Page 6 - Enrollment Guide 2023-24
P. 6


      Medical  SchoolCare has partnered with Cigna for many
           years to deliver comprehensive health care service
           and claims administration. We use Cigna’s National
           Open Access Plus network of providers. This gives
           you access to care in every state of the country.
           Primary care physician (PCP) referrals are not re-
           quired to seek care from a specialist.

        What Does National Network Mean?

        The expanded provider network consists of any Cigna
        contracted provider or facility in the country.
        Participants have in-network coverage not only
        regionally, but nationally as long as services are                         Key Terms
        provided by a Cigna contracted provider (you always
        have access to emergency care anywhere, worldwide).

        What Does Open Access Mean?                                  You must meet the entire deductible before the

                                                                     plan starts to pay medical and prescription drug
        Open Access means there is no requirement to                 benefits (excluding in-network preventive care
        designate a PCP for any plans. Therefore, no PCP             and certain preventive medications). NOTE: If you
        referrals are required. Participants can make                enroll one or more family members, you must
        appointments and receive services for in-network             meet the full family deductible before the plan
        covered benefits with any Cigna participating provider       starts to pay expenses for any one individual.
        without obtaining a referral from your PCP.

        Traditional Plan Suite                                       Coinsurance

                                                                     Once you’ve met the plan’s annual deductible,
        The Traditional Plan Suite includes long-established         you are responsible for a portion of your medical
        copay plans as well as a plan with a modest deductible       expenses, which is called coinsurance.
        for medical services.

        Consumer Driven Plan Suite                                   Out-of-pocket maximum
                                                                     Once your deductible and coinsurance add up to
        The Consumer Driven Plan Suite offers comprehensive          the plan’s annual out-of-pocket maximum, the
        health plans with deductibles that can be offered with       plan will pay 100% of all eligible covered services
        an HRA or HSA, depending on the plan. This gives you         for the rest of the plan year. NOTE: If you enroll
        more control of personal health care expenses.               one or more family members, you must meet the
                                                                     full family out-of-pocket maximum before the plan
                                                                     starts to pay covered services at 100% for any one
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