Cigna Nationwide Plan Highlights
| Nationwide Plan Highlights |
|---|
| Cigna High Deductible Health Plan (HDHP) |
|
Cigna Medical Plan Summary
Below is a summary of the benefits included with HDHP plan.
| Cigna High Deductible Health Plan (HDHP) | ||
|---|---|---|
| Plan Features | In-Network1,2 | Out-of-Network1,2 |
| Plan Deductible (Indiv./Fam.) | $2,000 per person when enrolled with employee-only coverage / $4,000 per person (this deductible applies if any dependents are enrolled) Not to exceed $5,200 per family |
|
| Out-of-Pocket Maximum (Indiv./Fam.) | $4,500 per person / Not to exceed $9,000 per family |
$7,000 per person / Not to exceed $14,000 per family |
| Plan Coinsurance | 15% after deductible1 | $40% after deductible1 |
| Lifetime Maximum | Unlimited | |
| Office Visit |
15% after deductible1 | 40% after deductible1 |
| Preventive Care Office Visit | No charge | 40% after deductible1 |
| Specialist Office Visit | 15% after deductible1 | 40% after deductible1 |
| Basic Lab & X-ray | 15% after deductible1 | 40% after deductible1 |
| Complex Lab & X-ray | 15% after deductible1 | 40% after deductible1 |
| Hospital Services | 15% after deductible1 | 40% after deductible1 |
| Emergency Room | 15% after deductible1 | |
| Prescription Drug (up to a 30 day supply) | ||
| Generic |
15% after deductible1 | Not Covered |
| Preferred Brand |
15% after deductible1 | Not Covered |
| Non Preferred brand |
15% after deductible1 | Not Covered |
| Mail Order Pharmacy (up to a 90 day supply) |
15% after deductible1 | Not Covered |