My Five-Month Battle for Reimbursement of a Covered Expense
Hey! One of my partners wrote a really good blog about fighting with Cigna.
My insurance plan covers laser facial hair removal as a gender-affirming procedure for transgender people. My partner, a trans woman who is on my insurance, got this procedure done, and getting it reimbursed was like pulling teeth.
Representatives of my health insurance company, Cigna Healthcare, told me falsely that my plan didn't cover the procedure when I called them to ask about my claim. Even after I got my employer's Human Resources department involved, Cigna continued to lie to me and deny my claim despite the terms of my plan. It took me five months, 12 phone calls, 3 emails, and an HR ticket to get my claim reimbursed.
Currently, most people get insurance through their employers, because it's much cheaper than buying insurance on the open market. The insurance company's revenue is determined by their relationships with employers, not patients. In other words, the employer, not the patient, is the customer.
This is why I had to contact HR in order to get any meaningful progress on my claim. When the employer is the customer, the employer must be involved in any claims process complicated enough to require human judgment. This means the patient must disclose private medical information to their employer, which can expose them to discrimination. I was lucky in this case, because I'm already out at work and the procedure wasn't for me, but I still had to pass personal medical information through a member of my employer's HR team. If I were a trans woman getting my own laser reimbursed, this process would have forced me to out myself to my employer.* Ideally, there would be no such thing as employer-sponsored health insurance at all.
*Applications of this dynamic to other types of claims, such as disability care and fertility treatments, are left as an exercise to the reader.
