Transcription of SAMPLE Cigna Open Access Plus Plan
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SAMPLE Cigna Open Access Plus Plan
SAMPLE Cigna Open Access Plus Plan Important Information THIS IS A SAMPLE DOCUMENT. NO BENEFITS ARE GUARANTEED. NO COVERAGE REPRESENTATION IS CONSIDERED TO BE ACTUAL MEDICAL BENEFITS PROVIDED TO YOU BY Cigna . Table of Contents Important Information ..6 Special Plan Provisions ..8 Important Notices ..9 How To File Your Claim ..11 Eligibility - Effective Date ..11 Employee Insurance .. 11 Waiting Period .. 11 Dependent Insurance .. 12 Important Information About Your Medical Plan ..12 Open Access Plus Medical Benefits ..13 The Schedule .. 13 Certification Requirements - Out-of-Network .. 25 Prior Authorization/Pre-Authorized .. 25 Covered Expenses .. 26 Prescription Drug Benefits ..34 The Schedule .. 34 Covered Expenses.
Provider. Participating Providers include Physicians, Hospitals and Other Health Care Professionals and Other Health Care Facilities. Consult your Physician Guide for a list of Participating Providers in your area. Participating Providers are committed to providing you and your Dependents appropriate care while lowering medical costs.
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