By Matthew Holt
It’s hard to imagine, but I may now be in possession of the stupidest letter I’ve ever received from an American health insurance company, and I’m the guy who received five identical letters in one day from Blue Shield of California telling me that they had changed primary care doctors when I had initiated the change.
A little backstory. As those who have been following my various soap operas will remember, last year I was diagnosed with a defective heart valve. I also have a failing left knee mainly due to snowboarding into a tree 24 years ago.
I was trying to put off the whole heart valve thing for as long as possible because it sounds painful and unpleasant, and I was hoping I could move forward with a knee replacement so my snowboarding can continue at a good pace. My doctors are at UC San Francisco and agreed that I should have the knee replacement on July 6, assuming my heart valve hadn’t gotten much worse. On June 16 I went to UCSF for a bunch of pre-knee replacement tests and they also checked my heart.
However, my new insurance company, thanks to my wife’s new job, is Cigna. Those of you in California may know that Cigna was having a huge dispute with the University of California Health System and that its contract with them was set to expire on June 30 of this year. Why a health plan and a large provider organization have contracts that expire mid-year when employers and people who use the health plan’s network buy them annually starting in January, I don’t know, and it’s ridiculously stupid. But let’s not get distracted because I’m not talking about that here!
Due to the fact that they would be out of network, the orthopedic team made the obvious suggestion that he move up the knee replacement. In fact, it was planned for June 22. This didn’t bother me too much, as you may have seen that some corrupt Italians have organized a football tournament that would give me plenty of games on TV to entertain me while I recovered.
Unfortunately, one of the previous tests I had on June 16 was an echocardiogram that indicated that my heart valve was in worse condition than it was at the beginning of the year. After many back-and-forths between the cardiac team, the knee team, and the anesthesia team, they all agreed to postpone the knee surgery until we discovered my heart.
Meanwhile, sometime late on Thursday, June 25 or early Friday, June 26, UC Health and Cigna took a step back and reached an agreement that will keep the UC system on Cigna’s network.
All of which brings me to July 6th when I received a letter from Cigna.
This is the one with more stupidity per square inch than any other communication I have ever received from an insurance company.
First things first; Cigna has a halfway decent website that I have accessed on many occasions. Cigna knows my email. Cigna knows my phone number and I can also receive a text message from them.
The letter was dated June 25, but I did not receive any emails, text messages, or carrier pigeon messages on that date. And if you go to the messages section of the website I’ve copied for you below, you’ll see that the only communication they’ve sent me shows that I can get a good deal by joining a gym. Although unfortunately the place I use is not in this offer….
So we established that they could have contacted me on June 25th, but instead I received their letter on July 6th.
What did the letter say?
Well, to be helpful, I’ve scanned a version below.
The first incredibly stupid thing is that they sent me a letter. This probably costs them a lot more than sending an email or text message, and it also arrived after the period discussed in the letter had ended.
The next incredibly stupid thing is that they told me that UCSF was not on their network on 06/25/2026. This is wrong. Even under the contract that was about to expire, UCSF was on Cigna’s network on 6/25/2026 and was going to be for another 4 days.
Now I’m not sure if the next incredibly stupid thing was Cigna’s fault or UCSF’s fault. Apparently UCSF had asked Cigna to cover the surgery I need, which is an aortic valve replacement and, by the way, involves me being hooked up to a heart-lung machine, which doesn’t sound like much fun.
But what’s incredibly stupid is that the approved effective dates for this were June 30th to July 4th. Now, there are two things worth knowing here. Although it was probably still true that on June 25, when this letter was written, UCSF was about to be kicked out of the Cigna Network on July 1, on June 30 they were still on the network. So the letter that said they were out of network when it was written was wrong. And it turns out that UCSF is still on the network now.
The second incredibly stupid thing is that at no time had I scheduled or planned to have surgery on those few days (June 30 to July 4) for which this approval was effective. I’m also pretty sure no one at UCSF thought I was going to have surgery on that date, mainly because I had a coronary angiogram on June 30th in continued preparation for surgery. A surgery planned for a date to be determined later this summer. Angiography was not the procedure mentioned in this letter.
Finally, although Cigna has approved this procedure, despite a date when it was never going to happen, they approved it at an out-of-network rate, and stated that there was a maximum amount they would pay. Helpfully, on the second page of the letter it says that “I may be able to save money by seeing a healthcare provider who is in my network” and “to see a list of these professionals, I should check the Cigna website.” She then scolds me by telling me that I chose a health professional who is not in the network. Of course, they don’t tell me how much they will pay or how much less I would pay out of pocket if I went to an in-network provider.
Except, of course, I already was and now I’m doing exactly that.
So, to summarize.
- Cigna sent me a letter that took 11 days to reach me instead of sending me an email or text.
- The information in the letter was incorrect regarding Cigna’s provider network.
- The period by which the requested procedure was approved was also incorrect
- And that period ended 2 days before I received the letter.
I guess we should congratulate them for doing the procedure more or less correctly.
It would be churlish of me to point out that Cigna CEO David Cordani was paid $23 million last year. I can only assume that the compensation committee of Cigna’s board of directors was not rewarding him based on the level of customer service accuracy his company provided. On the other hand, it is not clear what necessary services your company or your health insurance competitors actually offer. do provide.
And it would be equally rude of me to point out that no one else in the world outside of the United States has to deal with this.
Matthew Holt is editor and author of THCB
