Cigna Full HMO
Receive coverage for In-Network care only, coordinated by your Primary Care Physician (PCP).
Medical coverage offers health care protection for you and your family. You may visit any medical provider you choose, but In-Network providers offer the highest level of benefits and lower out-of-pocket costs.
Network providers charge members reduced, contracted fees instead of their typical fees. Providers outside the plan’s network set their own rates, so you may be responsible for the full cost of Out-Of-Network services (HMO plans) or the difference if a provider’s fees are above the Reasonable and Customary (R&C) limits (OAP and OAP HDHP plans). Additionally, several Out-Of-Network services require pre-authorization.
Receive coverage for In-Network care only, coordinated by your Primary Care Physician (PCP).
Receive the same benefits and coverage as the Cigna Full HMO, but with lower employee contributions. This plan has a narrower network of participating providers.
This plan has a higher deductible and the opportunity to enroll in a tax-free Health Savings Account (HSA).
You’ll save money when you choose network providers, though you can choose any provider you’d like.
Before you pick your medical plan for 2024, here’s a quick look at how the plans line up side by side.
Cigna Full HMO | Cigna HMO Select | Cigna OAP with HSA | Cigna OAP | |||
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In-Network | In-Network | In-Network | Out-Of-Network | In-Network | Out-Of-Network | |
Calendar Year Deductible | ||||||
Individual | $0 | $0 | $1,600 | $3,000 | $500 | $1,000 |
Individual - within a Family | N/A | N/A | $3,200 | $6,400 | N/A | N/A |
Family* | $0 | $0 | $3,200 | $6,550 | $1,500 | $3,000 |
Calendar Year Out-of-Pocket Maximum (Includes Deductible) | ||||||
Individual | $2,000 | $2,000 | $6,000 | $6,550 | $3,000 | $6,000 |
Family | $4,000 | $4,000 | $6,000 | $6,550 | $6,000 | $12,000 |
You pay | You pay | You pay | You pay | |||
Coinsurance | ||||||
Preventive Care | No Charge | No Charge | No Charge | 40%* | No Charge | 40% |
Primary Care Physician | $20 copay | $20 copay | 20%* | 40%* | $20 | 40%* |
Specialist | $40 copay | $40 copay | 20%* | 40%* | $40 | 40%* |
Urgent Care | $50 copay | $50 copay | 20%* | 20%* | $20 copay per visit | 40%* |
Emergency Room | $150 copay (waived if admitted) | $150 copay (waived if admitted) | 20%* | 20%* | $200 copay (waived if admitted) | $200 copay (waived if admitted) |
Pharmacy** | ||||||
Retail RX (up to 31-day supply) | ||||||
Tier 1 | $10 copay | $10 copay | $10 copay* | N/A | $10 copay | N/A |
Tier 2 | $30 copay | $30 copay | $30 copay* | N/A | $30 copay | N/A |
Tier 3 | $50 copay | $50 copay | $50 copay* | N/A | $50 copay | N/A |
Mail Order RX (up to 90-day supply) | ||||||
Tier 1 | $20 copay | $20 copay | $20 copay* | N/A | $20 copay | N/A |
Tier 2 | $60 copay | $60 copay | $60 copay* | N/A | $60 copay | N/A |
Tier 3 | $100 copay | $100 copay | $100 copay* | N/A | $100 copay | N/A |
*After deductible
**Specialty covered at applicable Tier
HMO plans are designed for you to visit in-network providers. You will need to choose a Primary Care Physician (PCP) and coordinate care with any specialists through this PCP. Note that services received outside the network are not covered, except for emergency services.
Start by visiting www.cigna.com and click on the “Find a Doctor” option the top of the screen. If you’re already a Cigna customer, you can log in directly to www.mycigna.com or use the myCigna® app to search within your current plan’s network.
For broader network searches, stick with the Cigna.com directory.
Under the “How are you Covered?” section, choose “Employer or School” to access the relevant information for your employee benefits.
Change the geographic location to the city/state or zip code you want to search. Select your preferred search type (name, specialty, or other search term) and enter the relevant details. Click on one of the suggestions or use the magnifying glass icon to see your results.
Answer any clarifying questions prompted by the system and verify your location. This is crucial as it determines the available networks. Optionally, you can select one of the plans offered by your employer during open enrollment for a more tailored experience.
By following these simple steps, you’ll be able to explore Cigna’s extensive network of healthcare providers, ensuring you have the information needed to make informed decisions about your healthcare.
The Cigna Select HMO Plan has the same benefits and coverage as the Cigna Full HMO plan, but with lower bi-weekly employee contributions. The plan has a narrower network of participating providers. To find a Cigna Select HMO provider, go to “Find A Doctor” at www.cigna.com.
A High Deductible Health Plan (HDHP) is made up of two unique components:
The HDHP works much like a PPO plan in that you have access to a broad network of providers and you may choose any provider when you need care. However, in exchange for a lower per-paycheck cost, you must satisfy a higher deductible that applies to almost all health care expenses, including those for prescription drugs. Remember, that higher deductible is offset by lower premiums and the ability to use a Health Savings Account (HSA). Once your deductible has been met, you will continue to pay a coinsurance and/or medical and prescription copays until your out-of-pocket maximum is met, then the plan pays 100%.
A HDHP could be a good fit for you if you prefer:
If you select the HDHP health plan, you may elect to contribute to your HSA on a pre-tax basis for your current or future health care expenses. Belkin will also contribute to your account each year. You decide when and how to use these funds; you can choose to save them to pay future health care expenses – even into retirement. There isn’t a “use it or lose it” rule, as there is with a Flexible Spending Accounts (FSAs). Any amount remaining in your account at the end of the year will carry over into following years until you need it. And if you leave Belkin for any reason (including retirement), you can take your funds with you.
Having an HSA offers a triple tax advantage:
This plan lets you visit the doctor of your choice. Although you may see a provider who does not participate in the plan’s network, in most cases your benefits are greater (and your out-of-pocket expenses smaller) when you see a network provider. You are not required to select a Primary Care Physician under this option. Once you reach the deductible, you will pay coinsurance until the out-of-pocket maximum is met, then the plan will pay 100% in-network.
For more information about any of the Cigna Plans, call Cigna at (800) 224-6224 or go to www.cigna.com.
Because health care has evolved over time, it’s important to be an active participant in your own health care management. That means being proactive, cost-conscious and selective about your health care choices, which can help save money, time and frustration.
Telemedicine | Doctor’s office | Urgent care clinic | Emergency room |
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Use it for | |||
A non-emergency medical or mental health issue that can be diagnosed by phone or online | A condition that doesn’t need immediate attention and can wait until the next day | A condition that needs immediate care but is not life- or limb-threatening | A life-threatening or potentially crippling condition that needs immediate attention |
Examples | |||
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Cost | |||
You pay: $ | You pay: $ | You pay: $$ | You pay: $$$ |
Find it | |||
Visit www.mdlive.com to register | Call your regular doctor or search for an in-network provider on your medical plan carrier’s website | Search for urgent care clinics near you at www.cigna.com | Call 911 or search online for the nearest hospital |