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Cigna Health Coverage

Cigna is an American worldwide health services company based in Bloomfield, Connecticut. Cigna offers Medicare and Medicaid products and health, life, and accident insurance coverages primarily to individuals in the United States. Cigna was founded in 1982 as the result of the merger of the Connecticut General Life Insurance Company (CG) and INA Corporation.

On March 7, 2018, it was announced that Cigna would buy Express Scripts in a $67 billion deal. The deal is the latest in a series of healthcare mergers that is sweeping through the health care industry. Like the proposed Aetna and CVS, many lawmakers are very reluctant supporting this merger involving Cigna because their argument is that it will give Medicare recipients less options to choose from.

It has been stated with these mergers it will create less competition. It is argued by Cigna and Express Scripts that the acquisition would benefit consumers by allowing the two companies to bring together patients’ medical and pharmacy histories to improve treatments and lower costs.

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Like Aetna, Mutual of Omaha, and United Healthcare, Cigna offers standardized supplement plans to Medicare recipients.

When the recipient joins the Medicare system they will have a variety of supplement (also known as medigap) plans to choose from ranging from Plan A through Plan N.

The reason a recipient should supplement their Medicare with a medigap plan is because Parts A & B only cover about 80% of hospital and medical costs. The idea is to choose a comprehensive supplement plan to pay for the remaining 20% that Medicare does not pay.

Supplement insurance policies are identified by letters A through N. All supplement plans are standardized by Medicare. A standardized plan must contain the same basic benefits, no matter which insurance company sells it, so the difference comes down to cost and customer service.


States

Cigna sells medigap plans in Pennsylvania, New Jersey, Delaware, North Carolina, and South Carolina.

Standardized medigap plans that are listed by Medicare are Plans A, B, C, D, F, high deductible Plan F, G, K, L, M and Plan N.

Cigna supplements sold in Pennsylvania, North Carolina and South Carolina are Plans A, B, C, D, F, high deductible F, G, and Plan N and sold under the name of “Cigna Health and Life Insurance Company”.

Cigna supplements sold in New Jersey are Plans A, B, C, D, F, high deductible F, G, and Plan N and sold under the name of “Loyal American Life Insurance Company”.

Cigna supplements sold in Delaware are Plans A, B, C, D, F, high deductible F, G, and Plan N and sold under the name of “American Retirement Life Insurance Company”.


Cigna does participate in crossover claims billing with Medicare. When a recipient has a doctor visit, the doctor naturally bills Medicare. Medicare covers the 80%, pays the doctor, and electronically bills the secondary medigap carrier the remaining 20%. This ensures the recipient does not receive the remaining 20% claim to be paid. However, if a recipient has Plan N coverage they may be billed for a small doctor visit co-pay.

As of January 1st 2020, all medigap insurance carriers will discontinue to sell plan F due to the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) passed by Congress and signed into law on April 16, 2015. If a recipient purchases Plan F before January 1st 2020 they will not lose their plan once the law is in effect.

The Medicare recipient has many benefits by choosing Parts A & B as their primary insurance carrier. One, you have an open network throughout the United States, you would not be limited to certain counties in your home state. Two, some referrals are needed to see a specialist if you want to change your doctor you can do so, as long as the physician accepts Medicare. Three, you can choose any Part D drug plan that will save you the most money.

In each zip code you have a choice of about 30 to 50 selected plans to choose from.


Supplement Plan F

If you purchase Plan F as your gap-plan you will cover the:

Basic, including 100% Part B coinsurance.

Skilled nursing facility co-insurance. $167.50 per day. Meaning if you require skilled care Medicare will pay days 1 through 20 and Plan F will pay days 21 to 100 days.

Part A deductible, which is the hospital deducible $1340.00

61 to 90 days $335 co-insurance

91 to 150 days $670 co-insurance

Part B deductible, which is anything medically necessary, $183.00 every calendar year

Part B Excess charges 100%. In numerous states around the United states, doctors and surgeons are allowed to bill 15% above Medicare’s allowed amount for covered listed procedures. For example, there are about 30 states where this could happen, NJ, NY and FL are three examples allowed to bill for excess charges.

Foreign Travel Emergency. Plan F will pay for up to $50,000 of care if you are on foreign land. In short, it should be enough money to stabilize you and transport you back into the United States for your care.

If you purchase Plan F, you would pay the monthly premium the insurance carrier charges, and the other 20% gap that Medicare does not pay will be paid by your secondary carrier. No deductibles and co-pays.


Supplement Plan G

If you purchase Plan G, your gap-plan you will cover the:

Basic, including 100% Part B coinsurance.

Skilled nursing facility co-insurance. $167.50 per day. Meaning if you require skilled care Medicare will pay days 1 through 20 and Plan F will pay days 21 to 100 days.

Part A deductible, which is the hospital deducible $1340.00

61 to 90 days $335 co-insurance

91 to 150 days $670 co-insurance

Does not cover the Part B calendar year deductible of $183.00

Part B Excess charges 100%. In numerous states around the United states, doctors and surgeons are allowed to bill 15% above Medicare’s allowed amount for covered listed procedures. For example, there are about 30 states where this could happen, NJ, NY and FL are three examples allowed to bill for excess charges.

Foreign Travel Emergency. Plan F will pay for up to $50,000 of care if you are on foreign land. In short, it should be enough money to stabilize you and transport you back into the United States for your care.

If you purchase Plan G, you would pay the monthly premium the insurance carrier charges and the calendar year Part B deducible of $183.00. No co-pays.


Supplement Plan N

If you purchase a Plan N as your gap-plan you will cover the:
Basic, including 100% Part B coinsurance, except up to a $20 copayment for a doctor visit, and up to a $50 copayment for an Emergency Room visit.

Skilled nursing facility co-insurance. $167.50 per day. Meaning if you require skilled care Medicare will pay days 1 through 20 and Plan F will pay days 21 to 100 days.

Part A deductible, which is the hospital deducible $1340.00

61 to 90 days $335 co-insurance

91 to 150 days $670 co-insurance

Does not cover the Part B calendar year deductible of $183.00

Part B Excess charges 100%. In numerous states around the United states, doctors and surgeons are allowed to bill 15% above Medicare’s allowed amount for covered listed procedures. For example, there are about 30 states where this could happen, NJ, NY and FL are three examples allowed to bill for excess charges.

Foreign Travel Emergency. Plan F will pay for up to $50,000 of care if you are on foreign land. In short, it should be enough money to stabilize you and transport you back into the United States for your care.

If you purchase Plan N, you would pay the monthly premium the insurance carrier charges and the calendar year Part B deducible of $183.00. Once your calendar year deducible is met, you are charged up to a $20 co-pay for doctor visits and a $50 co-pay for emergency room visits. Plan N does not cover you for Part B Excess Charges.


Supplement Plan A

If you purchase Plan A, you will pay the Part A initial hospital deductible of $1340.00. Medicare and Plan A combined will pay remaining hospital deductibles.

Regarding skilled nursing facility care, Medicare will pay for the first 20 days and you will be responsible for any days after.

If you purchase Plan A, the plan will pay for the first 3 pints of blood after the recipient pays the $183.00 Part B deductible with Medicare picking up 100% of additional amounts.

Medicare and Plan A will pick up 100% of hospice care.

The Part B medical services, the $183.00 deductible will be paid by the Medicare recipient. Any remainder approved amounts will be covered by Medicare and Plan A.

The recipient will be responsible for all Part B Excess Charges.

The recipient will be responsible for all Foreign Travel Medical costs.


Supplement Plan B

If you purchase Plan B to supplement Medicare A & B, you have almost the identical coverage as Plan A with one extra benefit. Under Plan B all Part A hospital deductibles will be covered beyond the first 60 days, as Plan A does not cover the first initial 60 hospital days. All other costs such as the remaining skilled care days, Part B excess charges and foreign travel will be to the recipient.

Plan C is almost identical to Plan F except for one gap in the coverage. Under Plan C the recipient will be responsible for all

Part B Excess charges whereas Plan F covers all Part B Excess charges no matter what state they could occur in.

Plan C is a much older plan than Plan F, so the Plan C so the monthly premium rates are usually much higher in costs.

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