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POS

One plan, more options

Patients covered by Point of Service (POS) plans have the opportunity to access care from out-of-network health care professionals. At enrollment, your patients that enroll in these CIGNA administered POS plans select a primary care physician (PCP) from our broad network of participating physicians to assist in managing their overall health. These patients can change their PCP at any time. PCPs are responsible for:

  • Providing routine care
  • Referring their patients to in-network or out-of-network specialty care health care professionals
  • Obtaining precertification for all in-network services that require it, and
  • Filing patient claims for in-network care

Your patients in CIGNA administered POS plans may be responsible for:

  • Deductibles for inpatient and outpatient facility charges
  • Coinsurance and/or deductibles for facility and physician charges

These payment responsibilities are listed on the patient's ID card. Coinsurance/deductible should not be collected at the time of service unless you have accessed the CIGNA Cost of Care Estimator®, located on our eServices page, to obtain an estimate of the patient's costs, and provide a copy of the Explanation of Estimate to the patient.

We also offer a POS Open Access plan, which allows patients enrolled in the plan to visit specialists without a referral.

Please contact us for more information about CIGNA POS plans, or about how to become a participating CIGNA health care professional.


     

Plan Highlights

  • PCP-coordinated care
  • Referrals required for coverage at the in-network benefit level
  • Health care professionals must obtain precertification for in-network services that require it
  • In-network and out-of-network coverage (in-network utilization encouraged)
  • Most payment responsibilities and precertification requirements shown on patient's ID card

Access our Quick Guide to CIGNA ID cards to view sample ID cards (PDF).