Cigna OAPIN

The Cigna OAPIN medical plan features copays for most services with no deductible to satisfy before the plan pays for eligible services. The OAPIN does not include out-of-network coverage.

Cigna OAPIN Medical Plan (Group # 3344694)

	In-Network Only
Annual Deductible	None
Accumulation Period	Time period to incur eligible expenses toward the deductible: Calendar Year
Annual Out-of-Pocket Maximum	$1,500 per individual, up to $3,000 per family
Office Visit	$15 copay for primary care physician or specialist
Chiropractic	$25 copay (coverage limited to 20 visits per calendar year)
Lab and X-ray	No charge
Urgent Care	$15 copay
Emergency Room	$100 copay (copay waived if admitted)
Hospitalization	$250 copay per admission
Outpatient Surgery	$100 copay in center; $125 copay in outpatient hospital
Outpatient Mental Health	0% coinsurance both In and OON
Fertility Coverage	$20k lifetime maximum fertility coverage has been added to Cigna plans starting on January 1st, 2024. Services include: • IUI, IVF, GIFT, ZIFT • Infertility drugs, testing, treatment • Short-term fertility preservation, preimplantation genetic testing, and more This change provides you with in-network resources, is tax-advantageous, and will simplify your fertility experience.
Transgender Health Services	After deductible, copays/coinsurance apply. Patients should work with a Cigna Case Manager to navigate care, find specialized providers, and ensure authorizations are in place for treatment along your journey. Covered services include but are not limited to: • Gender reassignment procedures including prosthetics; hair removal; top, bottom, and facial surgeries; and voice therapy • Hormone therapy and related lab testing • Behavioral counseling and routine medical care

Plan Documents

Cigna OAPIN Plan Benefit Summary

Prescription Drug Coverage

	Your Cost
Deductible	N/A
Out-of-Pocket Maximum	Combined with medical;
Generic	$10 copay
Brand Name	Preferred: $25 copay; Non-Preferred: $40 copay
Specialty	30% coinsurance up to $250 per script
Mail Order	90 days supply
Generic	$20 copay
Brand Name	Preferred: $50 copay; Non-Preferred: $80 copay
Specialty	30% coinsurance up to $500 per script

Save on Prescriptions

Go Generic: If you’re looking to minimize your out-of-pocket costs, use generic drug options when possible. Generic drugs have the same active ingredients as their brand-name counterparts but your copay will be less.

Mail-Order: If you’re taking a medication for a chronic condition, you can also save money by utilizing mail-order options, offering convenience and a larger supply for the same copay.