Cigna Silver PPO

These plans are for those who are looking for comprehensive coverage that includes low office visit copayments.

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Cigna Silver PPO - 2015
Health Insurance Plans for Individuals and Families

These plans are for those who are looking for comprehensive coverage that includes low office visit copayments with an unlimited number of office visits per calendar year and no charge for annualCigna health insurance physical exams. There is an individual calendar deductible of $2,000 and a family deductible of $4,000. All covered services contribute to the out-of-pocket maximum. Preventive care services, such as routine physical exams and mammogram screenings, are at no charge. This is the most popular Cigna plan in California and will satisfy your mandated individual health insurance requirement also known as "minimum essential health coverage ".

Plan Name Silver PPO
Medical DeductibleIndividual: $2,000 Family: $4,000
Drug Benefits DeductibleIndividual: $250 Family: $500
Default Medical Coinsurance20%
Default Drug Coinsurance20%
Annual Out-of-Pocket  
Out of Pocket Max for Med and Drug EHB Benefits (Total) Individual: $6,250 Family: $12,500
Emergency Health  
Urgent Care Centers or Facilities$90
Emergency Room Services $250 Copay after deductible
Emergency Transportation/Ambulance $250 Copay after deductible
Home Health Care  
Home Health Care Services20%
Hospitalization Services  
Inpatient Physician and Surgical Services20%
Habilitation Services$45
Inpatient Hospital Services (e.g., Hospital Stay) 20% Coinsurance after deductible
Skilled Nursing Facility 20% Coinsurance after deductible
Substance Abuse Disorder Outpatient Services$45
Substance Abuse Disorder Inpatient Services 20% Coinsurance after deductible
Maternity Care  
Delivery and All Inpatient Services for Maternity Care 20% Coinsurance after deductible
Prenatal and Postnatal CareNo Charge
Other Services  
Mental/Behavioral Health Inpatient Services 20% Coinsurance after deductible
Durable Medical Equipment20% Coinsurance after deductible
Hospice ServicesNo Charge
Bariatric Surgery 20% Coinsurance after deductible
Mental/Behavioral Health Outpatient Services$45
Acupuncture20% Coinsurance after deductible
Rehabilitative Speech Therapy$45
Rehabilitative Occupational and Rehabilitative Physical Therapy$45
Allergy Testing 20% Coinsurance after deductible
Chemotherapy 20% Coinsurance after deductible
Diabetes Education20% Coinsurance after deductible
Dialysis 20% Coinsurance after deductible
Infusion Therapy 20% Coinsurance after deductible
Prosthetic Devices20% Coinsurance after deductible
Radiation 20% Coinsurance after deductible
Reconstructive Surgery 20% Coinsurance after deductible
Transplant 20% Coinsurance after deductible
Treatment for Temporomandibular Joint Disorders 20% Coinsurance after deductible
Outpatient Services  
Outpatient Surgery Physician/Surgical Services20%
Outpatient Facility Fee (e.g., Ambulatory Surgery Center)20%
Outpatient Rehabilitation Services$45
Prescription Drug Coverage  
Generic Drugs $15
Non-Preferred Brand Drugs $70 Copay after deductible
Preferred Brand Drugs $50 Copay after deductible
Specialty Drugs 20% Coinsurance after deductible
Preventative Care  
Well Baby Visits and CareNo Charge
Preventive Care/Screening/ImmunizationNo Charge
Professional Services  
Other Practitioner Office Visit (Nurse, Physician Assistant)$45
Imaging (CT/PET Scans, MRIs) 20% Coinsurance after deductible
X-rays and Diagnostic Imaging20% Coinsurance after deductible
Specialist Visit$65
Laboratory Outpatient and Professional Services$45
Primary Care Visit to Treat an Injury or Illness$45

Benefits stated above are using in network preferred providers only. Click here for provider information.

 

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