Open Access Plus in Network

OPEN ACCESS PLUS
IN-NETWORK
See how your health plan works for you.
With the Open Access Plus In-network plan, you get access to a large network of health care professionals and
facilities. So, each time you need care, you choose the in- network doctor or facility that works best for you.
Enroll in the Open Access Plus In-network Predictable out-of-pocket costs – Depending on
plan and get these options for care: your plan, you may have to pay an annual amount
(deductible) before the plan begins to pay for covered
› Primary care physician (PCP) – You can decide to
health care costs. Once you meet your deductible, you
choose a PCP as your personal doctor to help
pay a copay or coinsurance (a portion of the charges)
coordinate care and act as a personal health
for most services from an in-network doctor or facility.
advocate. It’s recommended but not required.
Then, the plan pays the rest. Once you reach an annual
› In-network – For your health care to be covered by limit on your payments (out-of-pocket maximum), the
the plan, you must choose a health care professional health plan pays your covered health care costs at 100%.
who is in the Cigna Open Access Plus network.
24/7 service – Whenever you need us, customer service
› No-referral specialist care – If you need to see representatives will take your calls.
a specialist, you don’t need a referral to see an
Partner with a health advocate – Even when you’re not
in-network doctor.
sure where to begin, you’ll get confidential assistance
You may need precertification for hospital stays and from reliable, caring professionals who want to help you
some types of outpatient care. Use in-network health take an active role in your health.
care professionals, and there’s no paperwork to fill out.
Access to myCigna.com
› Out-of-network – If you choose to see a doctor who
› Learn more about your plan, and the coverage and
is not in the network, you will not have coverage
programs that come with it.
except in emergencies.
› Emergency and urgent care – When you need care,
› View claim history and account transactions; print
claim forms.
you have coverage.
› Find information and estimate costs for medical
procedures and treatments.
› Compare hospitals by number of procedures
performed, patients’ average length of stay and cost.
Offered by: Cigna Health and Life Insurance Company, Connecticut General Life Insurance Company or their affiliates.
831759 f 12/14
Do I have to choose a primary care Physician? Who must get precertification?
No, but it is recommended. A PCP gives you and your Your doctor will help you decide which procedures
covered family members a valuable resource and can be require you to be admitted to the hospital and which
a personal health advocate. can be handled on an outpatient basis. If your doctor
is in the Cigna network, he or she will arrange for
Do I need a referral to see a specialist? precertification. If you use an out-of-network doctor,
You do not need a referral to see a specialist. If you you must make the arrangements. Remember, your care
choose an out-of-network specialist, your care will will not be covered. Look at your plan documents to see
not be covered by your plan. which procedures need precertification.
How does my plan cover my care? How do I find out if my doctor is in the Cigna network
before I enroll?
When you visit a doctor who is in the Cigna network,
you receive in-network coverage and will have lower It’s quick and easy to search for in-network doctors,
out-of-pocket costs. That’s because our in-network specialists, pharmacies, and hospitals close to home and
health care professionals have agreed to charge lower work. Go to Cigna.com and click on “Find a Doctor.” You
fees, and your plan will pay for covered services. If you can review the doctor’s background, languages spoken
choose to visit a doctor outside of the network, your and hospital affiliations, and get directions.
care will not be covered by your plan.
What if I need to be admitted into the hospital?

In an emergency, you have coverage. Requests for
non-emergency hospital stays other than maternity
stays must be approved in advance or “precertified.”
This lets Cigna determine if the services are covered.
Precertification is not required for maternity stays of
48 hours for vaginal deliveries or 96 hours for cesarean
sections. Depending on your plan, you may be eligible
for additional coverage. Any hospital stay beyond the
first 48 or 96 hours must be approved.
All group health insurance policies and health benefit plans contain exclusions and limitations. For costs and complete details of coverage, see your employer’s insurance certificate, group service
agreement or summary plan description. Health care professionals and facilities who participate in Cigna’s network are independent practitioners solely responsible for the treatment provided to
their patients. They are not agents of Cigna.
Cigna” and the “Tree of Life” logo are registered service marks, and “Together, all the way.” is a service mark, of Cigna Intellectual Property, Inc., licensed for use by Cigna Corporation and its
operating subsidiaries. All products and services are provided by or through such operating subsidiaries, including Cigna Health and Life Insurance Company and Connecticut General Life
Insurance Company, and not by Cigna Corporation. In Texas, Open Access Plus In-Network plans are considered Exclusive Provider plans with certain managed care features.
831759 f 12/14 © 2014 Cigna. Some content provided under license.

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OPEN ACCESS PLUS

See how your health plan works for you.

What if I need to be admitted into the hospital?

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