Cigna

Hi there I also have a CIGNA and a complex medical issue and they frequently email me or call me to ask me if I want a personal case manager. Having worked with brain tumor patients and other cancer patients over the years I know there’s positives and negatives to this, it is a cost saving measure for the insurance company on the one hand but it’s also designed to help ensure people can more efficiently get the services they need. My guess is that if you are writing in here asking this question you are probably already a  good self advocate, and  you’re probably accessing all the services that you’re entitled to and so I wouldn’t worry so much about missing out on things. I’ve personally never opted in.

So sorry to hear that your husband is ill!

I have not had your specific experience, but your description of the situation is ringing a bell for me.

Ten years ago I was seriously ill, and when I came home from surgery, the phone rang, and it was some "advice nurse" from United Healthcare, our insurance company.

She starts off by ordering:  "Tell me about your discharge instructions."

I was still a bit groggy from sedation, but I was like (WTF?) "Excuse me, who are you?  I did not hire you.  The job of United Health Care is to pay the bills in a timely manner. Have a nice day."

We did not hear back from them.

My hunch is that you are spot-on right that this is a ploy by your insurance company to reduce costs, by second-guessing the care you are getting from the doctors and others your husband has hired. 

If you are not already an elder (as I seem to have become!), I must warn you that once a patient crosses the threshold of 65 years old, the health industry automatically assumes that you are demented and require their services to babysit you and tell you what to do. It becomes necessary for the patient to tell them to, err, take their patronizing attitude and shove it.

Studies have shown that cranky, self-actualizing old curmudgeons outlive sweet, submissive old people.

There are families who would like to have a "nurse navigator" and there are fine professional nurses who perform a valuable service in that area.  But unfortunately the current state of the health care system requires that patients self-advocate and defend ourselves from the profit-seeking insurance companies and their hirelings.

Wishing you and your husband all the best.

Hi! I can't speak specifically for "Cigna personal nurse advocates," but here's another perspective from a registered nurse who has worked in/alongside a similar role (nurse case managers, care coordinators, community health workers):  The main benefit is that your husband may have a better quality of life as a result of his care being managed by someone (a nurse) whose role is to coordinate all the moving pieces -- multiple primary care and specialty appointments, lab work, imaging, medical advice, ...sometimes even insurance-related issues, respite care (for you as his caretaker), etc. It certainly can add more phone calls and have you feeling like it's another cook in the kitchen, but the point is that the benefits outweigh the cost. It can be extremely difficult to manage everything going on (people to see, places to go, papers to sign), so having an advocate with medical knowledge and who can meet you at your level (vs. doctors who usually don't have the time to explain every detail) can be incredibly beneficial. Also even if you choose to have a nurse advocate, it should be your decision to end the relationship if you find it unhelpful. Again, I can't speak for Cigna's services and I obviously don't know the nurse so we can't be sure of outcome, but I am totally for this service if you have it available. At least try it! Or at least agree to talk with them about how it may benefit you and your husband. Best wishes to you both. 

You are right, this is Cigna trying to cut its costs. My family had the same thing happen with a different insurer. The "nurse advocate" or "care manager" or whatever is cheaper for them that your family member seeing doctors and specialists.  We simply told our insurer we were not interested and the calls stopped. 

Another resource: the California Department of Insurance has a "consumer hot line" toll free number 1-800-927-4357 if you have any questions about your rights or coverage on health insurance. You can find more at their webpage: https://www.insurance.ca.gov/01-consumers/110-health/50-h-rfa/index.cfm…;