 90/10 now, first it
was 80/20.I have a friend that has Cigna PPO and she has to pay more out of
pocket expenses because she doesnt need a referral from PCP to go to
another doctor out of (network)like I do. So I guess you pay more to get
less hassels with a PPO. I am ok with my plan so far. I have lost 75% of my
weight so far, and i am in the process of going to a P.S next monday.And i
had to get a referral from my PCP to go, but thats ok, he did give me a
referral with no problem because it is Medically necessary,(he agrees with
me) because I have an bacteria infection under my hanging skin on tummy and
breast.So I hope Cigna ok's this as fast as they did with the WLS
approval...Good luck
— Maria L.
October 1, 2002
I would always go with a PPO rather than an HMO - the main difference is in
the requirements to see other providers and specialists - with a HMO you
need referrals - with PPO you don't!!!
— DANA F.
October 1, 2002
I have Cigna PPO and love it. I guess it depends on your policy. My policy
is $15 co-pay for Dr. visits (including specialists) I don't have to have a
referral to go to a specialist. My Deductible is $50 in network and $200
out of network and they cover 100% after deductible in network and 80/20
out of network. I always find an in network Dr. too to save money. I am
just starting out trying to get approval but so far everyone I've talked to
at Cigna has been nice and helpful.
HTH,
— Marjorie F.
October 1, 2002
The PPO will give you less problems. The HMO has mre restrictions.
— Patty H.
October 1, 2002
The PPO will give you less problems. The HMO has more restrictions and no
out of network benefit.
— Patty H.
October 2, 2002
Original Poster here. THANK YOU ALL FOR YOUR INSIGHTS! I really appreciate
it! Will make my choice very carefully! :)
— Tammy O.
October 5, 2002
I have HMO and got my pcp to refer(sign a paper) When all the tests were
finished Cigna took 1 week to approve.
The restrictions where 75lbs with complications or 100lbs without but you
had to have been on a diet within the last year and prove it like weight
watchers.
— Rosanne C.
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