Using Your Cigna Healthcare Plan
A comprehensive member guide packed with information on how to use your plan to its fullest, now and throughout the year.
Using Your Cigna Healthcare Plan
A comprehensive member guide packed with information on how to use your plan to its fullest, now and throughout the year.
Welcome to Cigna Healthcare
It’s easy to get started using your plan.
Alaska residents: If you are having difficulties with claims, reimbursement, coverage eligibility, or to access your ID card, please log in to myCigna for 24/7 access to your account or to contact us.
Activate your myCigna® account
Activate your account on myCigna.1 Even if your plan is not fully active yet, you can get started with some of myCigna’s features. It’s quick and easy and the best way to manage your plan.
With myCigna you can:
- Find in-network doctors, care, and cost estimates
- Get access to 7 million+ verified patient reviews from other Cigna Healthcare® members
- Connect with virtual care (telehealth) providers, 24/7
- Print or view your ID card
- Manage prescriptions or find a pharmacy
- Available in English and Spanish
Manage Your Plan With myCigna
All aspects of your plan are available on myCigna. See who's covered, what's covered, your claims, health and wellness programs, and more.
Alaska residents: If you are having difficulties with claims, reimbursement, coverage eligibility, or to access your ID card, please log in to myCigna for 24/7 access to your account or to contact us.
Get the myCigna® mobile app1 and stay connected anywhere
Instant access to your health care data.
The myCigna app uses one-touch access, making it easy for you to update your profile settings and personalize, organize, and access your health information on the go.
Download the app today.
Your digital ID cards go everywhere you do
You may not automatically receive medical, vision, and pharmacy ID cards in the mail at the beginning of your plan year.
You have immediate access to your digital ID cards and proof of coverage anytime you need them, right from myCigna.com or the mobile app.
How to use them
Digital ID cards can be easily shared: Download the card image to save, share, print, or email to dependents or providers as needed. On your mobile device, you can add your ID card to your Apple Wallet® or Google Wallet™.
Providers will have different ways to process digital ID cards.
You can:
- Show your ID card on your phone screen at the provider's office
- Save an image and email it to them from your secure myCigna inbox
- Print an ID card to give to them
Your digital ID cards go everywhere you do
You may not automatically receive medical, vision, and pharmacy ID cards in the mail at the beginning of your plan year.
You have immediate access to your digital ID cards and proof of coverage anytime you need them, right from myCigna.com or the mobile app.
How to use them
Digital ID cards can be easily shared: Download the card image to save, share, print, or email to dependents or providers as needed. On your mobile device, you can add your ID card to your Apple Wallet® or Google Wallet™.
Providers will have different ways to process digital ID cards.
You can:
- Show your ID card on your phone screen at the provider's office
- Save an image and email it to them from your secure myCigna inbox
- Print an ID card to give to them
Introduction to Digital ID Cards
Discover how easy it is to access digital ID cards and share with your providers. (Length: 00:00:42)
Accessing Your Digital ID Cards
Learn more about how to access your digital ID cards with your myCigna account. (Length: 00:01:36)
Sharing Your Digital ID Cards
Find out how to store and share your digital ID cards with your digital wallet or directly from the app. (Length: 00:01:24)
Getting Care
Get virtual, in-person, or immediate care
Schedule your preventive care—it’s no additional cost to you
Preventive care is covered 100% by your plan when you go to in-network doctors and providers. This benefit, alone, can save you hundreds of dollars a year.
Preventive care usually includes:
Your annual check-up
Flu shots
Most routine screenings and vaccinations
Includes eligible in-network preventive care services. Some preventive care services may not be covered, including most immunizations for travel. Reference plan documents for a list of covered and non-covered preventive care service.
What about getting other kinds of medical care and services?
For visits with doctors and providers for medical issues that are not preventive, here are some tips:
- If required by your plan, get a referral from your Primary Care Provider (PCP)
- Go to in-network doctors, specialists, hospitals, and facilities
- Know how your plan covers you for non-preventive care and services
- Track where you are with your deductible and coinsurance, if they apply
Activate your myCigna account to view details of your coverage and covered services.
What about getting other kinds of medical care and services?
For visits with doctors and providers for medical issues that are not preventive, here are some tips:
- If required by your plan, get a referral from your Primary Care Provider (PCP)
- Go to in-network doctors, specialists, hospitals, and facilities
- Know how your plan covers you for non-preventive care and services
- Track where you are with your deductible and coinsurance, if they apply
Benefits of a Primary Care Provider (PCP)
There are many benefits of choosing a PCP, including preventive care and helping to manage and improve your overall health.
Finding a PCP
Are you looking for a PCP? This short video shows you how to log in or register on myCigna to search for a PCP and specialists. (Length: 00:02:23)
Checking PCP Profiles
PCP profiles on myCigna include an overview of each providers’ specialties and patient ratings, so you can review and compare to find someone that fits your needs. (Length: 00:01:16)
Building a Relationship with a PCP
Building a relationship with your PCP and visiting them regularly allows them to become familiar with your personal medical history and make recommendations. (Length: 00:01:35)
Need immediate care?
If you need to see a doctor right away, you have options depending on the type of medical care needed.
Convenience Care Clinics
When you need face-to-face medical attention for minor illnesses (flu shots, vaccines, allergies, etc.) but can’t wait for an appointment, a Convenience Care Clinic (walk-in clinic) is your best bet for immediate, affordable care.
Urgent Care Centers
If you need medical attention for a non-emergency medical condition (back pain, colds and flu, broken bones, etc.), an Urgent Care Center typically costs less than the ER with shorter wait times.
Need immediate care?
If you need to see a doctor right away, you have options depending on the type of medical care needed.
Convenience Care Clinics
When you need face-to-face medical attention for minor illnesses (flu shots, vaccines, allergies, etc.) but can’t wait for an appointment, a Convenience Care Clinic (walk-in clinic) is your best bet for immediate, affordable care.
Urgent Care Centers
If you need medical attention for a non-emergency medical condition (back pain, colds and flu, broken bones, etc.), an Urgent Care Center typically costs less than the ER with shorter wait times.
Convenience Care Clinics | Urgent Care Centers | Emergency Room (ER) | Virtual Care (Telehealth) | |
|---|---|---|---|---|
Cost |
|
| ||
Wait Times |
|
| ||
Severity |
|
| ||
Symptoms Treated | Allergies | Nausea and diarrhea | Trouble breathing | Allergies |
This information is for educational purposes only. It isn't medical advice and does not replace care from a physician. Cigna Healthcare isn't responsible for issues due to the use, misuse, interpretation or application of this information. Always ask your provider for appropriate examinations, treatment, testing, and care recommendations, including when you choose another provider for care.
Employee Assistance Program (EAP) - Real support for real life
If you purchase a plan through an employer*, you and anyone in your household has access to our Employee Assistance Program (EAP).3 Connect with licensed clinicians to help with emotional wellness, mental health, and other issues you may be experiencing such as help with finding elder care, caregiver support, pet care, and more.
Learn more about EAP services that may be available to you.
Employee Assistance Program (EAP) - Real support for real life
If you purchase a plan through an employer*, you and anyone in your household has access to our Employee Assistance Program (EAP).4 Connect with licensed clinicians to help with emotional wellness, mental health, and other issues you may be experiencing such as help with finding elder care, caregiver support, pet care, and more.
Learn more about EAP services that may be available to you.
Find, compare, and choose a dentist
If your plan includes dental coverage, you’ll have access to a large nationwide network. See any dentist you'd like, but you'll save more with a dentist in the Total or Advantage Networks.
Dentist Ratings
The Brighter Score® rates dentists based on affordability, professional history, verified patient reviews4, and estimated out-of-pocket costs for common dental procedures.
$0 Preventive Care
Pay $0 for a dental exam every six months including cleanings, oral exams, and routine x-rays with no deductible or copays.5
Verified Patient Reviews
Read verified patient reviews from other Cigna Healthcare customers based on their experience with network dentists, specialists, and dental offices.
Find, compare, and choose a dentist
If your plan includes dental coverage, you’ll have access to a large nationwide network. See any dentist you'd like, but you'll save more with a dentist in the Total or Advantage Networks.
Dentist Ratings
The Brighter Score® rates dentists based on affordability, professional history, verified patient reviews5, and estimated out-of-pocket costs for common dental procedures.
$0 Preventive Care
Pay $0 for a dental exam every six months including cleanings, oral exams, and routine x-rays with no deductible or copays.6
Verified Patient Reviews
Read verified patient reviews from other Cigna Healthcare customers based on their experience with network dentists, specialists, and dental offices.
Activate your myCigna account to get access to all of the above, or search for dentists using our public directory.
Get paid back for dental services that treat gum disease
Our Dental Oral Health Integration Program® is a no additional cost program that pays back your out-of-pocket costs (up to your plan’s maximum) for specific dental services that treat gum disease and tooth decay.6 Simply register for the program first before getting care from your dentist.
You qualify for the program if you're currently being treated for:
- Chronic Kidney Disease
- Diabetes
- Head and Neck Cancer Radiation
- Heart Disease
- Maternity
- Organ Transplant
- Stroke
- Rheumatoid Arthritis
- Sjogren's Syndrome
- Lupus
- Parkinson's Disease
- Amyotrophic Lateral Sclerosis (ALS)
- Huntington's Disease
- Opioid Misuse and Addiction
Get paid for dental services that treat gum disease
Our Dental Oral Health Integration Program® is a no additional cost program that pays back your out-of-pocket costs (up to your plan’s maximum) for specific dental services that treat gum disease and tooth decay.7 Simply register for the program first before getting care from your dentist.
You qualify for the program if you're currently being treated for:
- Chronic Kidney Disease
- Diabetes
- Head and Neck Cancer Radiation
- Heart Disease
- Maternity
- Organ Transplant
- Stroke
- Rheumatoid Arthritis
- Sjogren's Syndrome
- Lupus
- Parkinson's Disease
- Amyotrophic Lateral Sclerosis (ALS)
- Huntington's Disease
- Opioid Misuse and Addiction
Activate your myCigna account to view covered dental services and see if you're eligible for this program.
Continuity of Care
Is your doctor leaving your plan's network?
If so, and you're actively receiving treatment, you can apply for Continuity of Care. If approved, this may allow you to continue with your treatment or procedure with your health care provider at an in-network coverage level.
Starting a new plan? Avoid gaps in care.
You may be able to continue to receive services for certain medical and behavioral conditions at an in-network coverage level, even if your current health care provider isn’t in your new plan’s network. Apply for Transition of Care to determine if you are eligible.
To apply for either Continuity of Care or Transition of Care, go to Forms Center. These forms are under the Medical section.
Manage Prescriptions
Your plan may offer convenient, cost-saving programs and services including home delivery pharmacy, specialty medications through Accredo®, a Cigna Healthcare specialty pharmacy, access to thousands of in-network retail pharmacies, and more.
Make the Most of Your Cigna Healthcare Pharmacy Benefits
Watch this short video to learn how you can get easy access to affordable medications when you need them. (Length: 00:03:15)
Home Delivery with Express Scripts Pharmacy
Your Cigna Healthcare plan could include access to home delivery with Express Scripts Pharmacy®. It’s convenient, secure, and free for medications you’re taking on a regular basis.7
Features of this service, include:
90-day supply8
Fill up to a 90-day supply delivered with standard shipping at no extra cost9
24/7 access
Get 24/7 access to pharmacists to answer your questions
Auto refills
Sign up for automatic refills or refill reminders
Home Delivery with Express Scripts Pharmacy
Your Cigna Healthcare plan could include access to home delivery with Express Scripts Pharmacy®. It’s convenient, secure, and free for medications you’re taking on a regular basis.8
Features of this service, include:
90-day supply
Fill up to a 90-day supply delivered with standard shipping at no extra cost9
24/7 access
Get 24/7 access to pharmacists to answer your questions
Auto refills
Sign up for automatic refills or refill reminders
Activate your myCigna account to manage your prescriptions (if applicable) or learn more about home delivery.
Take any specialty medications?
As part of your Cigna Healthcare-administered pharmacy benefits, you may have access to Accredo, a Cigna Healthcare specialty pharmacy.10
If you have a complex medical condition such as multiple sclerosis, hepatitis C, or rheumatoid arthritis, Accredo can fill and deliver your specialty medication to your home (or location of your choice).11
Prescription cost and coverage tools
Price your medications
Use the Price a Medication tool on myCigna12 to look up medications covered by your plan, find low cost alternatives, network pharmacies, and more.
Activate your myCigna account to look up drugs and costs.
Price your medications
Use the Price a Medication tool on myCigna12 to look up medications covered by your plan, find low cost alternatives, network pharmacies, and more.
Visit Price a Medication to look up drugs and costs.
Claims and Accounts
Manage your claims
You just got back from a doctor’s visit, now what? In most cases, your in-network doctor will submit a claim for you. Once Cigna Healthcare reviews your claim, you’ll receive an explanation of benefits (EOB) document that shows you the cost for each service, what your plan covered, and any other costs that you may have to pay. Manage your claims with the following:
View Claims and EOBs
View and manage your claims and EOBs all in one place.
Submit a Claim Online
View, manage, or submit a claim for a recent visit.
Pay Claims
Make secure online payments with our partner, InstaMed®, or mark claims as paid to help you better track payments.
Activate your myCigna account to view, manage, or submit a claim or learn more about claims and EOBs.
What Is an EOB?
Learn what an EOB is, how it works, and how we help you understand your health care costs. (Length: 00:01:58)
What Is Included in an EOB?
Find out what costs and payments are listed in your EOB as well as how to check if your health plan covered your services. (Length: 00:02:01)
Working Through an EOB
Learn how to read your EOB and find out what you owe after your health plan and savings accounts paid their part. (Length: 00:01:21)
Pay medical expenses with a spending account
If your plan includes a health care spending account, you can use it to help pay eligible health care expenses.
A Health Savings Account (HSA) is a savings account (compatible with a high-deductible health plan) used to help pay for eligible health care expenses.
A Health Reimbursement Account (HRA) is only available through your employer. They contribute to it throughout the year to help pay for eligible health care expenses.
A Flexible Spending Account (FSA) is an account used to pay for eligible health care expenses for you, a spouse, or dependents on the plan.
Health and Wellness Programs and Services
If you’re being offered a Cigna Healthcare plan through your employer, you may have access to additional programs and services to help make your life easier and healthier.
Health and Wellness Programs and Services
If you’re being offered a Cigna Healthcare plan through your employer, you may have access to additional programs and services to help make your life easier and healthier.
Incentive Awards Program13
Get rewarded for taking actions to improve your health. Earn awards, including cash, when you take your health assessment, get an annual check-up, talk to a health coach, start an exercise program, and more.
Healthy Pregnancies, Healthy Babies Program
For eligible customers, this program provides support during and after pregnancy. This includes access to a Cigna Healthcare Maternity Coach, as well as useful tools and tips to help make it a healthier nine months and a healthier baby.
Lifestyle Management Programs
Connect with a health coach, online or by phone, to get personalized support if weight, tobacco use, or stress is affecting your health or your ability to live an active life.
Plan Documents and Forms
- View Plan Documents for Medical and Dental plans, past and present.
- View Customer Forms for important claims, privacy, or authorization forms.
* Not available if you have purchased your own insurance.
1 Customers under age 13 (and/or their parent/guardian) will not be able to register at myCigna.com.
2 App/online store terms and mobile phone carrier/data charges apply.
3 Cigna Healthcare provides access to virtual care through participating in-network providers. Not all providers have virtual capabilities. Cigna Healthcare also provides access to virtual care through national telehealth providers as part of your plan. This service is separate from your health plan’s network and may not be available in all areas or under all plans. Referrals are not required. Video may not be available in all areas or with all providers. All health care providers are solely responsible for the treatment provided to their patients; providers are not agents of Cigna Healthcare. Refer to plan documents for complete description of virtual care services and costs.
4 Employee assistance program services are in addition to, not instead of, your health plan benefits. These services are separate from your health plan benefits and do not provide reimbursement for financial losses. Program availability may vary by plan type and location, and are not available where prohibited by law.
5 Brighter features may vary by dentist. These and other dentist directory features are for educational purposes only and should not be the sole basis for decision-making. They are not a guarantee of the quality of care that will be provided to individual patients and you should consider all relevant factors when selecting a dentist.
6 Not all preventive services are covered, including athletic mouth guards. Refer to the policy for a complete list of covered and non-covered preventive services. Frequency limitations apply. Cigna Healthcare Dental plans in MD cover one dental cleaning per calendar year.
7 This program provides reimbursement for certain eligible dental procedures for customers with qualifying medical conditions. Customers must enroll in the program prior to receiving dental services to be eligible for reimbursement. Reimbursement is applied to and subject to any applicable annual benefits maximum. See your plan documents or contact Cigna Healthcare for complete program details.
8 Not all plans offer home delivery as a covered pharmacy option. Please log in to the myCigna app or website, or check your plan materials, to learn more about the pharmacies in your plan’s network.
9 Standard shipping costs are included as part of your prescription plan.
10 Not all plans offer Accredo as a covered pharmacy option. Please log in to the myCigna app or website, or check your plan materials, to learn more about the pharmacies in your plan's network.
11 As allowable by law.
12 Prices shown on myCigna are not a guarantee. Coverage falls under your plan terms and conditions. Visit myCigna for more information.
13 Healthy Rewards programs are NOT insurance. Rather, these programs give a discount on the cost of certain goods and services. The customer must pay the entire discounted cost. Some Healthy Rewards programs are not available in all states and programs may be discontinued at any time. Participating providers are solely responsible for their goods and services.
* Not available if you have purchased your own insurance.
1 App/online store terms and mobile phone carrier/data charges apply.
2 Cigna Healthcare provides access to virtual care through participating in-network providers. Not all providers have virtual capabilities. Cigna Healthcare also provides access to virtual care through national telehealth providers as part of your plan. This service is separate from your health plan’s network and may not be available in all areas or under all plans. Referrals are not required. Video may not be available in all areas or with all providers. All health care providers are solely responsible for the treatment provided to their patients; providers are not agents of Cigna Healthcare. Refer to plan documents for complete description of virtual care services and costs.
3 Employee assistance program services are in addition to, not instead of, your health plan benefits. These services are separate from your health plan benefits and do not provide reimbursement for financial losses. Program availability may vary by plan type and location, and are not available where prohibited by law.
4 Brighter features may vary by dentist. These and other dentist directory features are for educational purposes only and should not be the sole basis for decision-making. They are not a guarantee of the quality of care that will be provided to individual patients and you should consider all relevant factors when selecting a dentist.
5 Not all preventive services are covered, including athletic mouth guards. Refer to the policy for a complete list of covered and non-covered preventive services. Frequency limitations apply. Cigna Healthcare Dental plans in MD cover one dental cleaning per calendar year.
6 This program provides reimbursement for certain eligible dental procedures for customers with qualifying medical conditions. Customers must enroll in the program prior to receiving dental services to be eligible for reimbursement. Reimbursement is applied to and subject to any applicable annual benefits maximum. See your plan documents or contact Cigna Healthcare for complete program details.
7 Not all plans offer home delivery as a covered pharmacy option. Please log in to the myCigna® App or website, or check your plan materials, to learn more about the pharmacies in your plan’s network.
8 Some medications aren’t available in a 90-day supply and may only be packaged in lesser amounts. For example, 3 packages of oral contraceptives equal an 84-day supply. Even though it’s not a “90-day supply,” it’s still considered a 90-day prescription.
9 Standard shipping costs are included as part of your prescription plan.
10 Not all plans offer Accredo as a covered pharmacy option. Please log in to the myCigna app or website, or check your plan materials, to learn more about the pharmacies in your plan's network.
11 As allowable by law.
12 Prices shown on myCigna are not a guarantee. Coverage falls under your plan terms and conditions. Visit myCigna for more information.
13 Healthy Rewards programs are NOT insurance. Rather, these programs give a discount on the cost of certain goods and services. The customer must pay the entire discounted cost. Some Healthy Rewards programs are not available in all states and programs may be discontinued at any time. Participating providers are solely responsible for their goods and services.