March 21, 2010

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CIGNA – Health Savings 1500 – COLORADO

A comparison of the Health Savings 1500 offered by CIGNA is detailed out below for both Network and Non-Network coverage.

  Network Non-Network
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Network See Provider See Provider
Application Health Savings 1500 Application Health Savings 1500 Application
Brochure Health Savings 1500 Brochure Health Savings 1500 Brochure
Copay N/A N/A
Office Visit Primary Care Physician or Specialist CIGNA pays 80% after deductible is fulfilled Primary Care Physician or Specialist CIGNA pays 60% after deductible is fulfilled
Deductible Individual: $1,500, Family: $3,000 Individual: $3,000, Family: $6,000
Coinsurance CIGNA pays 80% of eligible charges CIGNA pays 60% of eligible charges
Coinsurance Limit N/A N/A
Out-of-Pocket Maximum Individual: $3,000, Family: $6,000 Individual: $9,000, Family: $18,000
Lifetime Maximum $5,000,000 per member $5,000,000 per member
Prescription Drugs Prescription Drugs (30-day supply)
  • Prescription Drug Deductible (per person, per year) Subject to integrated medical/pharmacy deductible. Combined in- and out-of-network (including in-network Mail Order)
  • Generic/Brand Name/Non-Preferred Brand Name- you pay $10/$35/$60
  • Self Injectables- CIGNA pays 70%
Mail Order Drugs (90-day supply)
  • Generic/Brand Name/Non-Preferred Brand Name- you pay $25/$85/$150
  • Self Injectables- CIGNA pays 70%
Prescription Drugs (30-day supply)
  • Prescription Drug Deductible (per person, per year) Subject to integrated medical/pharmacy deductible. Combined in- and out-of-network (including in-network Mail Order)
  • Generic/Brand Name/Non-Preferred Brand Name- CIGNA pays 50%
  • Self Injectables- CIGNA pays 50%
Mail Order Drugs (90-day supply)
  • Not Applicable
Emergency Room Hospital Emergency Room (including radiology, pathology and ER physician and ancillary charges) CIGNA pays 80% after deductible is fulfilled Hospital Emergency Room (including radiology, pathology and ER physician and ancillary charges) CIGNA pays 80% if true emergency, otherwise CIGNA pays 60% after deductible is fulfilled
Adult Preventative Care Adult preventive Care (age 7 and up)
  • Office Visit- CIGNA pays 80%
  • Mammogram, PAP Smear, PSA Screening- CIGNA pays 100% deductible waived
  • Routine Physicals and other routine services ($300 maximum per member, per year)- CIGNA pays 80% after deductible is fulfilled
 Child preventive Care (through age 6)
  • Office Visit, Immunizations- CIGNA pays 60% after deductible is fulfilled ($300 maximum per member, per year)
Child Preventative Care Child preventive Care (through age 6)
  • Office Visit- CIGNA pays 80% after deductible is fulfilled
  • Immunizations- CIGNA pays 100% deductible waived ($300 maximum per member, per year)
 Child preventive Care (through age 6)
  • Office Visit, Immunizations- CIGNA pays 60% after deductible is fulfilled ($300 maximum per member, per year)
Lab / X-Ray CIGNA pays 80% after deductible is fulfilled CIGNA pays 60% after deductible is fulfilled
Maternity Not covered Not covered
Physical Therapy CIGNA pays 80% after deductible is fulfilled (24 visit maximum per year, in- and out-of-network combined) CIGNA pays 60% after deductible is fulfilled (24 visit maximum per year, in- and out-of-network combined)
Skilled Nursing CIGNA pays 80% after deductible is fulfilled (30 day maximum per year for combined services, both in- and out-of-network) CIGNA pays 60% after deductible is fulfilled (30 day maximum per year for combined services, both in- and out-of-network)
Home Health Care CIGNA pays 80% after deductible is fulfilled (60 day maximum per year, in- and out-of-network combined) CIGNA pays 60% after deductible is fulfilled (60 day maximum per year, in- and out-of-network combined)
Mental Health
  • Inpatient - CIGNA pays 80% after deductible is fulfilled ($2,500 maximum per person, per year, in- and out-of-network combined)
  • Outpatient - CIGNA pays 80% after deductible is fulfilled (20 visit maximum per person, per year, in- and out-of-network combined)
    		•
  • Inpatient - CIGNA pays 60% after deductible is fulfilled ($2,500 maximum per person, per year, in- and out-of-network combined)
  • Outpatient - CIGNA pays 60% after deductible is fulfilled (20 visit maximum per person, per year, in- and out-of-network combined)
    		•
    Hospital Care Inpatient Hospital Services- CIGNA pays 80% after deductible is fulfilled (semi-private inpatient room and board, pharmacy, x-ray and laboratory, operating room, etc.) Inpatient Hospital Services- CIGNA pays 60% after deductible if fulfilled (semi-private inpatient room and board, pharmacy, x-ray and laboratory, operating room, etc.)
    Optional Benefits N/A N/A