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time of service. 1.
When you obtain medical care or fill a prescription, a claim is submitted to Cigna. With the exception of Preventive Care , below is what you can expect to pay at the
PCP Visit
$30 Copay $40 Copay $50 Copay
Specialist Visit Urgent Care visit
Coinsurance , up to a cer tain amount, as indicated on page 22
Pharmacy
Coinsurance for which you are responsible. 2.
Cigna processes your claim based on the covered expenses and negotiated discounts from in-network providers (if applicable), and applies any Copay , Deductible or
3.
If there are funds available in your HRA, Cigna will use the funds to:
• Pay the provider or pharmacy for expenses applied to your Deductible or Coinsurance . • Reimburse you by check for a Copay paid at the time of service. If there are no funds available in your HRA, you must pay the provider the amount for which you are responsible that was not paid at the time of service.
which you are responsible. 4.
Cigna provides an Explanation of Benefits (EOB) to you and the provider outlining the details of your claim including the amount paid to the provider by your plan and from your HRA, and any amounts applied to your Copay , Deductible or Coinsurance for
myCigna.com or by calling Cigna at (800) 244-6224. 5.
Information regarding your HRA, health care claims and benefits are available on
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