Cigna Member | HMO Referral Issues

[Special Agent]

that Humana Full Access PPO was oversold in N Florida by some agents.One of the big hospital network PCPs here Baptist will absolutely not see patients even long established patients if they have the Humana PPO

 

[newbie2001]

that Humana Full Access PPO was oversold in N Florida by some agents.One of the big hospital network PCPs here Baptist will absolutely not see patients even long established patients if they have the Humana PPO

Yeah… it's been popular. But I confirmed this health system will bill out of network for it.

It's my understanding that even if you have a PPO the docs office or health system has to agree to bill for it. Not a guarantee they will see you. Is that correct?

 

[Special Agent]

Yeah… it's been popular. But I confirmed this health system will bill out of network for it.

It's my understanding that even if you have a PPO the docs office or health system has to agree to bill for it. Not a guarantee they will see you. Is that correct?

yes that right and most will but it will be interesting to see if the out of network providers are going to made whole by Humana since there is no contract.

 

[Chazm]

With humana access PPO you can see any doctor who accepts Medicare and it's the same copay in or out. If they agree to the terms then they will bill then in or out. If they don't you'll get reimbursed.

I had one person on cignas PPO and their hmo network is pretty decent here in C FL.

But, to the OP, if Cigna's website (not crappy sunfires lookup system) says they're in network, Call Cigna and figure it out. It happens with any company.