Cigna Healthcare Plans

Health Plan Transparency Machine Readable Files https://www.ticmrf.com/59-6000572

This link leads to the machine readable files that are made available in response to the federal Transparency in Coverage Rule and includes negotiated service rates and out-of-network allowed- amounts between health plans and healthcare providers. The machine-readable files are formatted to allow researchers, regulators, and application developers to more easily access and analyze data.

Healthcare Plan Comparison

Cigna OAP Extended Network

Cigna LocalPlus Focused Network

Cigna SureFit Network

Prescription Coverage

Behavioral Health

Preventative Health Services

Urgent & Convenience Care Centers

Additional Resources

FAQs

1. What is a co-payment?
A co-payment is a fixed dollar amount you pay for covered healthcare services. The amount will
vary by type of plan and covered service.
2. What is a Tier 1 provider?

A Tier 1 provider is a provider of a designated network that has been identified by Cigna to have demonstrated the best outcome in management in patient treatment. This network includes both primary care physicians and specialists.

3. What specialties are included in this network?

There are 22 specialist providers located in South Florida.

4. How do I determine if my specialist is a Tier 1 provider?
Log-in to www.mycigna.com and click on Find Care and Costs. You can search by name or specialty. Once you’re on the online directory, look for Tier 1 provider designation.
5. Do I need a referral to see a specialist?
No. Referrals are not needed in any of the three Cigna healthcare plans.
6. What is an annual deductible?

An annual deductible is the annual amount you are responsible for medical services provided in a hospital or hospital-affiliated facility. This amount is separate from any co-payments.

7. What does the annual maximum out-of-pocket (MOOP) mean?

The annual maximum out-of-pocket is the amount you are responsible for before the plan pays 100 percent.

8. What does the plan co-insurance mean?

The plan co-insurance is the percentage by plan you pay for medical services provided in a hospital or hospital-affiliated facility. Co-insurance does not apply to fixed co-payments.

9. What happens if I am hospitalized?

Hospital admissions are subject to deductibles and co-insurance.