Specialist Care Without A Referral

Your patients covered by the Cigna Open Access Plus (OAP) plan receive referral-free access to specialists. If these patients choose an out-of-network health care professional, services are covered at a reduced benefit level.

The Cigna Open Access Plus In-Network (OAPIN) plan also provides referral-free access to specialty care. However, patients covered by these plans must visit health care professionals in the Open Access Plus network to receive coverage (only emergency and urgent care are covered when received from out-of-network health care professionals.)

In addition to their Cigna administered OAP or OAPIN plan, patients may also have a Cigna Choice Fund^®, an employer- or employee-funded account that can be used to pay for qualified health care expenses.

Primary Care Physician Coordination Available

Patients covered by these Cigna administered plans are encouraged and have the opportunity to select a Primary Care Physician (PCP) to coordinate their care and to provide:

• Routine checkups
• Follow-up care
• Information and guidance

Patients Covered by These Plans May Be Responsible for:

• Deductibles for inpatient and outpatient facility charges
• Coinsurance and/or deductibles for facility charges
• Coinsurance and/or deductibles for facility and physician charges
• Charges for out-of-network care (applies to your patients in Cigna Open Access Plus In-Network plans only)

These payment responsibilities are listed on the member ID card. Coinsurance/deductible 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 these Cigna plans, or about how to become a participating Cigna health care professional.