Standard: Copay: Not Applicable | Coinsurance: 30.00% Coinsurance after deductible
Specialist
Standard: Copay: Not Applicable | Coinsurance: 30.00% Coinsurance after deductible
Prescription Drug Information
Preferred Brand Drugs
Standard: Copay: Not Applicable | Coinsurance: 30.00% Coinsurance after deductible
Non Preferred Brand Drugs
Standard: Copay: Not Applicable | Coinsurance: 30.00% Coinsurance after deductible
Generic Drugs
Standard: Copay: Not Applicable | Coinsurance: 30.00% Coinsurance after deductible
Specialty Drugs
Standard: Copay: Not Applicable | Coinsurance: 30.00% Coinsurance after deductible
Inpatient Coverage
Hospital Services
Standard: Copay: Not Applicable | Coinsurance: 30.00% Coinsurance after deductible
Inpatient Services
Standard: Copay: Not Applicable | Coinsurance: 30.00% Coinsurance after deductible
Emergency and Urgent Care
Emergency Room
Standard: Copay: Not Applicable | Coinsurance: 30.00% Coinsurance after deductible
All Cigna products and services are provided exclusively by or through operating subsidiaries of Cigna Corporation, including Cigna Health and Life Insurance Company, Cigna HealthCare of Arizona, Inc., Cigna HealthCare of Illinois, Inc., Cigna HealthCare of North Carolina, Inc. and Cigna Dental Health, Inc. The Cigna name, logo and other Cigna marks are owned by Cigna Intellectual Property, Inc.
1-817-813-4562, TTY 711
