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Cigna Health Insurance Review from Florida

In the state of Florida health insurance is a precious commodity. Access to healthcare is limited, if not non existent without having good coverage. I am fortunate enough to have health insurance though my job and I am the only family member on it. However my family has an individual policy through Cigna and the monthly premiums are approximately $520 per month because the company I work for does not contribute to employee health insurance. We do our insurance this way because if we were on the group coverage through my company it would cost $850 a month extra! The insurance is a PPO with benefits administered through Cigna. There are sufficient doctors, pharmacies, and facilities on our list of providers and in the Orlando area.

A visit to a primary care physician has a co-pay of $20 as long as he is not a specialist. This includes most stuff that is done in his office, such as blood work and x-rays. My co-pay to see a specialist is $50 and also includes just about anything done in his office. None of my co-pays count towards our $1000 deductible or my co-insurance of 20%, which is has a $3000 out of pocket limit per calendar year. After I meet the $3000 out of pocket, co-insurance is paid at 100%. If I have blood work done outside a doctor’s office I end up paying a negotiated rate. For x-rays it is a preferred rate also. My wife gets mammograms and has no deductible or co-pay, they are paid at 100%. If I require an MRI, PET scan or other High Technology Scan my deductible comes into play then paid at 100%. Emergency room visits require $100 co-pay, but if I am admitted to the hospital the co-pay is waived. Out patient surgical procedures in network are subject to the deductible and co-insurance then the remainder is paid at 100%. If someone is admitted to an in-network hospital I have the same coverage - deductible and co-insurance must then be met. My wife and kid each get one preventive care visit per calendar year with a co-pay of $20 for anything done in the physician’s office.

The Cigna health insurance plan includes drug coverage. Purchased through an in-network pharmacy, monthly co-pays consist of $10 for generic, $50 for preferred name and $75 for non-preferred name. If I use mail order, co-pays for a 90 day supply consist of $20 for generic, $100 preferred name and $150 for non-preferred name. There is no dental or vision coverage on my plan. No maternity, well child care, and immunizations are included either. I think pre-certification for hospital admissions, out patient surgical procedures and High Technology Scans is recommended and maybe even required. In cases of emergency my insurance company is to be notified as soon as possible by myself, my family, or the medical facility.

My Cigna insurance was purchased with an agent. Any problems encountered, such as non payment of claims, are sent to the broker. It is investigated on our behalf and the issue resolved or an explanation is provided as to why the service is not covered. There is a lifetime maximum benefit of $5,000,000. All in all this is a good plan and I figure we save about $3600 a year figuring our health insurance this way. I wish my family could all be one health insurance plan, but my agent showed me this route and it was the only way to get the most affordable health insurance.



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