Cigna ca

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Plans contain exclusions and limitations and may not be available in all areas. For costs and details of coverage, see your plan documents. All rights reserved. Product availability may vary by location and plan type and is subject to change.

All health insurance policies and health benefit plans contain exclusions and limitations. For costs and details of coverage, review your plan documents or contact a Cigna representative. Selecting these links will take you away from Cigna. Cigna may not control the content or links of non-Cigna websites. Special Enrollment See all topics Looking for Medicare coverage?

Shop for Medicare plans. Member Guide. Find a Doctor. What is an HMO Plan? Loading data You can change your PCP at any time. Cigna may need to pre-certify hospitalizations and other outpatient care, but there's no paperwork for you when using in-network providers. Cigna HMO and HMO Open Access out-of-network services Out-of-network services will only be covered if the treatment is considered emergency or urgent care as defined by your health plan documents.

Are you a new member? Refer to your official plan documents for the name of the company that insures or administers your specific insurance policy or benefit plan. Cigna Behavioral Health, Inc. All insurance policies and group benefit plans may have exclusions, limitations, reduction of benefits and terms under which the policy may be continued in force or discontinued.

Rates may vary and are subject to change. Health coverage is provided subject to any deductibles, co-payment, or coinsurance provisions. For additional plan disclosures that may be applicable to your plan or state, please view our Product Disclosures.

Lucie, Sumter, Union, and Volusia. In Michigan and Minnesota, patient care services for worksite health and wellness centers are provided by HS Clinical Services, PC, an independently owned professional corporation.

All rights reserved. All insurance policies and group benefit plans contain exclusions and limitations. For availability, costs and complete details of coverage, contact a licensed agent or Cigna sales representative.

This website is not intended for residents of New Mexico. Selecting these links will take you away from Cigna.

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Come create a healthier world. Driving Growth. Improving Lives. Finding your career Doing something meaningful starts with a simple decision, a commitment to changing lives. At Cigna, our mission is to improve the health, well-being, and peace of mind of those we serve. We're making real progress, but we still have work to do. That's where you come in. From disruptive innovation in health services, medical advancements, and sustainable solutions — we're transforming health care as we know it.

We're passionate and we care about what we do — being there when our customers, colleagues, partners, and communities need us most. If you like taking on bold challenges, driving growth, and improving lives, this is the place for you.

View our teams. Our teams Dedicated. Bring your drive and passion for purpose. You'll get the opportunity to make a lasting impact on the lives of millions. Discover our teams. Military You know how to take ownership and see a job through — both qualities that we need on our team. See how we support veterans. Bring your vitality and curiosity to learn.

You'll get the chance to develop and grow your potential. Unlock your potential. Watch the video Close the popup. We need people with a passion for our purpose and a commitment to making a difference.

Here we believe relationships matter and we build ours on respect, empathy, and trust - united in the belief that together we can all play a part in making the world a healthier place. Meet the members of the Cigna family. When an appeal is expedited, Cigna will respond orally and in writing with a decision within 72 hours.

If you have request for language assistance please call member services using the number on your ID card. The California Department of Managed Health Care is responsible for regulating health care service plans. If you have a grievance against your health plan, you should first telephone your health plan at or the toll-free telephone number on your Cigna ID card [The hearing impaired may call the California Relay Service at ] and use your health plan's grievance process before contacting the Department.

Utilizing this grievance procedure does not prohibit any potential legal rights or remedies that may be available to you. If you need help with a grievance involving an emergency, or one that has not been satisfactorily resolved by your health plan, or one that has not been resolved after 30 days, call the Department for assistance.

If you are eligible for IMR, the IMR process will provide an impartial review of: medical decisions made by a health plan related to the medical necessity of a proposed service or treatment; coverage decisions for treatments that are experimental or investigational in nature; and payment disputes for emergency or urgent medical services.

The department also has a toll-free telephone number and a TDD line for the hearing and speech impaired. You have the right to contact the California Department of Insurance for assistance at any time. The Commissioner may be contacted at the following address and fax number:. If you have received an appeal decision from Cigna that you are not satisfied with, you may also request voluntary mediation with us before exercising the right to submit a grievance to the DMHC if you are enrolled in a Cigna HealthCare of California plan or to the California Department of Insurance if you are enrolled in a Cigna Health and Life Insurance Company plan.

In order for mediation to take place, you and Cigna each have to voluntarily agree to the mediation. Cigna will consider each request for mediation on a case-by-case basis.

Each side will equally share the expenses of the mediation. To initiate mediation, please submit a written request for mediation to:. To the extent permitted by law, Cigna contractually requires the use of binding arbitration when disputes are left unsettled by other means. If your plan is governed by ERISA, you have the right to bring civil action under Section a if you are not satisfied with the outcome of the appeal procedure.

In most instances, you may not initiate a legal action until you have completed the Cigna internal appeal process. You can notify us of complaints or appeals concerning behavioral health services in one of the following ways:. For more specific information about these grievance procedures, please refer to your Group Service Agreement or contact our Customer Services Department.

If the Behavioral Health customer is a minor or is incompetent or unable to exercise rational judgment or give consent, the parent, guardian, conservator, relative or other legal representative acting on behalf of the member, as appropriate, may submit a grievance to Evernorth Behavioral Health or the California Department of Managed Health Care DMHC or "the Department" as the agent of the member. In addition, a participating provider or any other person you identify may assist you or act as your agent in submitting a grievance to Behavioral Health or the DMHC.

If you have a grievance against your health plan, you should first telephone your health plan at or TTY for the hearing and speech impaired or the toll-free telephone number on your Cigna HealthCare identification card and use your health plan's grievance process before contacting the Department.

If you need help with a grievance involving an emergency, a grievance that has not been satisfactorily resolved by your health plan, or a grievance that has remained unresolved for more than 30 days, you may call the Department for assistance. If you are eligible for IMR, the IMR process will provide an impartial review of medical decisions made by a health plan related to the medical necessity of a proposed service or treatment, coverage decisions for treatments that are experimental or investigational in nature and payment disputes for emergency or urgent medical services.

The Department also has a toll-free telephone number: 1. Please refer to your plan documents for information that is applicable to your specific plan.

If you are considering becoming a plan member or customer and have questions about your plan coverage, please contact your employer. All plans may have exclusions, limitations, reduction of benefits and terms under which the policy may be continued in force or discontinued.

Rates may vary by plan and are subject to change. For a complete list of both covered and not covered services under your plan or policy, including benefits required by your state, see your evidence of coverage, plan booklet, insurance certificate or your employer's summary plan description. For additional plan or product disclosures that may be applicable to you, please visit our Product Disclosures page.

All rights reserved. Product availability may vary by location and plan type and is subject to change. All health insurance policies and health benefit plans contain exclusions and limitations.

For costs and details of coverage, review your plan documents or contact a Cigna representative. Selecting these links will take you away from Cigna. Cigna may not control the content or links of non-Cigna websites. Special Enrollment See all topics Looking for Medicare coverage? Shop for Medicare plans. Member Guide. Find a Doctor. Cigna in California. Overview General Information In California, Cigna offers a number of products, services, tools and capabilities to a wide variety of clients and to individuals.

Accessing Medical Services Cigna offers a broad network of health care professionals and facilities throughout California. Accessing Vision, Pharmacy and Mental Health and Substance Use Services Some plans include vision, pharmacy and mental health and substance abuse services.

For information about optometry services, please call the number on your ID card. Drug List: For information about which drugs are considered "Formulary" or "Preferred" and generally cost you less out-of-pocket, click on the following link: Prescription Drug List Language Assistance English: Cigna provides language assistance services free of charge to customers who live in California and customers who live outside of California and who are covered under a policy issues in California.

Please see our Continuity of Care Brochure: English [PDF] Spanish [PDF] Chinese [PDF] If you are currently enrolled and your health care professional or facility leaves the Cigna network, or a new enrollee transitioning to a Cigna plan, and are covered under a policy insured by Cigna Health and Life Insurance Company you may be able to continue to receive services from a health care professional or facility that is not in the Cigna network.

Through Covered California, you may also get help paying for your health insurance: Receive tax credits: You can use your tax credit to help pay your monthly premium. Reduce your out of pocket costs: Out-of-pocket costs are how much you pay for things like going to the doctor or hospital or getting prescription drugs.

To qualify for help paying for insurance, you must: Meet certain household income limits Be a U. Other rules and requirements apply. Medical Review of Requested Services or Supplies Covered Expense Covered Expenses are expenses for services or supplies which are not excluded from your benefit plan, are recommended by a Physician, and are Medically Necessary for the care and treatment of an Injury or a Sickness.

Prior Authorization Prior Authorization means the approval that must be received prior to services being rendered, in order for certain services and benefits to be covered expenses under your policy.

Where applicable, the Medical Director may compare the cost-effectiveness of alternative services, settings or supplies when determining least intensive setting. Behavioral Health Review of Request Services or Supplies Receiving Assistance If we administer administers your behavioral health benefits, our staff can answer your benefit questions and assist you in getting behavioral health care and can assist you or your provider with the claim submission process or help answer questions about how claims have been processed.

Open Access to Outpatient Benefits For routine outpatient office visits for behavioral care with an in-network psychiatrist or therapist, you do not need to contact us before your treatment appointment. Prior Benefit Authorization Required for Other Care For any other type of behavioral care, you must contact us to pre-authorize benefit coverage to receive the maximum amount payment for your claims.

The hearing impaired may call the California Relay Service dialing Simply mail the form to the address above or fax it to. Complaints If you are concerned about the quality of service or care you have received a benefit exclusion or an eligibility issue you should contact us to file a verbal or written complaint.

Appeals If you are not satisfied with the outcome of a decision that was made about your care and are requesting that Cigna reverse a previous decision, you should contact us to file a verbal or written appeal within one year of receiving the denial notice. To initiate mediation, please submit a written request for mediation to: Cigna HealthCare of California, Inc. PO Box Chattanooga, TN Mandatory Binding Arbitration To the extent permitted by law, Cigna contractually requires the use of binding arbitration when disputes are left unsettled by other means.

Cigna Dental Health of California, Inc. Evernorth Behavioral Health of California, Inc. The hearing impaired may call the California Relay Service at or. The disclosures in your plan documents take precedence. Certain mandates may only apply to certain plan types. State mandates may not apply to employer-funded or self-funded plans. Please contact your employer if you need to know whether your plan is self-funded and whether any state mandates apply to your plan.

Exclusions and Limitations All plans may have exclusions, limitations, reduction of benefits and terms under which the policy may be continued in force or discontinued.