The Open Access Plus (500) Plan allows you to see any licensed provider you choose, though benefits are higher when you receive care from a provider in the Open Access Plus network. Members have the option to choose a Primary Care Physician (PCP) to serve as a personal physician to help coordinate health needs.

Deductible and coinsurance apply. Once you reach your out-of-pocket maximum, the plan pays 100% of covered medical expenses for the rest of the year. You can compare the Open Access Plus (500) plan benefits to the other medical plans to determine if this plan is right for you.


Providers

With the Open Access Plus (500) plan, you have the freedom to receive care from any licensed provider. You will pay less when you use doctors, hospitals, and other health care facilities that participate in the Cigna network and have agreed to provide services to plan members at special discounted rates.

You will pay expenses up to your plan’s annual deductible ($500). Once you’ve met the deductible, you and the plan share in the costs – with the plan paying a larger portion – until you reach the annual out-of-pocket maximum ($2,000). This is known as “coinsurance.”

After you reach the out-of-pocket maximum, the plan picks up 100% of expenses for the rest of the year.

No referrals are necessary to see any physician or specialist in the network.


Preventative Care

Preventive care office visits and related procedures performed in the doctor’s office (coded as preventive by your physician) are covered at 100% only in-network. Recommended procedures performed outside the doctor’s office may result in deductible and coinsurance charges.

Some preventive drugs are covered at 100% with no co-pay or deductible; commonly used drugs are covered at 100%.

For a complete list of prescription drugs, please visit myCigna.


 

Open Access Plus (500) Plan

 Coverage In-Network Out-of-Network
Deductible

  • Individual
  • Family
Deductible

  • $500
  • $1,000
Deductible

  • $700
  • $1,400
Coinsurance (Co-ins.) 80/20% 60/40%
Maximum Out-of-Pocket

  • Individual
  • Family

Max

  • $2,000
  • $4,000
Max

  • $2,000
  • $4,000
Rx Out-of-Pocket

  • Individual
  • Family
Rx OoP

  • $4,850
  • $9,700
Rx OoP

  • $4,850
  • $9,700
Preventative Care Office Visit 100% Not Covered
Sick Office Visit $25 copay Deductible & 20% Co-ins.
Lab/X-Ray Deductible & Co-ins. Deductible & Co-ins.
CT/MRI/PET Scans Deductible & Co-ins. Deductible & Co-ins.
Outpatient Surgery Deductible & Co-ins. Deductible & Co-ins.
Hospital Visits Deductible & Co-ins. Deductible & Co-ins.
Specialist Visits $30 copay Deductible & 20% Co-ins.
Emergency Room Deductible & 20% Co-ins. Deductible & 20% Co-ins.
Retail Prescription Drugs
(30-day supply)

  • Generic
  • Preferred
  • Non-Preferred
Retail Prescription Drugs
(30-day supply)

  • $10
  • $25
  • $40
N/A
Mail-Order Prescription Drugs
(90-day supply)

  • Generic
  • Preferred
  • Non-Preferred
 Mail-Order Prescription Drugs
(90-day supply)

  • $20
  • $50
  • $80
N/A
Mental Health & Substance Abuse

  • Inpatient
  • Outpatient
Mental Health & Substance Abuse

  • Deductible & Co-ins.
  • $30 copay
Mental Health & Substance Abuse

  • Deductible & Co-ins.
  • Deductible & 20% Co-ins.

 

 

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