provider at the in-network cost-sharing amount for up to 90 days from the date you are notified of your provider’s termination. A continuing care patient is an individual who is: • undergoing a course of treatment for a serious and complex condition from the provider or facility. • pregnant and undergoing treatment for the pregnancy from the provider or facility. • undergoing a course of institutional or inpatient care from the provider or facility. • scheduled to undergo non-elective surgery, including receipt of post-operative care with respect to such a surgery. • determined to be terminally ill and is receiving treatment for such illness from the provider or facility. If applicable, Cigna will notify you of your continuity of care Any external review process available under the plan will apply to any adverse determination regarding claims subject to the No Surprises Act. Provider Directories and Provider Networks A list of network providers is available to you, without charge, by visiting the website or calling the phone number on your ID card. The network consists of providers, including Hospitals, of varied specialties as well as generic practice, affiliated or contracted with Cigna or an organization contracting on its behalf. options. Appeals A list of network pharmacies is available to you, without charge, by visiting the website or calling the phone number on your ID card. The network consists of pharmacies affiliated or contracted with Cigna or an organization contracting on its behalf. Provider directory content is verified and updated, and processes are established for responding to provider network status inquiries, in accordance with applicable requirements of the No Surprises Act. If you rely on a provider’s in-network status in the provider directory or by contacting Cigna at the website or phone number on your ID card to receive covered services from that provider, and that network status is incorrect, then your plan cannot impose out-of-network cost shares to that covered service. In-network cost share must be applied as if the covered service were provided by an in-network provider. Direct Access to Obstetricians and Gynecologists You do not need prior authorization from the plan or from any other person (including a primary care provider) in order to obtain access to obstetrical or gynecological care from a health care professional in our network who specializes in obstetrics
or gynecology. The health care professional, however, may be required to comply with certain procedures, including obtaining prior authorization for certain services, following a pre-approved treatment plan, or procedures for making referrals. For a list of participating health care professionals who specialize in obstetrics or gynecology, access the website This plan generally allows the designation of a primary care provider. You have the right to designate any primary care provider who participates in the network and who is available to accept you or your family members. For children, you may designate a pediatrician as the primary care provider. For information on how to select a primary care provider, and for a list of the participating primary care providers, access the website or call the phone number on your ID card. Your Rights and Protections Against Surprise Medical Bills When you get emergency care or are treated by an out-of- network provider at an in-network Hospital or ambulatory surgical center, you are protected from balance billing. In these situations, you should not be charged more than your plan’s copayments, coinsurance, and/or deductible. What is “balance billing” (sometimes called “surprise billing”)? When you see a doctor or other health care provider, you may owe certain out-of-pocket costs, such as a copayment, or call the phone number on your ID card. Selection of a Primary Care Provider coinsurance, and/or deductible. You may have additional costs or have to pay the entire bill if you see a provider or visit a health care facility that is not in your health plan’s network. “Out-of-network” means providers and facilities that have not signed a contract with your health plan to provide services. Out-of-network providers may be allowed to bill you for the difference between what your plan pays and the full amount charged for a service. This is called “ balance billing ”. This amount is likely more than in-network costs for the same service and might not count toward your plan’s deductible or annual out-of-pocket limit. “Surprise billing” is an unexpected balance bill. This can happen when you cannot control who is involved in your care – such as when you have an emergency or when you schedule a visit at an in-network facility but are unexpectedly treated by an out-of-network provider. Surprise medical bills could cost thousands of dollars depending on the procedure or service. You are protected from balance billing for: • Emergency services – If you have an emergency medical condition and get emergency services from an out-of- network provider or facility, the most they can bill you is
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