Cigna & YOU · 2017-10-31 · • Do you live in Cigna’s service area at least 6 months out of...
Transcript of Cigna & YOU · 2017-10-31 · • Do you live in Cigna’s service area at least 6 months out of...
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1H0354_792013 Approved 14_B_03_AZ_03
Cigna & YOU
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Cigna & You
intrOdUCtiOn
• CignaisaMedicareAdvantageOrganization.
• RepresentativesarelicensedinsuranceagentsandcertifiedappointedwithCigna.
• RepresentativesdonotworkforMedicare.
• AcommissionispaidtoeachagentwhoenrollsindividualsintoaCignaMedicareAdvantageplan.
• Youareundernoobligationtojoinaplan.
• YougivepermissiontodiscussCignaMedicareAdvantageplanswithyou.
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Cigna & You
Cigna, a COmpanY YOU Can trUst
CignaisoneofthelargestcompaniesfocusedonMedicareAdvantage —asaCoordinatedCareplanweunderstandyourneeds.
• Here tO staY –Cignaisaleadingglobalhealthcarecompanyservingmillionsofpeopleandcommunitiesaroundtheworldsince1792.*
• COmmitted tO YOU–Cignapartnerswithateamofdoctorsandprovidesthemwithextratoolstogiveyouthetime,attention,andqualitycareyoudeserve.Cignaisdedicatedtokeepingourcustomershealthy.
• mediCare apprOved–CignacontractswiththeCentersforMedicare&MedicaidServices(CMS)andoffersMedicareAdvantageplans.
• CUstOmer satisfaCtiOn–Cignaproudlyservesover1million*customers,9outof10**ofwhomrecommendCignatotheirfriendsandfamily.
*Based on December 31, 2012 statistics, found on the Cigna website at www.cigna.com/aboutus/cigna-fact-sheet**Based on the average data from the Art of Medicine Survey 2012.
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Cigna & You
YOUr priOrities
WHat is impOrtant tO YOU?
Whenconsideringyourhealthandyourpersonalhealthcarecoverage,your priorities matter.
imprOve quality of health
avOid loss of independence
remain active
LOWer out-of-pocket costs
maintain quality of health
minimize financial exposure to catastrophic health events
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Cigna & You
dO YOU Have:• MedicarePartAandPartB?
• Additionalcoveragethathelpswithyourhealthcarecosts?
• Prescriptiondrugcoverage?
abOUt YOU:• Whatdoyoulikeaboutyourcurrentcoverage?
• Doesanyonehelpyouwithdecisionsaboutyourhealthcare?
• DoyouhaveEndStageRenalDisease?
• DoyouliveinCigna’sserviceareaatleast6monthsoutoftheyear?
YOUr CUrrent COverage & YOU
a b d
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Cigna & You
mediCare part a and part b
HOspitaL insUranCe benefits covering Medicare approved amounts
mediCaL insUranCe benefits covering Medicare approved amounts
daYs 1-60:$1,184deductibleperbenefitperiod
daYs 61-90:$296perday
daYs 91-150:$592perday1
daYs 151+:Youpay100%
mediCare paYs:80%ofapprovedcharges
benefiCiarY paYs:20%ofapprovedcharges
• Monthlypremium$104.902
• Annualdeductible$147
The above cost-sharing is based on the current CMS amounts and are subject to change each year. 1Lifetime reserve days: With Original Medicare, once your hospital stay extends past 90 days you begin to use your 60 Lifetime Reserve days. When all 60 days are used, you must pay 100% out-of-pocket. 2Most people will pay $104.90, but your Part B premium may be higher based on your income.
part bpart a
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Cigna & You
part d
mediCare part C and part d
mediCare advantage (ma) pLans
presCriptiOn drUg pLans
• AreoperatedbyprivatecompaniescontractedwithMedicare.
• Medicarepaysamonthlyfeetotheplanforyourcare.
• Theplanthendirectlypaysthedoctorsandhospitals.
• PartCplanscombinehospitalcosts,doctorandoutpatientcareintooneplan.
• ExactcoverageandcostsaredifferentforeachMedicaredrugplan,butallplansmustofferatleastastandardlevelofcoveragesetbyMedicare.
• Plansareavailableasstand-aloneplans.
• SomeMedicareAdvantageplansofferbuilt-inprescriptiondrugcoverage.
part C
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Cigna & You
Benefits may vary by plan and service area.
YOUr mediCare OptiOns
80%
tHe gap
20%
Of apprOved CHarges:• Deductibles• Coinsurance
OriginaL mediCare
Supplementalplansareavailabletohelpcoverthe GAP.
Utilizes a team of doctors to coordinate YOUR healthcare
Better healthcare, better value
100%
mediCare advantage
Of mediCare benefits are COvered:• No / low monthly
plan premium• Low copayments• No deductibles
No GAP.
Extra coverage for YOU:
Prescription drugs Vision
Gym membership And more!
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Cigna & You
• Team approachtohealthcarefocused on prevention.
• Abilitytospeakwithacaringregistered nurse24hoursaday,sevendaysaweek.
• Offersyougreater valuewithloweroutofpocketcosts.
• Providesyouthesame Rights and ProtectionsasOriginalMedicare.
• You have earnedthisadditionalcoverage.
WHY CHOOse a Cigna mediCare advantage pLan?
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Cigna & You
getting tHe rigHt Care
OtHer pLans Cigna pLans Organizeddeliveryofcare
Cigna’s netWOrk
Somenetworkdoctorsparticipateinatightlyfocusedteamwithinthenetwork.Ifacustomerchoosesadoctorthatparticipatesinoneoftheseteams,thatdoctorwillbebetterequippedtocoordinatethecustomer’scarewithotherdoctorsandspecialistsonthesameteam.
You YouUrgent Care or Emergency Care
Urgent Care or Emergency Care
SpecialistSpecialist
Doctor
Doctor
Specialist
Specialist HospitalHospital
Specialist
&
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Cigna & You
Cigna’s Organized team apprOaCH
tHe keY tO better HeaLtH and better resULts:
Cignaensuresyourteamofdoctorsworktogethertoprovidebetterhealthcarewithafocusonprevention.
• Yourdoctoristheteam leaderforallyourhealthcareneeds,sotheyknowyourwholehealthpicture.
• Yourdoctorwillreferyoutotherightspecialistsandhospitals–andwork WITH them to keep you healthy.
• Thisteamworkapproachmakessureyoureceivequality care when and where you need it.
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Cigna & You
fOCUs On preventive Care
Preventive care isoneofCigna’scorebeliefs.Customersarecoveredforannualphysicalsandotherscreeningssuchas:
• Mammograms• OB/GYN“wellwoman”exams
• Bonedensityscreenings• Colorectalscreenings
Wepaydoctorsforthequality of caretheygivetocustomers,notthequantityofcustomerstheysee.
Throughpreventivecare,wecanidentifyserioushealthproblemsearlyandhelpyoumanagetheseproblemstokeepyourout-of-pocketcostslower.
it’s tHat simpLe. Through preventive care, we help you take care of your health.
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Cigna & You
LOWering the risk associated with:
WHat dOes tHis mean fOr YOU?
Cignapartnerswithdoctorswhoshareacommitmenttopreventivecare.
Cignacustomersreceivea* Breast Cancer
Colorectal Cancer
High Blood Pressure
Mammogram
Colonoscopy
Hypertension Control
*Percent reflects the relative change between Cigna P4Q population and reference population, Standard of Healthcare (SOHC). Patient results for customers enrolled in P4Q as of 12/31/11. SOHC results are based on Medicare/PPO 2011 population and collected by NCQA, release date 10/2012 (AC 5/14/13).
14% more
Cignacustomersreceivea*31% more
Cignacustomersreceive*25% more
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Cigna & You
+
WHat makes Cigna UniqUe?
Qualityofcareisthemainfocusforourteamofdoctors.Cignaprovidesthemwiththetoolstheyneedtogivetimeandattentiontoeachindividual.
Nurses who review charts in your doctor’s office to check for needed preventive screenings such as eye exams.
Nurses who assist your doctor in managing any chronic illness you may experience such as Diabetes.
360 Comprehensive Assessment Exams and health questions for your doctor to ask during your annual wellness exam.
+
tHe resULtsOurfocusonpreventionsupportshealthiercustomersandlowersmedicalcosts.
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Cigna & You
tHe rigHt COverage fOr YOU!
WhydoesenrollinginCignaseemtobeagooddecisionforbothyourhealthandyourbudget?
fOCUs On preventiOnteam apprOaCH
fOCUs On qUaLitY Of Care additiOnaL benefits
Cigna Medicare Advantage plans promote better health and may be a greater value than other options.
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Cigna & You
annUaL
speCiaL
initiaL
Therearethreetypesofenrollmentperiods:
WHen Can YOU enrOLL?
1
2
3
when you turn 65
year-round
at the end of the calendar year
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Cigna & You
WHen Can YOU enrOLL?
initiaL COverage enrOLLment periOd (iCep)Enrollmentfortheinitialperiod,orICEP,isthreemonthsbeforeyourbirthday,duringyourbirthdaymonth,andthreemonthsafteryourbirthday.
3 months befOre your
birthday
dUring your birthday
month
3 months after your
birthday
1
Example above is for a June birthday. If you are younger and qualify for Medicare due to a disability or other special circumstances, Medicare may work differently for you. Learn more at www.medicare.gov or call your local Social Security Administration office.
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Cigna & You
WHen Can YOU enrOLL?
speCiaL enrOLLment periOd (sep)Duetospecialsituations,youmaybeabletoenroll,switch,ordropyear-roundifyou:
• Loseinsurancethroughanemployer• Moveintooroutofaplanservicearea• GainorloseeligibilityforMedicaid• Qualifyfororhaveachange
toLowIncomeSubsidy(LIS)
• Liveinalong-termcarefacility• Becomeeligiblefora
SpecialNeedsPlan(SNP)• AreonMedicareDisabilityandturning65• Areonaplanthatisbeingterminated
2
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Cigna & You
WHen Can YOU enrOLL?
annUaL enrOLLment periOd (aep)ALLMedicareBeneficiariescanenroll,switch,ordropduringthistime:October 15th – December 7th
CoveragebeginsJanuary 1standwillcontinueforthecalendaryear.
AsanenrolledCignacustomer,youwillreceiveaNew Customer Welcome PacketthatwillgiveyoumoreinformationonyournewCignaplan.
3
Oct. 1st – Oct. 14th Dec. 8th – Sept. 30th
Oct. 15th – Dec. 7th Jan. 1st – Feb. 14th
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Cigna & You
Cigna presCriptiOn drUg benefit
Prescriptiondrugbenefitsworkoffacalendaryear:Jan. 1st – Dec. 31st
initiaL COverage
You pay copays and the plan pays the remaining prescription drug costs.
COverage gap (dOnUt HOLe)
Most plans have generic drugs covered with copays.
Non-covered generics drugs are discounted by 28%.
Most brand name drugs are discounted by 52.5% while in the Coverage Gap.
CatastrOpHiC COverage
At this point, you will only pay $2.55 for generic, $6.35 for brand, or 5%
whichever is greater until the calendar year ends.
DecJan$2,850
After the total drug cost equals $2,850, you have reached the Coverage Gap.
$4,550 Once your total out-of-pocket expenses paid
by you (including your discounts) reaches $4,550, you will exit the Coverage Gap.
531 2 4
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Cigna & You
keeping it simpLe
Access ALL your Cigna benefits byusingyourCignaIDCard,includingyourprescriptiondrugs.Dependingonthetypeofplan,networkrestrictionsmayapply.Somecustomersmayalsoneedtoshowastatemedicalassistanceand/orstateMedicaidcard.
YoudonotneedtoshowyourOriginalMedicarecard,butalwaysremembertostoreitinasafeplace.
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Cigna & You
Want tO Learn mOre?
GetmoreinformationsoyoucanmakeaninformeddecisionaboutyourhealthcarecoveragewithCigna.
Thesematerialsandotherusefulinformationareprovidedorcanbefoundonourwebsite:www.cignamedicare.com
sUmmarY Of benefits
presCriptiOn drUg fOrmULarY
prOvider direCtOrY
infOrmed deCisiOn gUide
SAMPLE
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Cigna & You
enrOLLment in Cigna is easY!
revieW the statement of understanding
COmpLete and sign the application*
keep a copy of the application for your records
Afteryouenroll,youwillreceivethefollowing:• VerificationCall• LetterofAcknowledgement/
Confirmation
• EnrollmentPacket• CustomerIDCard
Cigna invites YOU tO JOin!
321
Thank you for considering Cigna’s Medicare Advantage plans.
*You do not need to complete and sign the application if your enrollment is conducted over the phone or online.
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The benefit information provided herein is a brief summary, not a complete description of benefits. For more information contact the plan. Limitations, copayments, and restrictions may apply. Benefits, formulary, pharmacy network, premium and/or copayments/coinsurance may change on January 1 of each year. You must continue to pay your Medicare Part B premium. This information is available for free in other languages. Please call our customer service number at 1-855-561-3811 (TTY 711), 7 days a week, 8 a.m. - 8 p.m. Esta información está disponible de forma gratuita en otros idiomas. Favor de contactar a nuestro Departamento de servicio al cliente al 1-855-561-3811 (TTY 711), 7 días de la semana, 8 a.m. - 8 p.m. Premiums, copays, coinsurance, and deductibles may vary based on the level of Extra Help you receive. Please contact the plan for further details.
“Cigna,” “Cigna Medicare Select Plus Rx” (HMO) and the “Tree of Life” logo are registered service marks of Cigna Intellectual Property, Inc., licensed for use by Cigna Corporation and its operating subsidiaries. All products and services are provided by or through such operating subsidiaries, including Cigna HealthCare of Arizona, Inc. (CHC-AZ), and not by Cigna Corporation. Cigna Medicare Select Plus Rx HMO plans are offered by CHC-AZ under a contract with Medicare. As of the date of publication, Cigna Medicare Select Plus Rx plans are offered to employers and individuals in Maricopa County and certain zip codes within Apache Junction and Queen Creek, Arizona only. Enrollment in Cigna Medicare Select Plus Rx depends on contract renewal. © 2013 Cigna
need HeLp Or Have qUestiOns? taLk tO a representative tOdaY.
www.cignamedicare.com
Call toll-free: 1-855-561-3811 (TTY 711) 7 days a week, 8 a.m. - 8 p.m.