I was under Cigna Cobra. I broke my ankle when I was moving from Colorado to Kansas. I called for a doctor. To my dismay, my bills were declined by Cigna. They told me I was supposed to use a Cobra doctor. I took money out of my retirement, which got me in trouble with the IRS, to pay my bills.
Surgery was done on my other ankle a few years earlier. The Orthopedic Center of the Rockies in Fort Collins, Colorado made me pay for extra exams. I can't prove it, but I believe they delayed a second surgery because the insurance company wanted me to pay a larger percentage of the cost by waiting for a new fiscal year.