Cigna PPO
A PPO plan on the Cigna Open Access Plus network, giving you the freedom to see any provider while paying less in-network.
Cigna PPO
Key Details
- Carrier
- Cigna
- Plan Type
- PPO
- Network
- Cigna Open Access Plus
- HSA Eligible
- No
- FSA Eligible
- Yes
Employee Only
- Semi-Monthly Cost
- $132.50
Employee + Spouse
- Semi-Monthly Cost
- $280.00
Employee + Child(ren)
- Semi-Monthly Cost
- $255.00
Employee + Family (Spouse & Child(ren))
- Semi-Monthly Cost
- $457.50
Annual Deductible
- Cigna PPO In-Network
- $1,000 Individual $2,000 Family (Embedded)
- Cigna PPO Out of Network
- $1,000 Individual $2,000 Family (Embedded)
Annual Out-of-Pocket Maximum
- Cigna PPO In-Network
- $3,500 Individual $7,000 Family
- Cigna PPO Out of Network
- $6,000 Individual $12,000 Family
Office Visit Primary Provider
- Cigna PPO In-Network
- $20 Copay
- Cigna PPO Out of Network
- 55% after deductible
Office Visit Specialist
- Cigna PPO In-Network
- $40 Copay
- Cigna PPO Out of Network
- 55% after deductible
Preventive Care
- Cigna PPO In-Network
- Covered in Full
- Cigna PPO Out of Network
- 55% after deductible
Lab and X-ray
- Cigna PPO In-Network
- 20% after deductible
- Cigna PPO Out of Network
- 55% after deductible
Urgent Care
- Cigna PPO In-Network
- $50 Copay
- Cigna PPO Out of Network
- $50 Copay
Emergency Room
- Cigna PPO In-Network
- $150 Copay
- Cigna PPO Out of Network
- $150 Copay
Hospitalization
- Cigna PPO In-Network
- 20% after deductible
- Cigna PPO Out of Network
- 55% after deductible
Outpatient Surgery
- Cigna PPO In-Network
- 20% after deductible
- Cigna PPO Out of Network
- 55% after deductible
Retail (30-day supply) - Generic
- Cigna PPO In-Network
- $10 Copay
- Cigna PPO Out of Network
- 55% after deductible
Retail (30-day supply) - Preferred Brand
- Cigna PPO In-Network
- $40 Copay
- Cigna PPO Out of Network
- 55% after deductible
Retail (30-day supply) - Non-Preferred Brand
- Cigna PPO In-Network
- $70 Copay
- Cigna PPO Out of Network
- 55% after deductible
Retail (30-day supply) - Specialty
- Cigna PPO In-Network
- $150 Copay
- Cigna PPO Out of Network
- 55% after deductible
Mail Order (90-day supply) - Generic
- Cigna PPO In-Network
- $25 Copay
- Cigna PPO Out of Network
- 55% after deductible
Mail Order (90-day supply) - Preferred Brand
- Cigna PPO In-Network
- $100 Copay
- Cigna PPO Out of Network
- 55% after deductible
Mail Order (90-day supply) - Non-Preferred Brand
- Cigna PPO In-Network
- $175 Copay
- Cigna PPO Out of Network
- 55% after deductible
Mail Order (90-day supply) - Specialty
- Cigna PPO In-Network
- N/A
- Cigna PPO Out of Network
- N/A
Plan Notes
- Aggregate Deductible - When covering more than 1 person, co-insurance applies after the entire family deductible has been met.
- Embedded Deductible - When covering more than 1 person, co-insurance applies after the individual deductible has been met.