CIGNA Open Access Coinsurance Plus Choice Fund HRA

The plan summary provides a detailed listing of care options and coverages.

  • CIGNA Open Access Plus Coinsurance Plan with CIGNA Choice Fund HRA summary

General coverages are listed here for a quick overview.

In-Network options and coverages are as follows: 

Deductible $2,000/$4,000
Coinsurance 90% after deductible
Physician Copay 90% after deductible
Preventive Office Copay
Covered 100%
Outpatient Copay 90% after deductible
Inpatient Copay 90% after deductible
Home Health Care 90% after deductible
Emergency Care 90% after deductible
Urgent Care 90% after deductible
Retail Prescriptions $10/$25/$40 copay
Mail Order Prescriptions 
(90-day supply)
$20/$50/$80 copay
Enhanced Preventive Drugs N/A
Mental Health (MH) /
Substance Abuse (SA)
 
MH/SA Inpatient Facility Svcs
90% after deductible
MH/SA Outpatient Facility Svcs 90% after deductible
MH/SA Outpatient Svcs 90% after deductible
Routine Vision Exam
(Every 24 months)
Covered 100%
Max Out-Of-Pocket $4,000/$8,000

Out-of-Network options and coverages are as follows:

Deductible $2,000/$4,000
Coinsurance 70% after deductible
Physician Copay 70% after deductible
Preventive Office Copay
70% after deductible
Outpatient Copay 70% after deductible
Inpatient Copay 70% after deductible
Home Health Care 70% after deductible
Emergency Care 90% after deductible
Urgent Care 90% after deductible
Prescriptions

IN NETWORK
COVERAGE ONLY

Mental Health (MH) /
Substance Abuse (SA)
 
MH/SA Inpatient Facility Svcs
70% after deductible
MH/SA Outpatient Facility Svcs 70% after deductible
MH/SA Outpatient Svcs 70% after deductible
Routine Vision Exam
(Every 24 months)
$45
Max Out-Of-Pocket $4,000/$8,000