Health insurance is tricky. We can help.
At Cigna Healthcare, we’re here to make it all crystal clear so you have the knowledge to make smart decisions for your health and your wallet.
Already a member?
Understanding Your Plan
Terms to Know
Managing Your Plan
myCigna®
24/7 Customer Service
Saving on Your Plan
In-Network vs. Out-of-Network
Avoiding Surprise Bills
Virtual Care
Knowing common insurance terms helps you understand your coverage and manage your health.
Choose myCigna or customer service – either way we’re here to help.
Being prepared can help you save by estimating costs, finding in-network providers and $0 copay for virtual care.
myCigna
® 2024 Cigna Healthcare. All rights reserved
Privacy Legal Disclaimer Product Disclosures Cigna Company Names
Selecting these links will take you away from Cigna.com to another website, which may be a non-Cigna Healthcare website. Cigna Healthcare may not control the content or links of non-Cigna Healthcare websites. Detail.
Back to Top
Cigna Healthcare pays for covered doctor appointments or medical services until Bob’s plan year ends.
=
By the end of August, Bob has spent $3,000 between his deductible, copays and coinsurance. He has hit his out-of-pocket maximum.
S
+
Let’s say Bob’s annual out-of-pocket maximum is $3,000. His plan runs from January 1st through December 31st.
Good news: There’s only so much money you have to pay for covered health care services in a plan year. This is your out-of-pocket maximum. Depending on your plan design, this amount could include everything you spend on deductibles, copays and coinsurance — but never your monthly premium.
Out-of-Pocket Maximum
This example is for illustrative purposes only.
Once he’s met his deductible, Cigna Healthcare pays 80% of his surgery costs. And the remaining 20% is Bob’s responsibility.
Both Bob and Cigna Healthcare are footing the bill together. That’s the “co” in “coinsurance.”
Let’s say Bob needs surgery for a broken wrist, and he has 20% co-insurance in network.
Coinsurance sounds more complicated than it really is. It’s just the part you owe on your medical bill after Cigna Healthcare has paid. You and Cigna Healthcare share covered medical services. Think of it as splitting the check, only Cigna Healthcare pays more of the bill.
Coinsurance
FPO
Your deductible is the amount you pay up front before Cigna Healthcare begins sharing the cost. Think of it like a tipping point. Once you hit that number, Cigna Healthcare pays for a bigger portion of covered expenses. During the deductible phase, you’ll usually pay 100% of your medical bills — until you reach your deductible amount.
Deductible
Your copay is the amount you pay for covered services, like doctor visits, urgent care, prescriptions, etc. Depending on your plan, your copay could count towards your out-of-pocket costs. Let’s say you’re visiting your primary care physician (PCP) for cold symptoms. When you check out, you’re asked to pay a certain amount — for example, $35. That’s your co-pay.
Copay
Your premium is a monthly amount you pay for your coverage, like a monthly subscription cost. Your employer usually deducts it right from your paycheck, so you don’t have to deal with payments.
Health Insurance Premium
After all, knowledge pays — and saves.
Want to learn the lingo?
HOME
Make it easy. Understand the basics of your health coverage. Know before you go. Confirm that your doctor is in network. Avoid surprises. Make sure your doctors, facilities and prescriptions are covered by your plan. Take control. Search for lower-cost options, like urgent care centers or virtual health.
Plus, enjoy secure access to your ID cards through the myCigna App. Your digital ID cards are always accessible, easily shared with providers and can be saved in a digital wallet.
If you’re in the process of open enrollment, we offer pre-enrollment support to help you choose the right plan for your needs. And to get the most out of your plan, you can rely on your customer service team. We’re available by phone, as well as online chat via myCigna.com or the myCigna app. From pre-enrollment and throughout your entire health journey, we’re here to help:
Check out myCigna today.
And this: If you have pharmacy coverage through Cigna, you can compare medication costs, manage home delivery and view plan information.
7
And this: Get virtual care from a board-certified doctor or licensed clinician through MDLIVE.®
6
And this: Pay claims online through myCigna.com with our partner InstaMed using your choice of payment options.*
*Not all providers accept online bill pay. Feature coming soon to app!
5
And this: Manage and track your claims and deductibles.
4
And this: Download and share your ID card with your providers directly from your mobile phone or computer.
3
And this: Estimate costs for specific medical treatments.
2
Like this: Find an in-network provider by specialty, name, symptom, or location.
1
Let’s make things easy for you. Once you’re a member and you’ve registered at myCigna.com, you’ll find tools that allow you to make the most of your Cigna Healthcare plan.
myCigna.com and the myCigna® app
When it comes to your health plan, you’re in control.
myCigna® 24/7 Customer Service
Want to get in touch with Cigna Healthcare?
Enrolling or have questions? Call us to speak with a Cigna Healthcare customer service representative or nurse. Already a member? Visit myCigna.com or the myCigna app, and click to chat with a Cigna Healthcare team member.
See how easy it is to connect to care.
The information provided here is for educational purposes only. Product availability may vary by location and plan type and is subject to change. Plan details may vary so always refer to your plan documents for details related to your specific plan. Group health plans and insurance policies are insured and/or administered by Cigna Health and Life Insurance Company (CHLIC) or its affiliates. All plans have exclusions and limitations. For costs and details of coverage, see your plan documents. *MDLive $0 copay is not available in every state. Selecting these links will take you away from Cigna.com to another website, which may be a non-Cigna Healthcare website. Cigna Healthcare may not control the content or links of non-Cigna Healthcare websites. Detail.
Fast, customized care for skin, hair and nail conditions — no appointment required.
Dermatology
Talk therapy and psychiatry from the privacy of home.
Behavioral Care
On-demand care for hundreds of minor medical conditions.
Urgent Care
It’s not always easy to find time for the health care you need. That’s why Cigna Healthcare offers a $0 copay with MDLive for most virtual care visits*. Talk to a provider by phone or video whenever and wherever works best for you.
Your information is outdated.
It’s a new drug.
It’s brand name.
Why isn’t my prescription covered?
Why is my medical test not covered?
–
Sometimes doctors order tests that aren't covered. And sometimes, a prior authorization is required before scheduling a procedure. That’s why it’s so important to know what is and isn’t covered in your plan. Cigna Healthcare is here to help, so you’re always in control.
Why is my doctor no longer in network?
Providers come and go from health insurance plans for a lot of reasons. The good news: If your doctor is leaving the Cigna Healthcare network, you’ll get a heads-up so you have time to switch to a new in-network provider.
Why did I get a bill for my preventive care exam?
Preventive care exams and screenings are there to help keep you well. But if they reveal something that needs further testing or treatment, anything beyond that exam may not count as preventive care and could involve additional costs. You can take control by asking your doctor if tests are routine or if they may be an extra expense.
Some surprises are welcome, but not medical bills. Here are a few common causes for unexpected health care costs – and how to avoid them.
When Cigna Healthcare doesn’t have a contracted relationship with a doctor or facility, we do not have a say in what they charge for services. If your provider’s bill is higher than what your plan will pay, you might have to make up the difference. When you use an out-of-network doctor or facility, your deductible and coinsurance is usually higher.
Why does out-of-network care cost more?
Once you’re a member, search for in-network providers on myCigna.
Visit your employer’s open enrollment page or Cigna.com.
Considering Cigna Healthcare?
The Cigna Healthcare network of doctors and other health care providers has met Cigna Healthcare credentialing criteria-based on quality, care and cost effectiveness. As part of your Cigna Healthcare plan, you get negotiated savings, making it easy to find quality, affordable care right where you need it.
Once you’re a member and you’ve registered at myCigna.com, you’ll find tools that allow you to make the most of your Cigna Healthcare plan.
In-network vs. out-of-network
Let’s help you save on health care costs.
In-Network vs. Out-of-Network Avoiding Surprise Bills Virtual Care
Check out this video and learn how easy it is to choose in-network doctors using myCigna.com.
Learn how to estimate costs to help avoid surprise expenses on myCigna.
Check out this video to learn more about virtual care.
You can check all your prescriptions on myCigna to find out what is covered, costs and refills available.
Virtual care costs can vary. Make sure to check your plan for details.
It’s not always easy to find time for the health care you need. That’s why Cigna Healthcare offers a $0 copay with MDLive for virtual care visits. Talk to a provider by phone or video whenever and wherever works best for you.
Virtual Care for more than routine check-ups
