CIGNA Open Access Plus In-Network Copay Plan

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

General coverages are listed here for a quick overview.

In-Network options and coverages are as follows: 

Deductible $500/$1,000
Coinsurance 80% after deductible
Physician Copay $25/$40
Preventive Office Copay
Covered 100%
Outpatient Copay 80% after deductible
Inpatient Copay 80% after deductible
Home Health Care No Charge
Emergency Care $75
Urgent Care $35
Retail Prescriptions $10/$25/$40 copay
90-Day Prescriptions $20/$50/$80 copay
Enhanced Preventive Drugs N/A
Mental Health (MH) /
Substance Abuse (SA)
MH/SA Inpatient
Facility Svcs
80% after deductible
MH/SA Outpatient Facility Svcs 80% after deductible
MH/SA Outpatient Svcs $25
Routine Vision Exam
(Every 24 months)
Max Out-Of-Pocket $2,000/$4,000

Out-of-Network care options:

Routine Vision Exam
(Every 24 months) 

All other Out-of-Network care options are not covered by this plan.