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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: $25 copay (Deductible waived)
  • Specialist: $45 copay (Deductible waived)
    		•  CIGNA pays 60%
    OfficeVisit Office Visit -
    • Primary Care Physician: $25 copay (Deductible waived)
    • Specialist: $45 copay (Deductible waived)
    		 Office Visit -
    • Primary Care Physician: CIGNA pays 60%
    • Specialist: CIGNA pays 60%
    Deductible
    Coinsurance CIGNA pays 80% of eligible charges CIGNA pays 60% 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
      • Brand Name: You pay $35
      • Non-Preferred Brand Name: You pay $60
      • Self-Administered Injectable Drugs: CIGNA pays 50%
    • Home Delivery Pharmacy -
      • Generic: You pay $25
      • Brand Name: You pay $85
      • Non-Preferred Brand Name: You pay $150
      • Self Administered Injectable Drugs: CIGNA pays 50%
    		 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 Applicable
      • Brand Name: Not Applicable
      • Non-Preferred Brand Name: Not Applicable
      • Self Administered Injectable Drugs: Not Applicable
    Emergency Room Emergency & Urgent Care Services -
    • Hospital Emergency Room ($100 additional Deductible, waived if admitted): CIGNA pays 80%
    • Outpatient Professional Services (Including Radiology, Pathology and ER Physician): CIGNA pays 80%
    • Urgent Care Services: CIGNA pays 80%
    • Ambulance (Emergency transport only): CIGNA pays 80%
    		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 60%
    • 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 60%
    • Urgent Care Services: CIGNA pays the same level as In-Network if "true" emergency as defined in your plan, otherwise CIGNA pays 60%
    • Ambulance (Emergency transport only): CIGNA pays the same level as In-Network if "true" emergency as defined in your plan, otherwise CIGNA pays 60%
    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 60%
    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 60%
    Lab / X-Ray Lab, X-ray -
    • Physician's Office: CIGNA pays 100% to a maximum of $200 per year, combined with services provided at Independent/Lab X-Ray Facility, THEN 80% After Deductible
    • Independent/Lab, X-ray Facility: CIGNA pays 100% to a maximum of $200 per year, combined with services provided at Physician's Office THEN 80% After Deductible
    Ultrasound, CT/PET Scans and MRI: CIGNA pays 80%    		 Lab, X-ray -
    • Physician's Office: CIGNA pays 60%
    • Independent/Lab X-ray Facility: CIGNA pays 60%
    Ultrasound, CT/PET Scans and MRI: CIGNA pays 60%
    Maternity Not Covered Not Covered
    Physical Therapy
  • Cardiac & Pulmonary Rehabilitation (Calendar year maximum of 36 visits, combined in-and out-of-network): CIGNA pays 80%
  • Physical, Occupational and Chiropractic Therapy: CIGNA pays a maximum of $40 per visit
    		•
  • Cardiac & Pulmonary Rehabilitation (Calendar year maximum of 36 visits, combined in-and out-of-network): CIGNA pays 60%
  • Physical, Occupational and Chiropractic Therapy: CIGNA pays a maximum of $40 per visit
    		•
    Home Health Care
  • Home Health (Calendar year maximum of 60 visits, combined in and out-of-network): CIGNA pays 80%
  • Hospice: CIGNA pays 80%
    		•
  • Home Health (Calendar year maximum of 60 visits, combined in and out-of-network): CIGNA pays 60%
  • Hospice: CIGNA pays 60%
    		•
    Mental Health
  • Inpatient (Includes Acute, Partial & Residential Treatment): CIGNA pays up to a maximum of $200 per day
  • Outpatient (Includes Individual, Group & Intensive Outpatient Treatment): CIGNA pays maximum $30 per visit
    		•
  • Inpatient (Includes Acute, Partial & Residential Treatment): CIGNA pays up to a maximum of $200 per day
  • Outpatient (Includes Individual, Group & Intensive Outpatient Treatment): CIGNA pays maximum $30 per visit
    		•
    Hospital Care
  • Surgery (in any setting): CIGNA pays 80%
  • Facility Services (Inpatient Room and Board, Pharmacy, Lab & X-ray, Operating Room, etc.): CIGNA pays 80%
  • Physician Services: CIGNA pays 80%
  • Outpatient Surgery: CIGNA pays 80%
    		•
  • Surgery (in any setting): CIGNA pays 60%
  • Facility Services (Inpatient Room and Board, Pharmacy, Lab & X-ray, Operating Room, etc.): CIGNA pays 60%
  • Physician Services: CIGNA pays 60%
  • Outpatient Surgery: CIGNA pays 60%
    		•
    Verisign Truste