What type of insurance is cigna open access plus

Open Access Plus In-Network

Plan Highlights

• Encourages using a primary care physician
• May visit specialists without a referral
• Health care professionals obtain precertification for in-network services when required
• ID card shows most patient payment responsibilities and precertification requirements

Specialist Care Without A Referral

Your patients covered by the Cigna Open Access Plus (OAP) plan receive referral-free access to specialists. If these patients choose an out-of-network health care professional, services are covered at a reduced benefit level.

The Cigna Open Access Plus In-Network (OAPIN) plan also provides referral-free access to specialty care. However, patients covered by these plans must visit health care professionals in the Open Access Plus network to receive coverage (only emergency and urgent care are covered when received from out-of-network health care professionals.)

In addition to their Cigna administered OAP or OAPIN plan, patients may also have a Cigna Choice Fund®, an employer- or employee-funded account that can be used to pay for qualified health care expenses.

Primary Care Physician Coordination Available

Patients covered by these Cigna administered plans are encouraged and have the opportunity to select a Primary Care Physician (PCP) to coordinate their care and to provide:

• Routine checkups
• Follow-up care
• Information and guidance

Patients Covered by These Plans May Be Responsible for:

• Deductibles for inpatient and outpatient facility charges
• Coinsurance and/or deductibles for facility charges
• Coinsurance and/or deductibles for facility and physician charges
• Charges for out-of-network care (applies to your patients in Cigna Open Access Plus In-Network plans only)

These payment responsibilities are listed on the member ID card. Coinsurance/deductible should not be collected at the time of service unless you have accessed the Cigna Cost of Care Estimator® to obtain an estimate of the patient’s costs and provide a copy of the Explanation of Estimate to the patient.

Please contact us for more information about these Cigna plans, or about how to become a participating Cigna health care professional.

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1Cigna Collaborative Care (CCC) is Cigna's approach to achieving the same population health goals as ACOs: better health, affordability and experience. CCC participating providers are not available in all areas.

2Cigna August 2017 analysis of national medical book of business customers in the top 40 US markets, defined by market size, within 15-mile zip code radius (zip code to zip code distance) of one CCC primary care physician. Subject to change.

3For Emergency Services as defined by the applicable plan documents.

4Incentive programs are funded by the employer and may not be available with all product types

Product availability may vary by location and plan type and is subject to change. All group health insurance policies and health benefit plans contain exclusions and limitations. For costs and complete details of coverage, contact your Cigna representative.

Cigna Open Access Plus plans are insured and/or administered by Cigna Health and Life Insurance Company. Policy forms: OK - HP-APP-1 et al., OR - HP-POL38 02-13, TN - HP-POL43/HC-CER1V1 et al.

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1 Customers under age 13 (and/or their parent/guardian) will not be able to register at myCigna.com.

*Emergency Services and Urgent Care Services as defined by your plan documents are covered at the in-network level.

In Texas, Open Access Plus plans are considered Preferred Provider plans, and Open Access Plus In-Network plans are considered Exclusive Provider plans, with certain managed care features. Medical plans are insured and/or administered by Cigna Health and Life Insurance Company (CHLIC) or Connecticut General Life Insurance Company. Plans contain exclusions and limitations and may not be available in all areas. For costs and details of coverage, see your plan documents. Policy forms: OK - HP-APP-1 et al., OR - HP-POL38 02-13, TN - HP-POL43/HC-CER1V1 et al.

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