Cigna Nationwide Plan Highlights
| Nationwide Plan Highlights |
|---|
| Cigna High Deductible Health Plan (HDHP) |
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Cigna Medical Plan Summary
Below is a summary of the benefits included with HDHP plan.
| Cigna High Deductible Health Plan (HDHP) | ||
|---|---|---|
| Plan Features | In-Network | Out-of-Network |
| Plan Deductible (Indiv./Fam.) | $3,000 per person; Not to exceed $5,000 per family |
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| Out-of-pocket Maximum (Indiv./Fam.) | $5,200 per person / Not to exceed $10,000 per family (deductible included) | $7,000 per person / Not to exceed $14,000 per family (deductible included) |
| Plan Coinsurance | 10% after deductible | $40% after deductible |
| Lifetime Maximum | Unlimited | |
| Office Visit |
10% after deductible | 40% after deductible |
| Preventive Care Office Visit | No charge | 40% after deductible |
| Specialist Office Visit | 10% after deductible | 40% after deductible |
| Basic Lab & X-ray | 10% after deductible | 40% after deductible |
| Complex Lab & X-ray | 10% after deductible | 40% after deductible |
| Hospital Services | 10% after deductible | 40% after deductible |
| Emergency Room | 10% after deductible | |
| Prescription Drug (up to a 30 day supply) | ||
| Deductible Generic / Brand / Non-Formulary Mail Order Pharmacy (up to a 90 day supply) |
Plan deductible applies then member pays 20% until plan Out of Pocket Maximum is met. |
Not Covered |