Policy Documents

 

Choosing your health care plan is an important decision. To help you make an informed choice, a sample medical booklet document is available for your review.

 

Sample Booklets

 * Cigna Open Access Plus Plan

 * Cigna Comprehensive Plan

 * Cigna Exclusive Provider Plan

 * Cigna LocalPlus Plan

 * Cigna Preferred Provider Plan

 * Cigna HealthCare HMO-Open Access Plan

 * Cigna HealthCare Point of Service Plan

These are sample policy documents.

No benefits are guaranteed. No coverage representation is considered to be actual medical benefits provided to you by Cigna.

 

Mental Health Parity

 

The following Cigna health plan documents are available for your review. Each offers an explanation of Cigna's process for ensuring that financial requirements, quantitative treatment limitations, and non-quantitative treatment limitations comply with the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA).

Select your Cigna health plan from the options below and then choose from a list of documents explaining how Cigna complies with the Mental Health Parity and Addiction Equity Act of 2008.

Open Access Plus (OAP)

Open Access Plus Inpatient & Outpatient Pre-Authorization (PHS+/Preferred/Complete) & RX
Open Access Plus Inpatient Pre-Authorization (PHS) & RX
Open Access Plus Inpatient & Outpatient (PHS+/Preferred/Complete) Pre-Authorization, No RX
Open Access Plus Inpatient Pre-Authorization (PHS), No RX

Preferred Provider Organization (PPO)

Preferred Provider Organization Inpatient & Outpatient Pre-Authorization (PHS+/Preferred/Complete) & RX
Preferred Provider Organization Inpatient Pre-Authorization (PHS) & RX
Preferred Provider Organization Inpatient & Outpatient (PHS+/Preferred/Complete) Pre-Authorization, No RX
Preferred Provider Organization Inpatient Pre-Authorization (PHS), No RX

Network Point of Service (NPOS)

Network Point of Service Inpatient & Outpatient Pre-Authorization (PHS+/Preferred/Complete) & RX
Network Point of Service Inpatient Pre-Authorization (PHS) & RX
Network Point of Service Inpatient & Outpatient (PHS+/Preferred/Complete) Pre-Authorization, No RX
Network Point of Service Inpatient Pre-Authorization (PHS), No RX

Point of Service Open Access (NPOSOA)

Point of Service Open Access Inpatient & Outpatient Pre-Authorization (PHS+/Preferred/Complete) & RX
Point of Service Open Access Inpatient Pre-Authorization (PHS) & RX
Point of Service Open Access Inpatient & Outpatient (PHS+/Preferred/Complete) Pre-Authorization, No RX
Point of Service Open Access Inpatient Pre-Authorization (PHS), No RX

Point of Service (POS)

Point of Service Inpatient & Outpatient Pre-Authorization (PHS+/Preferred/Complete) & RX
Point of Service Inpatient Pre-Authorization (PHS) & RX
Point of Service Inpatient & Outpatient (PHS+/Preferred/Complete) Pre-Authorization, No RX
Point of Service Inpatient Pre-Authorization (PHS), No RX

HMO Point of Service (HMOPOS)

HMO Point of Service Inpatient & Outpatient Pre-Authorization (PHS+/Preferred/Complete) & RX
HMO Point of Service Inpatient Pre-Authorization (PHS) & RX
HMO Point of Service Inpatient & Outpatient (PHS+/Preferred/Complete) Pre-Authorization, No RX
HMO Point of Service Inpatient Pre-Authorization (PHS), No RX

HMO

HMO, Inpatient & Outpatient Pre-Authorization (PHS+/Preferred/Complete) & RX

Open Access Plus In-Network

Open Access Plus In-Network Inpatient & Outpatient Pre-Authorization (PHS+/Preferred/Complete) & RX
Open Access Plus In-Network Inpatient Pre-Authorization (PHS) & RX
Open Access Plus In-Network Inpatient & Outpatient Pre-Authorization (PHS+/Preferred/Complete), No RX
Open Access Plus In-Network Inpatient Pre-Authorization (PHS), No RX

Network Open Access

Network Open Access Inpatient & Outpatient Pre-Authorization (PHS+/Preferred/Complete) & RX
Network Open Access Inpatient Pre-Authorization (PHS) & RX
Network Open Access Inpatient & Outpatient Pre-Authorization (PHS+/Preferred/Complete), No RX
Network Open Access Inpatient Pre-Authorization (PHS), No RX

Network

Network Inpatient & Outpatient Pre-Authorization (PHS+/Preferred/Complete) & RX
Network Inpatient Pre-Authorization (PHS) & RX
Network Inpatient & Outpatient Pre-Authorization (PHS+/Preferred/Complete), No RX
Network Inpatient Pre-Authorization (PHS), No RX

Exclusive Provider Organization

Exclusive Provider Organization Inpatient & Outpatient Pre-Authorization (PHS+/Preferred/Complete) & RX
Exclusive Provider Organization Inpatient Pre-Authorization (PHS) & RX
Exclusive Provider Organization Inpatient & Outpatient Pre-Authorization (PHS+/Preferred/Complete), No RX
Exclusive Provider Organization Inpatient Pre-Authorization (PHS), No RX

Comprehensive / Indemnity

Comprehensive/Indemnity, Inpatient & Outpatient Pre-Authorization (PHS+/Preferred/Complete) & RX
Comprehensive/Indemnity, Inpatient Pre-Authorization (PHS) & RX
Comprehensive/Indemnity, Inpatient & Outpatient Pre-Authorization (PHS+/Preferred/Complete), No RX
Comprehensive/Indemnity, Inpatient Pre-Authorization (PHA), No RX

Topic Specific Information

Mental Health Parity General Summary
Non-Quantitative Treatment Limitations Summary
Networks/Provider Credentialing Only
RX Only
Inpatient Pre-Authorization Only (PHS)
Inpatient Pre-Authorization Only (PHS) - No Mental Health/Substance Use Disorder Coverage
Inpatient & Outpatient Pre-Authorization Only (PHS+/Preferred/Complete)
Inpatient & Outpatient Pre-Authorization Only (PHS+/Preferred/Complete) - No Mental Health/Substance Use Disorder Coverage

These are standard policy documents. No benefits are guaranteed. No coverage representation is considered to be actual medical benefits provided to you by Cigna.

 

If you want more details about your coverage, visit myCigna.com.