1. This is a list of the medications and other products covered at 100% under the plan’s pharmacy benefit at this time, based on existing legal requirements, and is subject to plan terms like limitations and exclusions. For example, this list of medications may change if legal requirements for preventive coverage changes. 2. The downloading and use of the myCigna App is subject to the terms and conditions of the App and the online stores from which it is downloaded. Standard mobile phone carrier and data usage charges apply. Actual App features available may vary depending on your plan and individual security profile. 3. Customers under age 13 (and/or their parent/guardian) will not be able to register at myCigna.com . 4. For plans renewing on or after January 1, 2023: Male condoms that are stocked behind the pharmacy counter and given to you by the pharmacist will be available at no cost-share to you. Quantity limits apply. 5. PPACA coverage requirements don’t apply to all plans. Log in to the myCigna App or myCigna.com , or check your plan materials, to find out how your plan covers these medications and how much they’ll cost you. 6. If your doctor feels these medications aren’t right for you, ask him or her to call Cigna. There may be other brands available at no cost-share to you. 7. Generic hormonal contraceptives are available at no cost-share to you, even though they may not be listed here. 8. This medication will only be covered at no cost-share ($0) if used alone instead of in combination with other HIV medications. 9. Quantity limits apply. Also, generic nicotine replacement therapy (known as“store-brands”) are available at no cost-share to you, even though they may not be listed here. 10. Not all plans cover vaccines in the same way. Log in to the myCigna App or myCigna.com , or check your plan materials, to find out how your specific plan covers them. You can also see a current list of covered vaccines and pharmacies in your plan’s network. Most immunizations for travel aren’t covered. Call your pharmacy to make sure your plan covers the vaccine and it’s available at their location. You shouldn’t need to make an appointment to get a vaccination. If you use an out-of-network pharmacy, vaccines may not be covered or may be subject to your plan’s copay, coinsurance, and/or deductible. Para obtener ayuda en español llame al número en su tarjeta de Cigna. Cigna reserves the right to make changes to this drug list without notice. Your plan may cover additional medications; please refer to your enrollment materials for details. Cigna does not take responsibility for any medication decisions made by the doctor or pharmacist. Cigna may receive payments from manufacturers of certain preferred brand medications, and in limited instances, certain non-preferred brand medications, that may or may not be shared with your plan depending on its arrangement with Cigna. Depending upon plan design, market conditions, the extent to which manufacturer payments are shared with your plan and other factors as of the date of service, the preferred brand medication may or may not represent the lowest-cost brand medication within its class for you and/or your plan. Health benefit plans vary, but in general to be eligible for coverage a drug must be approved by the Food and Drug Administration (FDA), prescribed by a health care professional, purchased from a licensed pharmacy and medically necessary. If your plan provides coverage for certain prescription drugs with no cost-share, you may be required to use an in-network pharmacy to fill the prescription. If you use a pharmacy that does not participate in your plan’s network, your prescription may not be covered, or reimbursement may be limited by your plan’s copayment, coinsurance or deductible requirements. Certain features described in this document may not be applicable to your specific health plan, and plan features may vary by location and plan type. Refer to your plan documents for costs and complete details of your plan’s prescription drug coverage. Product availability may vary by location and plan type and is subject to change. All group health insurance policies and health benefit plans contain exclusions and limitations. For costs and details of coverage, review your plan documents or contact a Cigna representative. All Cigna products and services are provided exclusively by or through operating subsidiaries of Cigna Corporation, including Cigna Health and Life Insurance Company, Connecticut General Life Insurance Company, and HMO or service company subsidiaries of Cigna Health Corporation. The Cigna name, logo, and other Cigna marks are owned by Cigna Intellectual Property, Inc. 968433 09/22 © 2022 Cigna. Some content provided under license.
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