March 16, 2010

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CIGNA – Open Access 5000 – FLORIDA

A comparison of the Open Access 5000 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 Open Access 5000 Application Open Access 5000 Application
Brochure Open Access 5000 Brochure Open Access 5000 Brochure
Copay Primary Care Physician - $30, Specialist - $50 CIGNA pays 60% after deductible is fulfilled
Office Visit Primary Care Physician - $30, Specialist - $50 CIGNA pays 60% after deductible is fulfilled
Deductible Individual: $5,000, Family: $10,000 Individual: $10,000, Family: $20,000
Coinsurance CIGNA pays 80% after deductible is fulfilled CIGNA pays 60% after deductible is fulfilled
Coinsurance Limit N/A N/A
Out-of-Pocket Maximum Individual: $5,000, Family: $10,000 Individual: $10,000, Family: $20,000
Lifetime Maximum $5,000,000 in- and out-of-network combined $5,000,000 in- and out-of-network combined
Prescription Drugs
  • Retail Pharmacy (per 30 day supply):
    • Brand Name Deductible - $500 per person, per calendar year
    • Generic/Preferred Brand Name/Non-preferred Brand Name - $10/$35/$60
    • Self Injectables - CIGNA pays 70% after deductible is fulfilled
  • Mail Order Pharmacy (per 90 day supply):
    • Brand Name Deductible - $500 per person, per calendar year
    • Generic/Preferred Brand Name/Non-preferred Brand Name - $25/$85/$150
    • Self Injectables - CIGNA pays 70% after deductible is fulfilled
    		•
  • Retail Pharmacy (per 30 day supply):
    • Brand Name Deductible - $500 per person, per calendar year
    • Generic/Preferred Brand Name/Non-preferred Brand Name - CIGNA pays 50% after deductible is fulfilled
  • Mail Order Pharmacy (per 90 day supply):
    • Generic/Preferred Brand Name/Non-preferred Brand Name - Not covered
    • Self Injectables - Not covered
    		•
    Emergency Room
  • Hospital Emergency Room - $100 additional deductible (deductible waived if admitted), then CIGNA pays 80%
    		•
  • Hospital Emergency Room - $100 additional deductible (deductible waived if admitted), then CIGNA pays 80%
    		•
    Adult Preventative Care
  • Adult Preventive Care (age 13 and up):
    • Routine Physicals - Office visits - $30/$50
    • Mammogram, Pap Smear, PSA Screening - CIGNA pays 100%, deductible waived
    		•
  • Children Through Age 12
    • Routine Physicals- Office visits - CIGNA pays 60%, deductible waived
    		•
    Child Preventative Care
  • Children Through Age 12:
    • Routine Physicals - Office visits - $30/$50
    • Immunizations - CIGNA pays 80%, deductible waived
    		•
  • Children Through Age 12
    • Routine Physicals- Office visits - CIGNA pays 60%, deductible waived
    		•
    Lab / X-Ray Lab, X-ray, Ultrasound, CT Scan and MRI – CIGNA pays 80% after deductible is fulfilled Lab, X-ray, Ultrasound, CT Scan and MRI – CIGNA pays 60% after deductible is fulfilled
    Maternity Not covered Not covered
    Physical Therapy Physical/Occupational/Speech Therapy - CIGNA pays a maximum of $30 per visit, per person, up to 24 combined visits per year. Physical/Occupational/Speech Therapy - CIGNA pays a maximum of $30 per visit, per person, up to 24 combined visits per year.
    Skilled Nursing Skilled Nursing Facility Care - CIGNA pays 80% after deductible is fulfilled (Maximum 30-days per person, per year, in- and out-of-network combined) Skilled Nursing Facility Care - CIGNA pays 60% after deductible is fulfilled (Maximum 30-days per person, per year, in- and out-of-network combined)
    Home Health Care Home Health Care - CIGNA pays 80% after deductible is fulfilled (Maximum 60 visits per person, per year, in- and out-of-network combined) Home Health Care - CIGNA pays 60% after deductible is fulfilled (Maximum 60 visits per person, per year, in- and out-of-network combined)
    Mental Health
  • Inpatient - CIGNA pays 80% after deductible is fulfilled ($2,500 maximum payment per person, per year, in- and out-of-network combined)
  • Outpatient - CIGNA pays 80% after deductible is fulfilled (20 visit maximum per year, in- and out-of-network combined)
    		•
  • Inpatient - CIGNA pays 60% after deductible is fulfilled – ($2,500 maximum payment per person, per year, in- and out-of-network combined)
  • Outpatient - CIGNA pays 60% after deductible is fulfilled (20 visit maximum per year, in- and out-of-network combined)
    		•
    Hospital Care Inpatient Hospital Services - CIGNA pays 80% after deductible is fulfilled Inpatient Hospital Services - CIGNA pays 60% after deductible is fulfilled
    Optional Benefits N/A N/A