What you need to know
You can choose among three different Cigna medical plans to protect both your health and your finances. All of our plans provide the same comprehensive coverage through the Cigna network of providers and facilities. At the same time, the plans offer you flexibility to choose between paying higher paycheck costs or lower amounts out of pocket when you need care.
The Cigna medical plans have similar features
All of the Cigna medical plans:
- Use Cigna’s national network of providers for medical care and CVS Caremark for prescriptions drugs.
- Cover the same health care services and prescription drugs.
- Offer 100% coverage for preventive care (no deductible or out-of-pocket cost to you for annual physical exams, lab tests, and age-appropriate screenings).
- Feature 24/7 care through telehealth services that let you connect with a board-certified doctor through video chat without leaving your home or office.
- Cover treatment for minor illnesses or routine vaccinations through retail clinics or walk-in clinics, such as CVS, Walgreens, Walmart, and Target.
- Offer you access to Cigna’s wellness programs, including personal health coaches and the Cigna 24-Hour Health Information Line featuring live support.
- Offer Centers of Excellence for certain surgical procedures: Some hospitals specialize in specific care and procedures, and it’s important to go to the right place to get the care you need. If you need surgery, such as bariatric, joint replacement, or cardiovascular surgery, use a Center of Excellence. Cigna representatives will help you research your options.
Check if your provider is in-network before enrolling
Go to cigna.com and click on "Find a Doctor, Mental Health/Confide/EAP Professional or Service." Then, under “Find Care & Costs,” select the applicable health facility or doctor in your area.
The plans differ in cost and network flexibility
All three plans provide you with the same comprehensive coverage through the Cigna network of providers and facilities. At the same time, the plans offer you the flexibility to choose between paying higher or lower paycheck costs, and paying higher or lower amounts out of pocket when you need care.
|Plan features||HSA Primary||HSA Plus||I&S Copay|
|Provider network flexibility||In-network and out-of-network coverage||In-network and out-of-network coverage||In-network coverage only|
|Deductible and out-of-pocket maximum||$$$||$$||$|
|Your premium cost per paycheck||$||$$||$$$|
|Prescription drugs||After meeting your plan’s deductible, you pay a percentage of the cost (coinsurance), up to a maximum per prescription||After meeting your plan’s deductible, you pay a percentage of the cost (coinsurance), up to a maximum per prescription||The plan deductible does not apply; you pay a copay amount per prescription|
Are you eligible to contribute to an HSA?
If any of these situations apply to you, you are not eligible to contribute to an HSA that year:
- I will be covered by Medicare or TRICARE.
- I will be covered by another non-high deductible plan (a plan with a deductible less than $1,500 for individuals and $3,000 for families in 2023.)
- I will receive reimbursements for medical expenses from someone else’s general purpose flexible spending account.
- I will be claimed as a dependent on someone else’s tax return.
Special note: You are still eligible to contribute to an HSA if you are not covered by Medicare but your spouse is.
What you pay for in-network care
|Plan Feature||HSA Primary||HSA Plus||I&S Copay|
|Out-of-pocket maximum||$6,500 individual|
|Coinsurance for all non-preventive care||You pay 20% coinsurance after deductible||You pay 20% coinsurance after deductible||You pay a copay for almost all services3|
|Office visit with primary care physician||You pay 20% coinsurance after deductible||You pay 20% coinsurance after deductible||You pay a $25 copay (not subject to deductible)|
|Office visit with specialist||You pay 20% coinsurance after deductible||You pay 20% coinsurance after deductible||You pay a $50 copay (not subject to deductible)|
|X-ray and lab||You pay 20% coinsurance after deductible||You pay 20% coinsurance after deductible||You pay a $50 copay after deductible|
1 Includes both pharmacy and medical expenses in HSA Primary and HSA Plus. Includes medical expenses only in I&S Copay.
2 If you cover one or more dependents, you must first meet the entire family deductible before the plan will begin to pay a benefit.
3 You pay 20% coinsurance after deductible for certain costs (e.g., ambulance transport, wheelchairs, prosthetics, and other medical equipment).
Getting to know an HSA medical plan
If you are covering one or more family members, you must first meet the entire family deductible before the plan will begin to pay a benefit. Expenses for all covered family members contribute toward the family deductible.
TRICARE Supplement Insurance
TRICARE is the Department of Defense’s health benefit program for the military community. TRICARE Supplement Insurance is a voluntary insurance plan designed to supplement your TRICARE benefits and help minimize health care expenses. Learn more about the program and determine your eligibility.
Cigna members: Save time and money with telehealth services
Connect virtually 24/7 with a board-certified doctor via a secure video chat from your laptop or mobile device. Once you meet your deductible, you pay only the applicable coinsurance for each visit.
When to contact Cigna
A Cigna Customer Service Representative can help you with a range of issues, including:
- Questions you may have about preventive care
- Connect you with a health coach or clinical case manager
- Help you locate doctors, hospitals, and other health care providers
- Resolve billing and insurance claim issues
- Assist with pre-authorizations
- Provide guidance in medical claims appeals process and assistance in filing appeals
Transparency in Coverage
In response to the federal Transparency in Coverage Rule, Cigna has created machine readable files that include negotiated service rates and out-of-network allowed amounts between the Cigna health plans and healthcare providers.