Cigna Prior Authorization: Fill & Download for Free

I work in an outpatient psych clinic so I do all the prior authorizations and the answer is, usually. The most difficult insurance for new meds like trintellix, etc are the Medicare part d third parties like Cigna Heathspring. They want the patient to fail several other cheaper meds. Your mental health is secondary to their bottom line. Most private insurance isn't an issue unless there's just a ridiculous dose or quantity. Usually can get around that by talking to their pharm-d.

State filing documents with New York indicate it's a carrier - not a broker. As such - and perhaps because of that - the challenges are numerous and formidable.The Company is authorized pursuant to its Charter to transact the kind of insurance as described in the following numbered paragraph of Section 1113(a) of the New York Insurance Law:Paragraph Line of Business (3)(i) Accident and health insuranceThe Company’s Charter indicates that the corporate purpose of Oscar is to carry on any business whatsoever that an insurance company licensed in New York State may deem proper or convenient in connection with any of the foregoing purposes or otherwise, or that it may deem calculated, directly or indirectly, to improve the interests of the Company.In accordance with the provisions of Section 1314 of the New York Insurance Law, the Company, as of June 20, 2013, had placed into a bank account at First Republic Bank, in the name of the Superintendent of Financial Services, qualifying U.S Treasury bills with a book value of $299,802.49, in satisfaction of the $200,000 deposit required pursuant to Section 4206 of the New York Insurance Law.In addition to the $300,000 initial surplus required by Section 4204 of the NYIL, an additional $44,700,000 of capitalization is required based on the Company’s submitted business plan and financial projections. $35,700,000 was to be invested prior to licensure, and another $9,000,000 must be invested by September 30, 2013, or the Company will not be allowed to sell or issue any insurance policies (until the $9 million has been invested, and confirmed by the Department). The Department has capitalization commitments from Thrive Capital Partners III, L.P., Mulberry, and Oscar regarding the $9 million investment requirement. [1]Three of the biggest challenges I see are:Like most health insurance companies, they don't own the providers or networks they must contract with for most of the expensive healthcare services and that's a significant variable in consumers choosing health coverage. It's also a risk in terms of service delivery. Slick websites and consumer "shopping" appeal may be good hooks to buy - but actual healthcare delivery is (ultimately) a larger determining factor - and Oscar doesn't own/control that.Like all health insurance companies, Oscar is also limited by new Medical-Loss-Ratios that effectively cap health insurance profits. Obamcare now requires MLR's of 80% - 85% - which means that 80% -85% of all premium dollars must be spent on healthcare delivery. Things like administration, claims processing, sales, marketing, HR and profits are relegated to the remaining 15% to 20%. The Net Profit Margin of even the big insurance companies (Aetna, Cigna, UnitedHealth etc...) is rarely above 5%.They aren't the cheapest plan available on the exchanges where they do sell health insurance - and cost is often the largest single determinant of buying an expensive product that most people actively avoid using. Just because you HAVE health insurance coverage - doesn't mean you're eager to use it often.[1] Report on Orgnization of Oscar Insurance Corporation - July, 2013

Why do some people still believe that the events that happened on January 6th, 2021 at the US Capitol were just a bunch of patriotic Trump supporters letting our Congressmen know their feelings, and not an act of insurrection or sedition?Well, first let us define the terms sedition and insurrection:SEDITION: Sedition is overt conduct, such as speech and organization, that tends toward rebellion against the established order. Sedition often includes subversion of a constitution and incitement of discontent toward, or insurrection against, established authority. Sedition may include any commotion, though not aimed at direct and open violence against the laws. Seditious words in writing are seditious libel. A seditionist is one who engages in or promotes the interest of seditionSedition is a serious felony punishable by fines and up to 20 years in prison and it refers to the act of inciting revolt or violence against a lawful authority with the goal of destroying or overthrowing it. The following provides an overview of this particular crime against the government, with historical references.Seditious Conspiracy and Federal Law: The BasicsThe federal law against seditious conspiracy can be found in Title 18 of the U.S. Code (which includes treason, rebellion, and similar offenses), specifically 18 U.S.C. § 2384. According to the statutory definition of sedition, it is a crime for two or more people within the jurisdiction of the United States:To conspire to overthrow or destroy by force the government of the United States or to level war against them;To oppose by force the authority of the United States government; to prevent, hinder, or delay by force the execution of any law of the United States; orTo take, seize, or possess by force any property of the United States contrary to the authority thereof.Free Speech, Sedition, and TreasonIn order to get a conviction for seditious conspiracy, the government must prove that the defendant in fact conspired to use force. Simply advocating for the use of force is not the same thing and in most cases is protected as free speech under the First Amendment. For example, two or more people who give public speeches suggesting the need for a total revolution "by any means necessary" have not necessarily conspired to overthrow the government. Rather, they're just sharing their opinions, however unsavory. But actively planning such an action (distributing guns, working out the logistics of an attack, actively opposing lawful authority, etc.) could be considered a seditious conspiracy.Ultimately, the goal is to prevent threats against the United States while protecting individuals' First Amendment rights, which isn't always such a clear distinction.Sedition - FindLawSedition, a serious felony punishable by fines and up to 20 years in prison, refers to the act of inciting revolt or violence against a lawful authority with the goal of destroying or overthrowing it. FindLaw provides an overview of this particular crime against the government, with historical references.https://www.findlaw.com/criminal/criminal-charges/sedition.htmlINSURRECTION: Insurrection Law and Legal DefinitionInsurrection refers to an act or instance of revolting against civil authority or an established government. It is a violent revolt against an oppressive authority. Insurrection is different from riots and offenses connected with mob violence. In insurrection there is an organized and armed uprising against authority or operations of government whereas riots and offenses connected with mob violence are simply unlawful acts in disturbance of the peace which do not threaten the stability of the government or the existence of political society.The following is a case law defining Insurrection:Insurrection means “a violent uprising by a group or movement acting for the specific purpose of overthrowing the constituted government and seizing its powers. An insurrection occurs where a movement acts to overthrow the constituted government and to take possession of its inherent powers.” [Younis Bros. & Co. v. Cigna Worldwide Ins. Co., 899 F. Supp. 1385, 1392-1393 (E.D. Pa. 1995)]According to Merriam-Webster, "insurrection" is the "act of revolting against civil authority or an established government." Other definitions, like that of the Cambridge Dictionary, specify the act is usually a violent one. Synonyms include "revolt" or "uprising," according to Merriam-Webster.Rebellion or Insurrection - FindLawFindLaw's overview of the crimes of rebellion and insurrection, including how they compare to the crimes of treason and sedition. Learn more in FindLaw's Criminal Law section.https://www.findlaw.com/criminal/criminal-charges/rebellion-or-insurrection.htmlAs one who doesn’t see the break-in as insurrection or sedition, I feel the incident has been exaggerated to comply with the Leftist narrative about how evil these White Supremacists are, while at the same time trying to claim that BLM and antifa are imbued with moral principles.Of the 300 or so people who’ve been arrested, most of the people who engaged in the break-in were not a politically motivated crew — none of them voted, few of them knew anything about politics, or cared. They are just part of the national flotsum that travels around participating in violent actions where ever they happen.And why not?Until January 6th, they had never been held to account for their actions anywhere.There were, however, deeply committed Trump supporters who wanted to make a statement about the stolen election, and possibly hoped that a last minute appeal would persuade Mike Pence to allow a ten day period to perform an audit on the election in the six states.That is specifically what the protestors were there for. To “peacefully and patriotically” make the case for an audit of the election.Part of that group of Trump supporters were some who part of an organization called “Oathkeepers”. They are people who have a background in aw enforcement or the military and taken an oath to defend the Constitution “from all enemies foreign and domestic”..As described by the wife of a member of the group who has been arrested: “’As Mrs. Harrelson explained, in the FBI’s affidavit justifying Mr. Harrelson’s arrest there was “mention of Go To Meetings that Kenneth participated in. The discussions that took place on those calls were about things the members could do to protect people from harm, specifically from violent ANTIFA. There was no conspiracy to harm anyone, only to protect people. The Oath Keepers have spent the past few months discussing ways to keep their communities informed about the violent activities of the BLM and ANTIFA groups, and also prepared to defend their neighborhoods and homes from invasion by those often violent, extremists.The Oath Keepers are made up of a diverse group of people; a variety of skin colors and races. They all have a common goal of defending the United States Constitution. Included in their mission is protecting and serving the community. They have spent countless volunteer hours helping with natural disasters cleanup and getting food and supplies to people in need. They also protect people at rallies, and that is why my husband traveled to Washington D.C.’”The Political Persecution Of The Oath KeepersThere have been some 300+ people arrested in connection with the January 6 riot at the US Capitol, a few of the arrestees were caught on video or still cameras breaching police lines, breaking intohttps://oathkeepers.org/2021/03/the-political-persecution-of-the-oath-keepers/Part of the definition of both sedition or insurrection is the desire to overturn or overthrow the government, which is not at all what any of these protestors were trying to do.According to the capitol police, the only weapons found were a few guns which were not discharged, baseball bats, a flagpole, and cans of bear spray.In my opinion, the idea of actually hoping to overturn the government by entering the Capitol Building largely unarmed is absurd, and it’s nonsense to belief that people who are committed to defending the Constitution would be likely to take part in any effort to overthrow the government.The F.B.I. are intent on finding the members of the Oathkeepers guilty of at least sedition, which carries a 20 year sentence. While they turned loose almost immediately the people known to have participated in other acts of violence such as riots, they have been holding members of the Oathkeepers for weeks, despite the fact that these people have homes, families and businesses and they re not about to leave the country.One of the most remarkable things about the last year is how many people affiliated with BLM and antifa have been seen at a number of riots in different cities, yet they never seem to be apprehended. And if apprehended, they are bailed out immediately, no matter how many priors they had, enabling them to burn, loot, vandalize and murder in the next city.And yet, people who have served our country honorably in either the military or law enforcement have been incarcerated for weeks with no hope of getting out until their trial for, essentially, trespassing into a federal building to protest something that is disturbing to half the country.