Cigna Medical Plans Details

Cigna Medical

You have three plan options to choose from through Cigna. Cigna plans offer out-of-network coverage and additional wellness and support programs. All plans include free preventive care and free preventive care medications. Additionally, Cigna members have access to Paladina which offers affordable and convenient primary, preventive, and urgent care services. Please note that while Paladina does not show as a Cigna network provider, it is a care option for Cigna members.

Cigna One Guide

Cigna One Guide is here to ensure you’re able to make the best decisions possible when it comes to your health care needs.

Pre-Enrollment Support

Cigna One Guide is a service available to you during the enrollment period to help determine your health care needs and best plan option. You don’t have to be a current Cigna member to take advantage of this service. Your personal guide will help you:

  • Easily understand the basics of health coverage
  • Identify the types of health plans available to you
  • Check if your doctors are in-network
  • Get answers to other questions you have

If you could use support in understanding your health plan options, call 888-806-5042.

Post-Enrollment Support

Cigna members can continue to rely on the Cigna One Guide team. Your Cigna One Guide can help you:

  • Learn how your coverage works
  • Find in-network care providers
  • Connect with health coaches
  • Connect with dedicated one-on-one support for complex health situations
  • Get cost estimates

To get in touch with your Cigna One Guide, visit www.mycigna.com, download the MyCigna app, or call 800-244-6224.

Cigna Medical Plan Comparison

You have access to three Cigna medical plan options. Cigna offers both in-network and out-of-network coverage. For employees who don’t have easy access to in-network facilities, members of Cigna also have access to primary care through Paladina.

Plan Features Cigna Copay Plus Cigna Copay Basic Cigna HDHP (HSA Qualified)
In-Network Out-of-Network In-Network Out-of-Network In-Network Out-of-Network
Annual Deductible $750 individual*
$2,000 family*
$1,500 individual*
$3,000 family*
$1,250 individual*
$2,500 family*
$3,000 individual*
$6,000 family*
$1,750 individual**
$3,500 family**
$4,500 individual**
$6,000 family**
Employee Coinsurance 20% 50% 20% 50% 25% 50%
Annual
Out-of-Pocket Maximum***
$3,500 individual
$7,000 family
$7,000 individual
$14,000 family
$4,500 individual
$9,000 family
$10,000 individual
$20,000 family
$5,000 individual
$8,000 individual within a family
$10,000 family
$9,000 individual
$14,400 individual within a family
$18,000 family
Annual Company HSA Contribution None None Up to $720
You pay:
Preventive
Care Visit
Covered in full Covered in full Covered in full
Primary
Care Visit
$20 copay 50% after deductible $20 copay  50% after deductible 25% after deductible 50% after deductible
Paladina Primary
Care Visit
$0 copay $0 copay $40 copay
Specialist Visit $40 copay 50% after deductible $40 copay  50% after deductible 25% after deductible 50% after deductible
Urgent Care $75 copay 50% after deductible $75 copay  50% after deductible 25% after deductible 50% after deductible
Emergency Room
(copay waived
if admitted)
$1,000 copay 20% after deductible 25% after deductible
Inpatient Services 20% after deductible 50% after deductible 20% after deductible  50% after deductible 25% after deductible 50% after deductible
Prescription Drugs: Retail (up to a 30-day supply)
Preventive Covered in full if prescribed by a doctor
Generic $10 copay Not covered $7 copay Not covered $10 copay after deductible Not covered
Brand Formulary $30 copay Not covered $30 copay Not covered $40 copay after deductible Not covered
Non-Formulary $60 copay Not covered $60 copay Not covered $60 copay after deductible Not covered
Specialty 20% up to
$120 copay
Not covered 20% up to
$120 copay
Not covered 25% after deductible up to
$120 copay
Not covered
Prescription Drugs: Mail Order (up to a 90-day supply)
Generic $20 copay Not covered $14 copay Not covered $20 copay
after deductible
Not covered
Brand Formulary $60 copay Not covered $60 copay Not covered $80 copay
after deductible
Not covered
Non-Formulary $120 copay Not covered $120 copay Not covered $120 copay
after deductible
Not covered
Specialty 20% up to
$240 copay
Not covered 20% up to
$240 copay
Not covered 25% after deductible up to
$240 copay
Not covered

*Deductible is embedded. Family members meet only their individual deductible and then their claims will be covered under the plan coinsurance; if the family deductible has been met prior to their individual deductible being met, their claims will be paid at the plan coinsurance.

**Deductible is aggregate. All family members contribute towards the family deductible. An individual cannot have claims covered under the plan coinsurance until the total family deductible has been satisfied.

***Out-of-pocket max is embedded. After each eligible family member meets his or her individual out-of-pocket maximum, the plan will pay 100% of their covered expenses. Or, after the family out-of-pocket maximum has been met, the plan will pay 100% of each eligible family member’s covered expenses.

No-Cost Preventive Prescriptions

Both Cigna and Kaiser medical plans include preventive care medications at no out-of-pocket cost to you. You can use your OptumRX member ID card to get free preventive care medications providing that the medication is:

  • Prescribed by a health care professional
  • Age and condition appropriate
  • Filled at an in-network pharmacy

Examples of covered medications include:

  • Asprin, folic acid, and other select common over-the-counter medications
  • Nicotine cessation medications
  • Human immunodeficiency virus preventive medications
  • Breast cancer preventive medications
  • Statin preventive medications
  • Birth control products
  • Flu shots and other vaccines

For pharmacy-related resources and tools including an in-network pharmacy locator, visit www.optumrx.com/oe_stateofcolorado. For customer service including home delivery, call 844-564-2201 or 800-498-5428 (TDHI for hearing impaired).

Finding a Doctor

Save money by using in-network services. To find a doctor, visit www.mycigna.com.

Is Your Doctor Not Currently In-Network? Submit a Doctor Request Form and Cigna will reach out to your doctor to see if they can be brought into the Cigna Network.

Surgical and Treatment Support Program

Cigna’s Surgical Treatment and Support Program covers you in the event of certain non-emergency surgeries. This benefit is offered at no additional cost to you and your covered dependents, and the eligible procedures are 100% covered by the plan with no copay or coinsurance (deductible must be met for Cigna HDHP participants).

Covered procedures include:

  • Low back disk surgery
  • Hip arthroplasty
  • Hip replacement
  • Knee arthroplasty
  • Knee replacement
  • Laminectomy
  • Spinal fusion

To take advantage of this benefit, call 855-678-0042.

Your Rights

This website highlights some of your benefit plans. Your actual rights and benefits are governed by the official plan documents. If any discrepancy exists between this communication and the official plan documents, the plan documents will prevail. The State of Colorado reserves the right to change any benefit plan without notice. Benefits are not a guarantee of employment.

Your Benefits Team

Division of Human Resources
303-866-3434 or 800-719-3434 state_benefits@state.co.us

Your Department’s Human Resources Office: Benefit Administrator List

Accessibility

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