2023 Medical Insurance Comparison Chart
Benefit Comparison
Jump to Insurance Premiums
Plan Description | High Deductible - $4,000 | High Deductible - $1,750* | Traditional |
Medical Deductible: Employee Only | $4,000 | $1,750 | $1,000 |
Medical Deductible: Employee/Family | $8,000 | $3,500* | $2,000 |
Out of Pocket Max (Medical): Employee Only | $6,000 | $4,000 | $5,000 |
Out of Pocket Max (Medical): Employee/Family | $12,000 | $8,000* | $10,000 |
Prescription Max: Employee Only | N/A | N/A | $3,100 |
Prescription Max: Employee/Family | N/A | N/A | $6,200 |
Preventive** | 0% Co-Ins | 0% Co-Ins | 0% Co-Ins |
Primary Care | 20% Co-Ins | 20% Co-Ins | $25 Co-Pay |
Specialist | 20% Co-Ins | 20% Co-Ins | $50 Co-Pay |
Virtual Care | $55 average cost per visit | $55 average cost per visit | $25 Co-Pay |
Inpatient Facility | 20% Co-Ins | 20% Co-Ins | 30% Co-Ins |
Outpatient Facility | 20% Co-Ins | 20% Co-Ins | 30% Co-Ins |
Emergency Department | 20% Co-Ins | 20% Co-Ins | 30% Co-Ins |
Urgent Care | 20% Co-Ins | 20% Co-Ins | 30% Co-Ins |
Imaging - Out Patient Facility | 20% Co-Ins | 20% Co-Ins | 30% Co-Ins |
Laboratory - Out Patient Facility | 20% Co-Ins | 20% Co-Ins | 30% Co-Ins |
Phys, Occ & Speech Therapy-Out Patient Facility | 20% Co-Ins | 20% Co-Ins | 30% Co-Ins |
Phys, Occ & Speech Therapy-Out Patient Professional | 20% Co-Ins | 20% Co-Ins | 30% Co-Ins |
Skilled Nursing Facility | 20% Co-Ins | 20% Co-Ins | 30% Co-Ins |
In-Network Retail Pharmacy | |||
Rx Deductible: Employee Only | $0 | $0 | $150 |
Rx Deductible: Employee/Family | $0 | $0 | $300 |
Generics | $15 Co-Pay | $15 Co-Pay | $15 Co-Pay |
Preferred Brand | $40 Co-Pay | $40 Co-Pay | $40 Co-Pay |
Non-Preferred Brand | $70/20%/>$70 or 20% up to $300 per Rx | $70/20%/>$70 or 20% up to $300 per Rx | $70/20%/>$70 or 20% up to $300 per Rx |
Specialty High-Cost | $70/20%/>$70 or 20% up to $300 per Rx | $70/20%/>$70 or 20% up to $300 per Rx | $70/20%/>$70 or 20% up to $300 per Rx |
Out-of-Network Retail Pharmacy | |||
Rx Deductible: Employee Only | N/A | N/A | $150 |
Rx Deductible: Employee/Family | N/A | N/A | $300 |
All Brands | 70% Co-Ins | 30% Co-Ins | 50% Co-Ins |
Out-of Network Benefits | |||
Out of Network Co-Insurance | 40% after deductible | 40% after deductible | 50% after deductible |
Out of Network Individual Deductible | $5,000 | $3,000 | $2,000 |
Out of Network Family Deductible | $10,000 | $6,000 | $4,000 |
Out of Network Individual Max | $10,000 | $5,000 | $6,500 |
Out of Network Family Max | $20,000 | $10,000 | $13,000 |
* The way the deductible and the out of pocket maximum work is important if you cover anyone other than yourself.
- With the Traditional Plan and the HDHP - $4,000, after each eligible family member meets his or her individual deductible and individual out of pocket maximum, covered expenses for that family member will be paid based on the coinsurance level specified by the plan. Or, after the family deductible has been met, covered expenses for each eligible family member will be paid based on the coinsurance level specified by the plan.
- With the HDHP - $1750, all eligible family members contribute towards the family plan deductible and out of pocket maximum. The family deductible and the family out of pocket maximum must be met before the plan will pay each eligible family member's covered expenses based on the coinsurance level specified by the plan.
** No charge for wellness visits as long as the doctor's office codes the visit as a preventative check-up.
The above information is not a complete list of covered and excluded services and is for informational purposes only. If there is a discrepancy between the above information and that of the official Cigna Group Contract & Summary Plan Description (SPD), the Cigna Group Contract & SPD will prevail. Please see the Cigna SPD for complete details on benefits, exclusions, and limitations.