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Cigna - Cigna Connect 1200
Missouri, 2017
Plan Type
EPO
Metal Tier
Gold
Out of Pocket Maximum
$5,900
Deductible
$1,200
Emergency Room Care: 20% Coinsurance after deductible
Cost Sharing Benefits (In Network)
Policyholders are generally responsible for 100% of costs until the deductible amount is met. After the deductible has been met the policyholder is responsible for the coinsurance / copay until the out of pocket maximum is reached at which point the insurance company assumes 100% of all costs.
| Deductible (Individual) | $1,200 |
|---|---|
| Deductible (Family) | $2,400 |
| Coinsurance | Not applicable |
| Out of Pocket Maximum (Individual) | $5,900 |
| Out of Pocket Maximum (Family) | $11,800 |
Doctor Visits
| Primary Care Visit | Data Not Available |
|---|---|
| Specialist Visit | Data Not Available |
| Inpatient Facility | 20% Coinsurance after deductible |
| Inpatient Physician | 20% Coinsurance after deductible |
| Emergency Room Services | 20% Coinsurance after deductible |
Tests and Imaging
| Imaging (CT/PET Scans, MRIs) | 20% Coinsurance after deductible |
|---|---|
| Laboratory Outpatient and Professional Services | 20% Coinsurance after deductible |
| X-Ray and Diagnostic Imaging | 20% Coinsurance after deductible |
Health Management Programs
| Asthma | Available |
|---|---|
| Depression | Not available |
| Diabetes | Available |
| Heart Disease | Available |
| High Blood Pressure / High Cholesterol | Available |
| Lower Back Pain | Not available |
| Pain Management | Not available |
| Pregnancy | Available |
| Weight Loss | Not available |
Other
| Mental / Behavioral Health Inpatient | 20% Coinsurance after deductible |
|---|---|
| Mental / Behavioral Health Outpatient | 20% Coinsurance after deductible |
| Rehabilitative Speech Therapy | 20% Coinsurance after deductible |
| Rehabilitative Occupational & Physical Therapy | 20% Coinsurance after deductible |
| Outpatient Facility | 20% Coinsurance after deductible |
| Outpatient Surgery | 20% Coinsurance after deductible |
Prescription Drugs
| Generic Rx | Data Not Available |
|---|---|
| Preferred Brand Rx | Data Not Available |
| Non Preferred Brand Rx | 50% Coinsurance after deductible |
| Specialty Drugs |
Other Plans in Missouri
| Plan | Deductible | Coinsurance | Out of Pocket |
|---|---|---|---|
| Plan Cigna Connect 3000 | Deductible $3,000 | Coinsurance Not applicable | Out of Pocket $7,150 |
| Plan Cigna Connect 2700 | Deductible $2,700 | Coinsurance Not applicable | Out of Pocket $7,150 |
| Plan Cigna Connect 2700 | Deductible $2,700 | Coinsurance Not applicable | Out of Pocket $7,150 |
| Plan Cigna Connect 6400 | Deductible $6,400 | Coinsurance Not applicable | Out of Pocket $7,150 |
| Plan Cigna US-MO Connect 6650 | Deductible $6,650 | Coinsurance Not applicable | Out of Pocket $7,150 |
| Plan Cigna Connect 1200 | Deductible $1,200 | Coinsurance Not applicable | Out of Pocket $5,900 |
| Plan Cigna US-MO Connect 6650 | Deductible $6,650 | Coinsurance Not applicable | Out of Pocket $7,150 |
| Plan Cigna Connect 4000 | Deductible $4,000 | Coinsurance Not applicable | Out of Pocket $7,000 |
| Plan Cigna Connect 6400 | Deductible $6,400 | Coinsurance Not applicable | Out of Pocket $7,150 |
| Plan Cigna Connect 4000 | Deductible $4,000 | Coinsurance Not applicable | Out of Pocket $7,000 |
| Plan Cigna US-MO Connect 3500 | Deductible $3,500 | Coinsurance Not applicable | Out of Pocket $7,150 |
| Plan Cigna Connect HSA 5500 | Deductible $5,500 | Coinsurance Not applicable | Out of Pocket $6,550 |
| Plan Cigna US-MO Connect 3500 | Deductible $3,500 | Coinsurance Not applicable | Out of Pocket $7,150 |
| Plan Cigna Connect 3000 | Deductible $3,000 | Coinsurance Not applicable | Out of Pocket $7,150 |
| Plan Cigna Connect HSA 5500 | Deductible $5,500 | Coinsurance Not applicable | Out of Pocket $6,550 |