Quick Answer: What Is Open Access Plus?
Cigna Health and Life Insurance Co.'s Open Access Plus is a flexible, employer‑sponsored health insurance offering a wide network of doctors, hospitals, and specialists without requiring referrals for most services. It combines high‑deductible health plan (HDHP) features with a health savings account (HSA) option, giving members control over spending while providing comprehensive coverage for preventive care, emergencies, and chronic‑condition management.
- Quick Answer: What Is Open Access Plus?
- Key Features of Open Access Plus
- Eligibility and Enrollment
- How Costs Are Structured
- Benefits Overview
- Comparing Open Access Plus to Other Cigna Plans
- How to Maximize Your Open Access Plus Coverage
- Common Questions About Open Access Plus
- Does the plan cover out‑of‑network care?
- Can I switch to a different Cigna plan mid‑year?
- What happens if I don't meet the deductible?
- Is there a grace period for the deductible?
- Where to Find More Information
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Key Features of Open Access Plus
The plan is designed for individuals and families who want broad provider choice and the ability to manage out‑of‑pocket costs. Core attributes include:
- Large national and regional provider network
- No primary‑care physician (PCP) referrals for most specialists
- Preventive services covered at 100% before the deductible
- Option to pair with a Cigna HSA for tax‑advantaged savings
- Out‑of‑network coverage at reduced rates
Eligibility and Enrollment
Open Access Plus is typically offered through employers as part of a group benefits package. Eligibility criteria generally are:
- Full‑time employment (often 30+ hours/week) with a participating employer
- Meeting any waiting period set by the employer (commonly 30‑90 days)
- Choosing the plan during open enrollment or qualifying life events (e.g., marriage, birth)
Individuals can also enroll via a Cigna broker or through the Cigna Marketplace if the plan is made available in their state.
How Costs Are Structured
Open Access Plus blends premium payments with deductible and out‑of‑pocket expenses. Below is a typical cost framework (exact amounts vary by employer size, location, and family size):
| Cost Component | Typical Range | Explanation |
|---|---|---|
| Monthly Premium | $200‑$600 (individual) / $500‑$1,200 (family) | Employer often subsidizes a portion; employee pays the rest. |
| Annual Deductible | $1,500‑$3,000 (individual) / $3,000‑$6,000 (family) | Amount you pay before insurance shares costs. |
| Out‑of‑Pocket Maximum | $5,000‑$7,500 (individual) / $10,000‑$15,000 (family) | Cap on total spending; after this, plan pays 100%. |
| Coinsurance | 20% after deductible | Member pays 20% of allowed charges until out‑of‑pocket max. |
Benefits Overview
Open Access Plus covers a wide array of services, including:
- Preventive care (annual exams, immunizations, screenings) at no cost before deductible
- Hospitalization and surgery
- Emergency room visits
- Mental health and substance‑use treatment
- Prescription drugs (tiered formulary)
- Telehealth and virtual visits
- Wellness programs and disease‑management resources
Members can also access Cigna's 24/7 nurse line and online member portal for claims, benefits tracking, and HSA management.
Comparing Open Access Plus to Other Cigna Plans
Many employers offer a menu of Cigna options. The table below highlights how Open Access Plus stacks up against two common alternatives: Cigna Classic Care (PPO) and Cigna Secure (HDHP without HSA).
| Feature | Open Access Plus | Cigna Classic Care (PPO) | Cigna Secure (HDHP) |
|---|---|---|---|
| Network Flexibility | Broad, no PCP referrals | Broad, PCP referrals for specialists | Broad, similar to Open Access Plus |
| HSA Eligibility | Yes | No | Yes |
| Typical Premium | Mid‑range | Higher | Lower |
| Deductible | Moderate | Low‑moderate | High |
How to Maximize Your Open Access Plus Coverage
To get the most value, consider these strategies:
- Use in‑network providers whenever possible to avoid higher out‑of‑network fees.
- Take advantage of preventive services that are covered 100% before meeting your deductible.
- Contribute to an HSA if your employer offers one; contributions are tax‑deductible and can roll over year to year.
- Review the formulary annually to ensure your prescriptions are on a preferred tier.
- Leverage telehealth for routine visits to save time and reduce costs.
Common Questions About Open Access Plus
Does the plan cover out‑of‑network care?
Yes, but at a reduced reimbursement rate. You'll pay a higher coinsurance (often 40%) after the deductible.
Can I switch to a different Cigna plan mid‑year?
Generally only during a qualifying life event (e.g., marriage, birth, loss of other coverage) or during the employer's open enrollment window.
What happens if I don't meet the deductible?
You'll continue paying the full cost of services until the deductible is met, except for preventive care, which remains free.
Is there a grace period for the deductible?
Some plans offer a short grace period (typically 30 days) after the plan year ends to meet the deductible before the new year's deductible resets.
Where to Find More Information
For the most accurate, up‑to‑date details, consult:
- Your employer's benefits portal or HR representative
- Cigna's official member handbook (available online after login)
- Cigna customer service (1‑800‑CO‑CIGNA)