NEW Medical cards are in the mail
CIGNA is mailing NEW medical cards to be used effective July 1, 2020. The new cards are necessary because CIGNA changed to Express Scripts as the Pharmacy Benefit Manager (PBM). This means all participants* need to provide a copy of the new card to their retail pharmacy for prescriptions to be charged correctly.
*There is no impact to those using mail order or specialty pharmacies as that change over happened earlier in the plan year.
Your Medical Options
The District offers the Cigna Choice OAP medical plan, the Basic OAPIN medical plan, and the Cigna PeakMed (NEW eff 07/01/2020) medical plan. Our group number for all three plans is 3340855. You can also waive coverage.
How the Cigna Medical Plans Work
The 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 OAPIN medical option is known as an Open Access Plan In-Network Only (OAPIN) plan and 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 (including injectable drugs) effective 01/01/2020 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.
How the Cigna PeakMed Plan Works – EFFECTIVE JULY 1, 2020
Cigna and PeakMed are working together to provide you a better healthcare experience. The Cigna PeakMed plan is available to all benefit eligible employees. Doctor visits are ZERO COST at PeakMed, and they don’t require additional copays or deductibles. PeakMed provides members unlimited access to PeakMed LifeCenters (primary care clinics), PeakMed TeleMed personal provider 24/7, and wholesale pricing on in-house generic medications and lab tests.
Cigna PeakMed requires use of only PeakMed as a direct primary care provider. If they are unable to provide the medical services needed, the participant is subject to the Cigna OAPIN network provisions connected to this plan. For specialty care and other medical services outside of PeakMed, employees will be referred to the appropriate network provider within Cigna. If you wish to contact Cigna directly to ask any questions about specialists or hospital services, call 1-800-244-6224. You can also register on mycigna.com to review your coverage and estimate costs. Employees will be responsible for out-of-pocket expenses related to vaccines, pharmacy, and lab tests with the option to pay cash or submit to insurance. PeakMed's on-site pharmacy stocks most generic medications but does not provide insulin, name brand, or controlled substances.
Establish Care with PeakMed
Employees can establish care with a PeakMed provider by calling (844) 673-2563 or via email at firstname.lastname@example.org
PeakMed LifeCenter Locations
Northgate LifeCenter 13271 Bass Pro Dr Suite 140, Colorado Springs, CO 80921 Phone: (719) 394-8664
Tejon LifeCenter 421 S. Tejon St. Suite 250, Colorado Springs, CO 80903 Phone: (719) 623-3068
Tutt LifeCenter 6945 Tutt Blvd, Colorado Springs, CO 80923 Phone: (719) 380-7325
Inverness LifeCenter 195 Inverness Dr. W, Suite 100, Englewood, CO 80112 Phone: (702) 575-7325
Littleton LifeCenter 2600 W Belleview Ave, Suite 200, Littleton, CO 80123 Phone: (702) 624-6761
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!
- Establish care with PeakMed
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.