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Open Access 1000 – Cigna –

A comparison of the Open Access 1000 offered by Cigna is detailed out below for both Network and Non-Network coverage.

  Network Non-Network
Copay
  • Primary Care Physician: $30 (Deductible waived)
  • Specialist Physician: $40 (Deductible waived)
    		•  CIGNA pays 50%
    OfficeVisit Office Visit -
    • Primary Care Physician: $30 copay (Deductible waived)
    • Specialist Physician: $40 copay (Deductible waived)
    		 Office Visit -
    • Primary Care Physician: CIGNA pays 50%
    • Specialist Physician: CIGNA pays 50%
    Deductible
    Coinsurance CIGNA pays 70% of eligible charges CIGNA pays 50% of eligible charges
    Coinsurance Limit N/A N/A
    Out-of-Pocket Maximum N/A N/A
    Lifetime Maximum Unlimited Unlimited
    Prescription Drugs Prescription Drugs -
    • Prescription Drug Deductible (Combined Retail & Home Delivery Pharmacy, deductible only applies to Brand Name Drugs): $250 per member per year
    • Retail Pharmacy -
      • Generic: You pay $10 per 30-day supply
      • Brand Name: You pay $35 per 30-day supply
      • Non-Preferred Brand Name: You pay $60 per 30-day supply
      • Self- Administered Injectable Drugs: CIGNA pays 70%
    • Home Delivery Pharmacy -
      • Generic: You pay $25 per 90-day supply
      • Brand Name: You pay $85 per 90-day supply
      • Non-Preferred Brand Name: You pay $150 per 90-day supply
      • Self-Administered Injectable Drugs: CIGNA pays 70%
    		 Prescription Drugs -
    • Prescription Drug Deductible (Combined Retail & Home Delivery Pharmacy, deductible only applies to Brand Name Drugs): $250 per member per year
    • Retail Pharmacy -
      • Generic: CIGNA pays 50%
      • Brand Name: CIGNA pays 50%
      • Non-Preferred Brand Name: CIGNA pays 50%
      • Self- Administered Injectable Drugs: CIGNA pays 50%
    • Home Delivery Pharmacy -
      • Generic: Not Available
      • Brand Name: Not Available
      • Non-Preferred Brand Name: Not Available
      • Self-Administered Injectable Drugs: Not Available
    Emergency Room Emergency & Urgent Care Services -
    • Hospital Emergency Room ($100 additional deductible, waived if admitted): CIGNA pays 70%
    • Outpatient Professional Services (Including Radiology, Pathology and ER Physician): CIGNA pays 70%
    • Urgent Care Services: CIGNA pays 70%
    • Ambulance (Emergency transport only): CIGNA pays 70%
    		 Emergency & Urgent Care Services -
    • Hospital Emergency Room ($100 additional deductible, waived if admitted): CIGNA pays the same level as In-Network if "true" emergency as defined in your plan, otherwise CIGNA pays 50%
    • Outpatient Professional Services (Including Radiology, Pathology and ER Physician): CIGNA pays the same level as In-Network if "true" emergency as defined in your plan, otherwise CIGNA pays 50%
    • Urgent Care Services: CIGNA pays the same level as In-Network if "true" emergency as defined in your plan, otherwise CIGNA pays 50%
    • Ambulance (Emergency transport only): CIGNA pays the same level as In-Network if "true" emergency as defined in your plan, otherwise CIGNA pays 50%
    Adult Preventative Care Preventive Care for All Ages (Routine physicals and other routine preventive services): CIGNA pays 100% (Deductible waived) Preventive Care for All Ages (Routine physicals and other routine preventive services): CIGNA pays 50%
    Child Preventative Care Preventive Care for All Ages (Routine physicals and other routine preventive services): CIGNA pays 100% (Deductible waived) Preventive Care for All Ages (Routine physicals and other routine preventive services): CIGNA pays 50%
    Lab / X-Ray
  • Lab, X-ray, and Ultrasound: CIGNA pays 70%
  • CT/PET Scans and MRI: CIGNA pays 70%
    		•
  • Lab, X-ray, and Ultrasound: CIGNA pays 50%
  • CT/PET Scans and MRI: CIGNA pays 50%
    		•
    Maternity Not Covered Not Covered
    Physical Therapy
  • Cardiac & Pulmonary Rehabilitation (Unlimited visits): CIGNA pays 70%
  • Physical, Occupational, Speech Therapy and Spinal Manipulation (Calendar year maximum of 24 visits, combined in and out-of-network): CIGNA pays 70%
    		•
  • Cardiac & Pulmonary Rehabilitation (Unlimited visits): CIGNA pays 50%
  • Physical, Occupational, Speech Therapy and Spinal Manipulation (Calendar year maximum of 24 visits, combined in and out-of-network): CIGNA pays 50%
    		•
    Home Health Care
  • Home Health (Calendar year maximum of 30 visits, combined in and out-of-network): CIGNA pays 70%
  • Hospice: CIGNA pays 70%
    		•
  • Home Health (Calendar year maximum of 30 visits, combined in and out-of-network): CIGNA pays 50%
  • Hospice: CIGNA pays 50%
    		•
    Mental Health
  • Inpatient (Includes Acute, Partial & Residential Treatment; Calendar year maximum of 30 days, combined in and out-of-network): CIGNA pays 70%
  • Outpatient (Includes Individual, Group & Intensive Outpatient Treatment (Calendar year maximum of 20 visits, combined in and out-of-network): CIGNA pays 70%
    		•
  • Inpatient (Includes Acute, Partial & Residential Treatment; Calendar year maximum of 30 days, combined in and out-of-network): CIGNA pays 50%
  • Outpatient (Includes Individual, Group & Intensive Outpatient Treatment (Calendar year maximum of 20 visits, combined in and out-of-network): CIGNA pays 50%
    		•
    Hospital Care
  • Surgery (in any setting): CIGNA pays 70%
  • Facility Services (Inpatient Room and Board, Pharmacy, Lab & X-ray, Operating Room, etc.): CIGNA pays 70%
  • Physician Services: CIGNA pays 70%
  • Outpatient Surgery: CIGNA pays 70%
    		•
  • Surgery (in any setting): CIGNA pays 50%
  • Facility Services (Inpatient Room and Board, Pharmacy, Lab & X-ray, Operating Room, etc.): CIGNA pays 50%
  • Physician Services: CIGNA pays 50%
  • Outpatient Surgery: CIGNA pays 50%
    		•
    Verisign Truste