Copays
Limitations
Network & Access
RX & Extras
What's covered or Not
100

What's the copay for a PCP Visit?

What is "$40 copay in network"

100

How many visits per plan year do you get for Chiropractic services?

What is "30 visits"

100

What kind of network does the Copay 3500 and Copay 4500 use?

What is "Cigna PPO"

100

What is the Preventative Generic Prescriptions copay?

What is "$0 copay"

100

What is the copay for routine annual physical exams, wellness screenings and immunizations?

What is "$0 copay, covered under preventative services"

200

What are the combined visits allowed for PCP, Specialists and Urgent care visits?

What is "There is no limitations on visits for PCP, Specialist and Urgent care"

200

What are the limitations for Home Health care?

What is "200 visits per plan year"

200

What happens if the customer sees a provider outside the network without prior authorization?

What is "They may face higher costs"

200

What is the Non-Preventative Generic Prescriptions copay?

What is "$20 copay"

200

What is the copay/coinsurance for dental services?

What is "Dental services are not covered"

300

What is the Coinsurance after the deductible is met?

What is "30% for 4500 plan; 20% for 3500 plan"

300

What are the limitations for Hospice Care?

What is "210 visits per plan year"

300

*BONUS 1000 PTS* What is the maximum days for Inpatient Treatment for Chemical Abuse & Dependency?

What is "30 days Maximum"

300

What is the Preferred Brand and Non-Preferred Brand copay?

What is "$65 copay for Preferred; $95 for Non-Preferred"

300

What is the copay for Acupuncture services?

What is "Acupuncture is not covered"

400

How much are Anesthesia services?

What is "full price until deductible is met, and then customer pays coinsurance"

400

What are the limitations for Inpatient Care Substance Abuse?

What is "7 days maximum"
400

What is the Specialty Prescriptions copay?

What is "$200 copay"

400

Is cosmetic surgery covered?

What is "Only if its medically necessary and pre-approved"

500

How much are Radiology services?

What is "$500 First Dollar coverage, whatever is left is paid 100% by customer until deductible is met and then they pay coinsurance"

500

What are the limitations for Rehabilitation, Physical, Speech, and Physical Therapies?

What is "Combined 30 visits per plan year. Prior Authorization is required after 6 visits" 

500

What is the supply limit for all prescriptions?

What is "up to 30-day supply"

500

How much is the copay for IVF and other infertility treatments?

What is "IVF and fertility treatments and not covered and must be paid fully by the customer"