March 18, 2010

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CIGNA – Open Access 3000 – GEORGIA

A comparison of the Open Access 3000 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 3000 Application Open Access 3000 Application
Brochure Open Access 3000 Brochure Open Access 3000 Brochure
Copay Primary Care Physician: $35 copay, Specialist: $45 copay CIGNA pays 60% after deductible is fulfilled
Office Visit Primary Care Physician: $35 copay, deductible waived, Specialist: $45 copay, deductible waived CIGNA pays 60% after deductible is fulfilled
Deductible Individual: $3,000, Family: $6,000 Individual: $6,000, Family: $12,000
Coinsurance CIGNA pays 70% of eligible charges CIGNA pays 60% of eligible charges
Coinsurance Limit N/A N/A
Out-of-Pocket Maximum Individual: $4,000, Family: $12,000 Individual: $12,000, Family: $36,000
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 insured person, per year, in- and out-of-network combined, including Mail Order): $300
  • Generic: You pay $10
  • Brand Name: You pay $35
  • Non-Preferred Brand Name: You pay $60
  • Self Injectables: CIGNA pays 70%
Mail Order Drugs (90-day supply):
  • Generic: You pay $25
  • Brand Name: You pay $85
  • Non-Preferred Brand Name: You pay $150
  • Self Injectables: CIGNA pays 70%
 Prescription Drugs (30-day supply):
  • Brand Name Prescription Drug Deductible (per insured person, per year, in- and out-of-network combined, including Mail Order): $300
  • Generic: You pay $10
  • Brand Name: You pay $35
  • Non-Preferred Brand Name: You pay $60
  • Self Injectables: CIGNA pays 70%
Mail Order Drugs (90-day supply):
  • Generic: You pay $25
  • Brand Name: You pay $85
  • Non-Preferred Brand Name: You pay $150
  • Self Injectables: CIGNA pays 70%
Emergency Room Hospital Emergency Room: $100 additional deductible (waived if admitted), CIGNA pays 70% after deductible is fulfilled Hospital Emergency Room: $100 additional deductible (waived if admitted), CIGNA pays 70% if true emergency, otherwise CIGNA pays 60% after deductible is fulfilled
Adult Preventative Care Adult Preventive Care (age 6 and older):
  • Office Visit: $35/$45 copay, deductible waived
  • Mammogram, PAP Smear, PSA, Colorectal Cancer Screening: CIGNA pays 70%, deductible waived
  • Routine Physicals ($300 maximum per member, per year): $35/$45 copay, deductible waived (includes immunizations, flu shots and lab work)
 Child Preventive Care (through age 5):
  • Office Visit: CIGNA pays 60%, deductible waived
  • Immunizations/Lab work: CIGNA pays 60%, deductible waived
Child Preventative Care Child Preventive Care (through age 5):
  • Office Visit: $35/$45 copay, deductible waived
  • Immunizations/Lab work: CIGNA pays 70%, deductible waived
 Child Preventive Care (through age 5):
  • Office Visit: CIGNA pays 60%, deductible waived
  • Immunizations/Lab work: CIGNA pays 60%, deductible waived
Lab / X-Ray CIGNA pays 100% up to $200 deductible waived, then CIGNA pays 70% after deductible is fulfilled CIGNA pays 60% after deductible is fulfilled
Maternity Not covered (except for pregnancy complications) Not covered (except for pregnancy complications)
Physical Therapy CIGNA pays 70% 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 70% 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 70% after deductible is fulfilled (60 visit maximum per year, in- and out-of-network combined) CIGNA pays 60% after deductible is fulfilled (60 visit maximum per year, in- and out-of-network combined)
Mental Health
  • Inpatient: CIGNA pays 70% after deductible is fulfilled (30 day maximum per insured, per year, in- and out-of-network combined)
  • Outpatient: CIGNA pays 70% after deductible is fulfilled (48 visit maximum per insured, per year, in- and out-of-network combined)
  • Inpatient: CIGNA pays 60% after deductible is fulfilled (30 day maximum per insured, per year, in- and out-of-network combined)
  • Outpatient: CIGNA pays 60% after deductible is fulfilled (48 visit maximum per insured, per year, in- and out-of-network combined)
Hospital Care Inpatient Hospital Services: CIGNA pays 70% after deductible is fulfilled Inpatient Hospital Services: CIGNA pays 60% after deductible is fulfilled
Optional Benefits N/A N/A