United Brachial Plexus Network, Inc.

Hello everyone,
We have to change our insurance from United Healthcare PPO to either Cigna PPO or Blue Cross Blue Shield PPO. We are in Texas. Anyone have pro's and con's on each, how are they with therapy, surgery. United Healthcare was great for us. No problems with therapy or surgery. Thanks for all your input.

in case no one answers this one, call down to the business office at the hospital and ask them which they have the best results from ?

One thing you will have to consider if the doctors and specialists that you see are on their directory? How many therapy sessions your get a year? I had Cigna and had to fight them every step of the way for every little thing for my daughter. I really had to fight them for my daughter's first surgery because we were having it done in Texas and we are from Ohio. They wanted my daughter to have the surgery done by someone that was not board certified and had no experience with Brachial Plexus injuries. We had to hire an attorney to fight for us and finally got her surgery covered in-network. But, for her second surgery I had no problem with them matter of fact that covered everything 100%. I wanted a case manager to help me and they never followed through with that after I requested it several times. My employer got rid of them and my husband and daughter now have United Health Care PPO and I HATE THEM WITH A PASSION!! Cigna was saints compared to them! Texas filed a formal complaint against them along with us to the Ohio Dept of Insurance. They played soooo many games with us regarding our daughter's third surgery. I finally got her third surgery approved the day we were leaving for Texas! We are having her fourth surgery in September and Texas said we shouldn't have any problems with this surgery because it's a continuation of the third surgery but I'm not holding my breath with that! I can't really say anything about Blue Cross Blue Shield. I do have Anthem for myself which is I think affiliated with Blue Cross and Blue Shield and I haven't had any problems with them but I haven't had to deal with anything really catastrophic with them. I suggest you contact your dept of Insurance and see who has a better track record in your state. Good Luck with your decision!

We have Blue Cross Blue Shield PPO, and they covered MQ surgery, although you should ask the specific surgeon (not just the facitlty) if they work with BCBS. Sometimes they have to make arrangements. Also, BCBS just changed their therapy coverage (pt, ot and speech) to cover any amount of services deemed necessary by a doctor. We just got Matthew covered for PT 2x per week, OT 2 x per week and speech 1x per week. This is very good coverage! Good luck!
Cathy

FYI. When we scheduled our daughter's mod quad surgery for 2/02, Dr. Nath was not in network (not part of the PPO) so we scheduled the surgery with Dr. Shenaq who was in network. When we met with Dr. Nath at the clinic appt. he told us that he was back in network but that both himself and Dr. Shenaq were going to drop out of network. That would definitely make things a lot harder for us if our daughter needs another surgery in the future! But nothing has been easy since she has been born, so it would just be another battle.

We have used both insurances. We had Blue cross for primary and Mod Quad. We had Cigna PPO for the Capsulodesis. We are from Washington State. From our experiences there are pros and cons for both. Blue Cross allowed us 52 OT visits and 52 PT visits a year. Cigna only allows 30 visits a year and that is combined OT and PT together. For surgery Cigna was better. They Covered 100% after we payed a $200 hospital stay charge. We had to fight Blue cross tooth and nail to get 80% payed. It took us over a year the first time and almost a year the second time to get it all settled and they were both preapproved. Good luck with your decision. The whole insurance thing is such a headache.
Jodi