2024 Medical Insurance Comparison Chart

Benefit Comparison

 

Base High Deductible

Value High Deductible

Choice Open Access

Services

In-Network

In-Network

In-Network

Deductible

·       Individual

·       Family

Embedded*

$4,000

$8,000

Non- Embedded**

$2,500

$4,500

Embedded*

$1,000

$2,000

Coinsurance

·       Plan Pays

·       You Pay

 

80%

20%

 

80%

20%

 

70%

30%

Out-of-Pocket Max

·       Individual

·       Family

 

$6,000

$12,000

 

$5,000

$10,000

 

$4,000

$8,000

Preventive Services

Covered at 100%

Covered at 100%

Covered at 100%

Primary Care

20% after deductible

20% after deductible

$25

Specialist Visit

20% after deductible

20% after deductible

$50

Virtual Care

20% after deductible;

$55 average cost per visit

20% after deductible;

$55 average cost per visit

$25 Copay

Urgent Care

20% after deductible

20% after deductible

30% after deductible

Emergency Room

20% after deductible

20% after deductible

30% after deductible

Hospitalization

20% after deductible

20% after deductible

30% after deductible

Once Annual Eye Exam

$15 Copay

$15 Copay

$15 Copay

Services

Out-of-Network

Out-of-Network

Out-of-Network

Deductible

·       Individual

·       Family

Embedded

$5,000

$10,000

Non-Embedded

$4,000

$8,000

Embedded

$2,000

$4,000

Coinsurance

·       Plan Pays

·       You Pay

 

60%

40%

 

60%

40%

 

50%

50%

Out-of-Pocket Max

·       Individual

·       Family

 

$10,000

$20,000

 

$8,000

$16,000

$6,500

$13,000

The way the deductible and the out of pocket maximum work is important if you cover anyone other than yourself.

  • With the Choice Open Access and the Base High Deductible $4,000 (Embedded), after each eligible family member meets their 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 Value High Deductible $2,500 (Non-Embedded), 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.