March 18, 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 - $35, Specialist - $50 CIGNA pays 60% after deductible is fulfilled
Office Visit Primary Care Physician - $35 copaySpecialist - $50 copay CIGNA pays 60% after deductible is fulfilled
Deductible Individual: $5,000, Family: $10,000 Individual: $10,000, Family: $20,000
Coinsurance CIGNA pays 80% of eligible charges CIGNA pays 60% of eligible charges
Coinsurance Limit N/A N/A
Out-of-Pocket Maximum Individual: $5,000, Family: $10,000 Individual: $10,000, Family: $20,000
Lifetime Maximum $5,000,000 per member $5,000,000 per member
Prescription Drugs Prescription Drugs (30-day supply)
  • Brand Name Prescription Drug Deductible (per person, per year, in- and out-of-network combined, including in-network Mail Order)- $500
  • Generic/Brand name/Non-Preferred brand Name- you pay $10/$35/$60
  • Self Injectables- CIGNA pays 70%
Mail Order drugs (90-day supply)
  • Brand Name Prescription Drug Deductible (per person, per year, in- and out-of-network combined, including in-network Mail Order)- $500
  • Generic/brand name/Non-Preferred Brand Name- you pay $25/$85/$150
  • Self Injectables- CIGNA pays 70%
 Prescription Drugs (30-day supply)
  • Brand Name Prescription Drug Deductible (per person, per year, in- and out-of-network combined, including in-network Mail Order)- $500
  • 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)- $100 Additional Deductible (waived if admitted) CIGNA pays 80% after deductible is fulfilled Hospital Emergency Room (including radiology, pathology and ER physician and ancillary charges)- $100 Additional Deductible (waived if admitted) 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- $35/$50 copay
  • Mammogram, PAP Smear, PSA Screening- CIGNA pays 80% deductible waived
  • Routine Physicals and other routine services ($300 maximum per member, per year)- $35/$50 copay
 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- $35/$50 copay
  • Immunizations- CIGNA pays 80% 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% CIGNA pays 60%
Maternity Not covered Not covered
Physical Therapy CIGNA pays a maximum payment of $30 per visit, per member after deductible is filled (24 visit maximum per year, in- and out-of-network combined) CIGNA pays a maximum payment of $30 per visit, per member after deductible is filled (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 is fulfilled (semi-private inpatient room and board, pharmacy, x-ray and laboratory, operating room, etc.)
    Optional Benefits N/A N/A