HMO and Network

Plan Highlights

  • Care coordinated by primary care physician
  • Referrals required
  • Health care professionals obtain precertification for in-network services when required
  • In-network coverage only
  • Most payment responsibilities and precertification requirements shown on the member ID card

Network-only Plans

HMO and Network plans are network-only plans. Your patients who enroll in these Cigna administered plans select a primary care physician (PCP) from our broad network of participating physicians. Their PCP assists in managing their overall health. These patients can change their PCP at any time. PCPs are responsible for:

  • Providing routine care
  • Referring their patients to in-network specialty care health care professionals
  • Obtaining precertification for all services that require it
  • Filing patient claims

Cigna's HMO and Network plans offer in-network coverage only, except in emergency and urgent care situations. We also offer HMO Open Access and Network Open Access plans, which allow patients to visit in-network specialists without a doctor’s (PCP) referral.

Patients in Cigna administered HMO and Network plans may be responsible for:

  • Deductibles for inpatient and outpatient facility charges
  • Coinsurance and/or deductibles for facility and physician charges

These payment responsibilities are listed on the member ID card. Coinsurance/deductible amounts should not be collected at the time of service unless you have accessed the Cigna Cost of Care Estimator® to obtain an estimate of the patient’s costs and provide a copy of the Explanation of Estimate to the patient.

Please contact us for more information about Cigna HMO and Network plans or about how to become a participating Cigna health care professional.