Your Medical Options
The District offers the Choice PPO (now the Choice OAP) medical plan and the Basic HMO (now the Basic OAPIN) medical Plan. Our group number for both plans is 3340855. You can also waive coverage.
How the Medical Plans Work
The Choice PPO (now Choice OAP) medical option is known as an Open Access Plan (OAP). Cigna's OAP is a nationwide network of doctors, hospitals and other providers who have contracted with Cigna to provide medical care at reduced costs. To find a provider, log on to www.cigna.com or call member services at 1-800-244-6224. For helpful directions on finding a provider, click here. This plan does not require a Primary Care Physician, referrals to see a specialist, and pre-existing conditions do not apply.
Each time you need medical care, you decide if you want to use a health provider who participates in the network (called a network provider) or one who doesn't (called an out-of-network provider). If you use a network provider, you'll receive a higher level of benefits than if you use an out-of-network provider. To find a network provider, log on to www.cigna.com or call member services at 1-800-244-6224.
The Basic HMO (now Basic OAPIN) medical option is known as an Open Access Plan In-Network Only (OAPIN) plan consists of the same nationwide network of doctors, hospitals and other providers who have contracted with Cigna to provide medical care at reduced costs. This plan is an "open access" plan, so no referral is required to see an OAPIN Specialist. To find a network provider, log on to www.cigna.com or call member services at 1-800-244-6224. NOTE: There are no out-of-network benefits, except Emergency and Urgent Care.
***Please review Prescription Drug Changes effective 01/01/2019 and 07/01/2019 under the 'Good to Know' section.***
Certain drugs require that your physician complete a preauthorization form and submit it to the insurance carrier prior to your prescription being filled. Your doctor's office can obtain the necessary paperwork from the Cigna provider portal or they can contact Cigna at 1-800-244-6224 to obtain a copy of the form.
Certain procedures require that your physician complete a pre-authorization form and submit it to the insurance carrier prior to the procedure being performed. Ultimately it is your responsibility to ensure this has happened before moving forward with the procedure.
Get More From Your Health Care
Your healthcare coverage is your most important benefit. Here are a few suggestions on how to make the most of your coverage.
- Utilize in-network providers.
- Practice preventive medicine.
- Use the emergency room for emergency situations only. Urgent care facilities are available for non-emergency situations and cost you less money.
- Utilize generic prescription drugs or the mail order program whenever possible. For a mail order prescription form click here.
- Register on www.mycigna.com to access additional services such as:
- Order ID cards
- Check claim status
- Find a physician, hospital, facility
- AND MANY MORE!
Know Before You Go
Members should verify that the facility / provider they are using is in-network with Cigna. That information can be obtained by (1) downloading the mycigna app, (2) visiting mycigna.com or (3) calling 1.800.244.6224 to talk to a Cigna customer service representative. It is also recommended that members inquire at the facility / provider if the claim is going to be submitted to the insurance carrier as an Urgent Care or ER coded claim as the cost to the member would be substantially higher if the visit was coded as an ER claim.
The below "Know Before You Go" document can be found under the File Library for logged-in staff.