2016 CIGNA
heAlth CAre CoverAGe
MedICAl ANd phArMACy
IMportANt to you
Look at your health in a whole
new way. Let us work with
you to coordinate your health
care needs. Let us provide you
with support and services, so
that your doctors can focus on
providing care, and you
Medical Plan . . . 4
Pharmacy . . . 5
Pharmacy: Prior Authorization Drugs . . . 7
Pharmacy: Prescription Drug List . . . 8
Pharmacy: Specialty Medications . . . 19
Pharmacy: Preventive Prescription Drugs . . . 23
MDLive . . . 25
Your Health Has Met its App . . . 26
myCigna.com . . . 27
Savings at your Fingertips . . . 28
value-added Services . . . 30
Cigna Health Pregnancies, Healthy Babies . . . 31
Questions & Answers . . . 32
CoNtACt INForMAtIoN
Medical & prescription drug plan
Cigna
P.O. Box 182223
Chattanooga, TN 37422-2223
800.244.6224
open Access plus plan your insurance pays
Benefit highlights
In-network
Out-of-network
Annual individual deductible
$1,500
$3,000
Maximum annual family deductible
$3,000
$6,000
Lifetime maximum
unlimited
unlimited
Major medical out-of-pocket maximum
(Individual/Family)
$6350 /$12700
$9,000/$18,000
Office visits
Primary care
Specialists
Allergy shots and other therapeutic injections
Chiropractic care (20 visits maximum PCY)
80%
70%
80% or 70%
70%
60% AD*
MD Live Telemedicine
$15
N/A
Preventive care**
Well-baby care
Immunizations
Annual routine exam
Women’s exams: include mammogram and PAP test (1 PCY*)
Vision exam (1 exam PCY)
100%
100% AD
Diagnostic lab/X-ray services
(outpatient/independent facility)
Minor – Lab, X-ray
Major – CT, PET, MRI, MRA and Nuclear Medicine
80%
70%
60%
Maternity
Maternity fees/provider
Maternity hospital stay (includes newborn care)
80% AD
80% AD
60% AD
Emergency
Emergency room
Ambulance
$200 member copay and 80% AD
80% AD
$200 member copay and 80% AD
80% AD
Urgent care facility
70%
60%
Inpatient hospital facility
80% AD
60% AD
Outpatient day surgery
80% AD
60% AD
Mental health/chemical dependency – inpatient facility
Hospital services
80% AD
60% AD
MH/CD OP therapy
80%
60% AD
Intensive OP therapy
80%
60% AD
*
PCY
= Per calendar year.
AD
= After deductible.
**See the preventive health benefits quick reference guide for detailed information on wellness exams and immunizations.
MedICAl plAN
To help you fill your prescriptions, Cigna’s prescription drug plan provides access to more than 52,000 national and independent pharmacies. You can also order your prescriptions online, over the phone or through the mail for convenient home delivery.
prescription drug coverage highlights: When you choose a plan in Cigna’s Open Access Plus Network – regardless of which plan you choose – you will receive the following prescription drug coverage:
pharmacy-purchased drugs (member pays)
Generic drugs
Preferred brand drugs
Non-preferred brand drugs
$10 copay
per prescription
up to a 31-day supply
30%
($125 per prescription maximum)
up to a 31-day supply
50%
($150 per prescription maximum)
up to a 31-day supply
At participating pharmacies only. You must present your ID card with any new prescription or refill. For all paper-submitted claim forms, you must pay full price for
the prescription and then submit a claim form for reimbursement.
home delivery purchased drugs (member pays)
Generic drugs
Preferred brand drugs
Non-preferred brand drugs
$20 copay
per prescription
up to a 90-day supply
30%
($375 per prescription maximum)
up to a 90-day supply
50%
($450 per prescription maximum)
up to a 90-day supply
Many people incorrectly think that there is a difference between generic and brand name prescription drugs. The truth is, a generic drug is the same as a brand-name drug, with few exceptions. However, because of the surge in direct-to-consumer marketing of prescription drugs, customers become more familiar with certain drugs and often falsely believe these high-profile,
high-cost drugs are automatically the best option for treating their medical conditions. You should also know that, in most cases, less expensive and more effective alternatives to some well-known drugs exist. So the next time you see your doctor about a prescription, ask if a less expensive generic equivalent is available.
Getting the most out of your coverage: make careful decisions about prescription drugs
phArMACy
what is a generic drug?
A generic drug is a drug that is chemically identical to a brand-name drug in dosage, safety, strength, performance and intended use. They are able to be sold to the public for less because it costs less for manufacturers to develop, produce and market these drugs.
what is a preferred brand drug?
A preferred brand drug is a brand-name drug that is on Cigna’s list of accepted brand-name drugs.
what is a non-preferred brand drug?
A non-preferred brand drug is a brand-name drug that is not on Cigna’s list of accepted brand-name drugs. Go to myCigna.com, my plans > pharmacy, for additional drug information.
what is a specialty drug?
A specialty drug is a prescription medication that requires special handling, administration or monitoring. You’re allowed up to two fills before you’re required to use Cigna Home Delivery Pharmacy.
I want to…
Find links to popular tasks, such as searching for a pharmacy, downloading a form and printing iD cards.
prescription drug price quotes
Compare costs of your prescription drugs at specific retail pharmacies and Cigna Home Delivery Pharmacy.Cigna home delivery pharmacy
Order a new prescription or refill an existing prescription through our convenient mail-order service. Take
advantage of our lower costs and get a 90-day supply delivered to your door at no additional cost for delivery.
Claim search
Search for pharmacy claims for the primary plan subscriber for the past 16 months.
Cigna: prior authorization drugs
Using the latest medical research, along with guidelines from the U.S. Food and Drug Administration (FDA) and national medical organizations, the Cigna Pharmacy and Therapeutics Committee, a panel of participating in-network doctors and pharmacists, regularly evaluates the safety and effectiveness of prescription medications that are included on the prescription drug list. This evaluation also includes the determination of which drugs will require prior authorization based on safety, appropriate use or coverage design. For medications or doses that require prior authorization, your doctor may call or fax the appropriate prior authorization form to Cigna to request coverage for the prescription. Your doctor should make this request before writing the prescription. To determine if prior authorization is required, your doctor should check the Cigna
Prescription Drug List or visit the website at Cigna.com for the complete prescription drug list.
if the request is approved, the doctor will receive a fax confirmation. The authorization will be processed in
Cigna’s claim system to allow you to have coverage for this drug. The length of the authorization will depend on the diagnosis and drug. When your physician advises you that the drug has been approved, you should contact a participating pharmacy to fill the
prescription(s). if the request is denied, you and your doctor will be notified that coverage for the drug is not authorized. if you have questions, please call Cigna Customer Service at the toll-free number on your Cigna iD card.
The following list identifies the drugs that may require prior authorization and is subject to change on a quarterly basis.
›
AGe indicates that the drug requires priorauthorization if your age meets the age limit shown.
›
PA indicates that the drug routinely requires prior authorization to ensure appropriate treatment regimens are followed.›
QL indicates that the drug requires prior authorization only when the quantity requested exceeds certain limits.Brand name reason
Accutane
QL
Aciphex
PA
Actiq
PA
Agrylin
PA
Amerge
QL
Anzemet
QL
Arava
PA
Arixtra
QL
Avita
AGE 46≥
Axert
QL
Celebrex
PA
Clavaris
QL
D.H.E. 45
QL
Differin
GE 46≥
Diflucan (150mg)
QL
Dostinex
QL
Duragesic
QL
Emend
QL
Epipen, Epipen Jr.
QL
Exubera (combo pkg & kit)
PA
Brand name reason
Pulmozyme
PA
Regranex
PA
Relenza
QL
Relpax
QL
Retin-A, Retin_A Micro
AGE≥46
Revatio
PA
Revia
QL
Sporanox
PA, QL
Sprycel
PA
Synarel
PA, QL
Tamiflu
PA, QL
Tarceva
PA
Toradol
PA, QL
Vfend
PA
Zegerid
PA
Zithromax
QL
Zmax
QL
Zofran, Zofran ODT
QL
Zomig, Zomig ZMT
QL
Zyvox
PA
Brand name reason
Fragmin
QL
Frova
QL
Gleevec
PA
Glucagon
QL
lmitrex
QL
Innohep
QL
Iressa
PA
Kytril
PA, QL
Lamisil
PA
Lariam
QL
Lovenox
PA
Malarone
QL
Maxalt, Maxalt MLT
QL
Migranal
PA
Nexium
QL
OxyContin
PA
Panretin
PA
Penlac
PA
Prilosec
QL PA
Proscar
AGE 39≥
GENERICS PREFERRED BRANDS NON-PREFERRED BRANDS Add/Adhd ANd stIMulANts
amphetamine/ dextroamphetamine clonidine HCl dexmethylphenidate HCl dexmethylphenidate HCl ER guanfacine methamphetamine methylphenidate HCl methylphenidate/ ER/24 HR ER modafinil (PA) Adderall XR Focalin XR Ritalin LA 10 mg Strattera Vyvanse Adderall (PA,ST) amphetamine/ dextroamphetamine XR Aptensio XR (PA,ST) Concerta (PA,ST) Daytrana (PA,ST) Desoxyn (PA,ST) Dexedrine (PA,ST) Evekeo (PA,ST) Focalin (PA,ST) Intuniv Kapvay Metadate CD (PA,ST) Methylin (PA,ST) Nuvigil (PA) Provigil (PA) Quillivant XR (PA,ST) Ritalin (PA,ST) Ritalin ER Ritalin LA 20 mg, 30 mg, 40 mg, 60 mg (PA,ST) Ritalin SR (PA,ST) Xyrem (PA) Zenzedi (PA,ST) AIds/hIv abacavir abacavir/lamivudine/ zidovudine didanosine lamivudine lamivudine/zidovudine nevirapine nevirapine ER stavudine zidovudine Aptivus Crixivan Emtriva Epivir HBV Epivir solution Epzicom Fuzeon Invirase Isentress Kaletra Lexiva Norvir Prezista Rescriptor Reyataz Selzentry Sustiva Truvada Viracept Viramune XR Viread Atripla Combivir Complera Edurant Epivir Evotaz Fulyzaq Intelence Prezcobix Retrovir Stribild Tivicay Triumeq Trizivir Tybost Videx Viramune Vitekta Zerit Ziagen
The Drug List divides medications into generic, preferred, brand categories and specialty injectables. Common examples of each of these categories are provided. This is a partial list and subject to change. Please see Cigna.com for a current Drug List.
GENERICS PREFERRED BRANDS NON-PREFERRED BRANDS AllerGy azelastine HCl azelastine nasal budesonide clemastine fumarate cyproheptadine desloratadine epinephrine (QL) flunisolide nasal fluticasone nasal hydroxyzine ipratropium nasal levocetirizine montelukast olopatadine nasal spray triamcinolone nasal Astepro Epipen 2 pk (QL) Epipen Jr. (QL) Nasonex Veramyst Adrenaclick (QL) Astelin Atrovent (nasal) Auvi-Q (QL) Beconase AQ (PA,ST) Children’s QNASL Dymista (PA,ST) Flonase (PA,ST) Karbinal ER Omnaris (PA,ST) Patanase QNASL (PA,ST) Rhinocort AQ (PA,ST) Semprex-D Singulair Xyzal Zetonna (PA,ST) AlzheIMer’s dIseAse donepezil donepezil HCl galantamine hydrobromide memantine rivastigmine (caps) Aricept Aricept ODT Exelon Namenda Namenda XR Namzaric Razadyne Razadyne ER ANxIety alprazolam buspirone diazepam lorazepam oxazepam Lorazepam Intensol Niravam
AsthMA ANd respIrAtory
albuterol solution (nebulizer solution) albuterol sulfate (syrup, tabs) budesonide caffeine citrate cromolyn sodium (nebulizer solution) dyphylline guaifenesin/ theophylline Advair Diskus/HFA Anoro Ellipta Asmanex TwistHaler Atrovent HFA Breo Ellipta Combivent Respimat Flovent Diskus/HFA ProAir HFA/RespiClick Pulmicort Pulmozyme (PA) QVAR Serevent Spiriva Accolate Accuneb nebulizer Adcirca (PA) Adempas (PA) Aerospan Alvesco Arcapta Arnuity Ellipta Asmanex HFA Brovana nebulizer Daliresp Dulera Esbriet (PA)
Understanding the Cigna prescription drug list: Common examples of drugs in each of the drug classes are
provided in the drug list. if you don’t see a specific drug listed in this document, a complete list of medications and their coverage categories can be found on Cigna.com by clicking on “Drug List” under “Popular Links.” For a complete, current list of preferred medications, please call Cigna Customer Service at 800.244.6224 or visit the website at Cigna.com.
GENERICS PREFERRED BRANDS NON-PREFERRED BRANDS AsthMA ANd respIrAtory (continued)
ipratropium bromide (nebulizer solution) levalbuterol (nebulizer solution) metaproterenol sulfate (syrup, tabs) montelukast prednisolone sod phosphate sildenafil terbutaline sulfate theophylline anhydrous zafirlukast Symbicort Ventolin HFA Xolair (PA) Foradil Incruse Ellipta (ST) Letairis (PA) Ofev (PA) Opsumit (PA) Orapred ODT Orenitram ER (PA) Perforomist Prelone Proventil HFA Revatio (PA) Singulair Stiolto Respimat Striverdi Respimat Tracleer (PA) Tudorza Pressair (ST) Tyvaso (PA) Ventavis (PA) Xopenex HFA Xopenex nebulizer BIrth CoNtrol Altavera Alyacen Amethia Amethia Lo Amethyst Apri Aranelle Aubra Aviane Azurette Balziva Briellyn Camila Camrese Camrese Lo Caziant Chateal Cryselle Cyclafem Dasetta Daysee desogestrel-ethinyl estradiol Elinest Emoquette Enpress Enskyce BeYaz Lo Loestrin FE Lomedia 24 FE LoSeasonique Minastrin 24 FE NuvaRing Ortho TriCyclen Lo Angeliq Brevicon Cyclessa Depo-Provera Subq Desogen Ella Estrostep FE Fem FE Generess FE Loestrin Loestrin FE Mircette Modicon Natazia Norinyl 1+35 Norinyl 1+50 Nor-QD Ortho-Cept Ortho-Cyclen Ortho Evra Ortho Micronor Ortho-Novum 7-7-7 Ortho-Tri-Cyclen Ovcon-35 Quartette Safyral
GENERICS PREFERRED BRANDS NON-PREFERRED BRANDS BIrth CoNtrol (continued)
Errin Estarylla ethinyl estradiol/ drospirenone Falmina Gianvi Gildagia Gildess Heather Introvale Jencycla Jolessa Junel Junel FE Kariva Kelnor Kurvelo Larin Larin FE Leena Lessina Levonest levonorgestrel levonorgestrel-ethestra levonorgestrel-ethin estradiol Levora l-norgest-eth estr/ethin estra Loryna Low-Ogestrel Lutera Lyza Marlissa Microgestin Microgestin FE Mono-Linyah Mononessa Myzilra Necon Next Choice Nora-Be
noreth a-et estra/fe fumarate norethindrone norethindrone-ethinyl estrad Seasonale Seasonique Tri-Norinyl Yasmin 28 Yaz
BIrth CoNtrol (continued) norethindrone-ethinyl estradiol/iron norgestimate-ethinyl estradiol norgestrel-ethinyl estradiol Nortrel Ocella Ogestrel Orsythia Philith Pimtrea Pirmella Portia Previfem Quasense Reclipsen Sprintec Sronyx Syeda Tilia FE Tri-Estarylla Tri-Legest FE Tri-Linyah Trinessa Tri-Previfem Tri-Sprintec Trivora Velivet Vestura Viorele Wera Wymzya FE Xulane Zarah Zenchent Zenchent FE Zeosa Zovia BlAdder proBleMs oxybutynin/XL potassium citrate ER tolterodine tartrate trospium chloride Elmiron Toviaz VESIcare Detrol (PA,ST) Detrol LA (PA,ST) Ditropan XL (PA,ST) Enablex (PA,ST) Gelnique (PA,ST) Myrbetriq (PA,ST) Oxytrol (PA,ST–For Men
Only) Urocit-K CANCer anastrozole azacitadine bexarotene bicalutamide capecitabine cyclophosphamide doxorubicin HCl exemestane flutamide letrozole lomustine tamoxifen citrate temozolomide (PA) Gleevec (PA) Granix Hexalen Leukeran
Lupron Depot (PA) Lysodren Matulane Myleran Neulasta (PA) Neupogen Nexavar (PA) Revlimid (PA) Sprycel (PA) Sutent (PA) Tarceva (PA) Temodar (PA) Thalomid (PA) Xeloda Zolinza (PA) Afinitor (PA) Afinitor Disperz (PA) Arimidex Aromasin Bosulif (PA) Caprelsa (PA) Casodex Cometriq (PA) Droxia Erivedge (PA) Fareston Farydak (PA) Femara Gilotrif (PA) Ibrance (PA) Imbruvica (PA) Inlyta (PA) Iressa (PA) Jakafi (PA) Lenvima (PA) Lynparza (PA) Mekinist (PA) Pomalyst (PA) Purixan Stivarga (PA) Sylatron (PA) Tarfinlar (PA) Targretin Tasigna (PA) Tykerb (PA) Valchlor Votrient (PA) Xalkori (PA) Xtandi (PA) Zelboraf (PA) Zydelig (PA) Zykadia (PA) Zytiga (PA) CArdIovAsCulAr Blood thINNer/ANtI-ClottING anagrelide aspirin/dipyridamole ER cilostazol clopidogrel dipyridamole enoxaparin (QL) fondaparinux (QL) heparin (QL) ticlopidine warfarin Effient Fragmin (QL) Xarelto Aggrenox Agrylin (PA) Arixtra (QL) Brilinta Coumadin Eliquis (ST) Jantoven Lovenox (QL) Plavix Pletal Pradaxa (ST) Savaysa (ST) Zontivity
GENERICS PREFERRED BRANDS NON-PREFERRED BRANDS CArdIovAsCulAr (continued)
hIGh Blood pressure/heArt MedICAtIoNs
acebutolol HCl acetazolamide amiloride HCl amiloride/HCTZ amlodipine besylate amlodipine/atorvastatin amlodipine/valsartan amlodipine/valsartan/ HCTZ atenolol benazepril HCl benazepril HCl/ amlodipine benazepril HCl/HCTZ bendroflumethiazide/ nadolol betaxolol HCl bisoprolol fumarate bisoprolol/HCTZ bumetanide candesartan candesartan/HCTZ captopril captopril/HCTZ carvedilol chlorothiazide chlorthalidone chlorthalidone/atenolol clonidine HCl clonidine patch Clorpres diltiazem diltiazem 24 HR ER doxazosin mesylate enalapril maleate enalapril maleate/HCTZ eplerenone felodipine fosinopril sodium furosemide guanfacine hydralazine HCl hydralazine/reserpine/ HCTZ hydrochlorothiazide indapamide irbesartan irbesartan/HCTZ isradipine labetalol HCl lisinopril lisinopril/HCTZ losartan potassium Azor Benicar Benicar HCT Bystolic Coreg CR Tekturna Tekturna HCT Tribenzor Accupril (PA,ST) Accuretic (PA,ST) Aceon (PA,ST) Altace (PA,ST) Atacand (PA,ST) Atacand HCT (PA,ST) Avalide (PA,ST) Avapro (PA,ST) Betapace AF Cardura Cardura XL Catapres, Catapres TTS Coreg Corgard Corlanor (PA) Cozaar (PA,ST) Diovan (PA,ST) Diovan HCT (PA,ST) Dutoprol Edarbi (PA,ST) Edarbychlor (PA,ST) Entresto (PA) Epaned Exforge Exforge HCT Hemangeol Hyzaar (PA,ST) Inderal LA Innopran XL Levatol Lotensin (PA,ST) Lotensin HCT (PA,ST) Lotrel Mavik (PA,ST) Maxzide Micardis (PA,ST) Micardis HCT (PA,ST) Norpace Norpace CR Norvasc Nymalize Prestalia Prinivil (PA,ST) Prinzide (PA,ST) Sotylize Sular Tarka Tekamlo Teveten (PA,ST) Teveten HCT (PA,ST) Toprol XL
GENERICS PREFERRED BRANDS NON-PREFERRED BRANDS CArdIovAsCulAr (continued)
hIGh Blood pressure/heArt MedICAtIoNs
(continued) losartan potassium/ HCTZ methazolamide methyldopa methyldopa/HCTZ metolazone metoprolol succinate metoprolol tartrate metoprolol/HCTZ minoxidil moexipril HCl moexipril HCl/HCTZ nadolol nicardipine HCl nifedipine nimodipine perindopril erbumine pindolol prazosin HCl propranolol HCl propranolol/HCTZ quinapril quinapril HCl/HCTZ ramipril (caps only) reserpine sotalol HCl spironolactone spironolactone/HCTZ telmisartan telmisartan/amlodipine telmisartan/HCTZ terazosin HCl timolol maleate torsemide trandolapril trandolapril/verapamil triamterene HCl valsartan valsartan HCTZ Vecamyl-mecamylamine HCl verapamil Vaseretic (PA,ST) Vasotec (PA,ST) Verelan Zestoretic (PA,ST) Zestril (PA,ST) other amiodarone amiodarone HCl disopyramide flecainide isosorbide dinitrate isosorbide mononitrate nitroglycerin propafenone SR Multaq Nitrolingual spray Tikosyn Lanoxin Nitromist Ranexa (ST) Rythmol SR Samsca
Cholesterol lowerING atorvastatin choline colestipol fenofibrate fenofibric acid fluvastatin gemfibrozil lovastatin niacin
omega-3 acid ethyl esters pravastatin simvastatin Crestor Lescol XL Simcor Welchol Zetia Advicor Altoprev (PA,ST) Antara Caduet Colestid Fenoglide Juxtapid (PA) Kynamro (PA) Lescol Liptruzet (PA,ST) Livalo (PA,ST) Lofibra Lovaza Mevacor (PA,ST) Niaspan Pravachol (PA,ST) TriCor Trilipix Vascepa (ST) Vytorin (PA,ST) Zocor (PA,ST) depressIoN amitriptyline bupropion bupropion SR citalopram desipramine duloxetine HCl escitalopram fluoxetine fluvoxamine imipramine mirtazapine nortriptyline paroxetine paroxetine CR protriptyline sertraline trazodone venlafaxine venlafaxine XR
Pristiq ER Aplenzin (PA,ST) Brintellix (PA,ST) Celexa (PA,ST) Desvenlafaxine ER (PA,ST) Desvenlafaxine Fumarate ER (PA,ST) Effexor XR (PA,ST) Emsam Fetzima (PA,ST) Forfivo XL (PA,ST) Irenka (PA,ST) Khedezla (PA,ST) Luvox CR Marplan Oleptro ER (ST) Paxil (PA,ST) Paxil CR (PA,ST) Prozac / Prozac Weekly
(PA,ST) Remeron Sarafem (PA,ST) Tofranil Venlafaxine HCl ER (PA,ST) Viibryd (PA,ST) Vivactil Wellbutrin (PA,ST) Wellbutrin SR (PA,ST) Zoloft (PA,ST) dIABetes acarbose chlorpropamide glimepiride glipizide glipizide/metformin glyburide glyburide micronized glyburide/metformin metformin ER metformin HCl nateglinide pioglitazone pioglitazone HCl pioglitazone/ glimepiride pioglitazone/metformin repaglinide tolazamide tolbutamide BD Insulin Syringes/ Pen Needles GlucaGen HypoKit (QL) Glucagon Emergency Kit (QL) Humalog Humulin Invokamet Invokana Janumet Janumet XR Januvia Kombiglyze XR Lantus Lantus SoloStar Levemir NovoFine/NovoTwist needles Novolin Novolog
OneTouch test strips Onglyza Prandimet SymlinPen Trulicity (QL) Victoza (QL) Avandamet Avandia Bydureon (QL) Byetta Cycloset Duetact Farxiga (ST) Fortamet Glucophage XR Glyset Jardiance (ST) Prandin Precose Starlix Tanzeum (QL,ST) VGo Xigduo XR (ST)
eNdoCrINe ANd MetABolIC
allopurinol cabergoline (QL) desmopressin megestrol acetate octreotide (PA) Colcrys Increlex (PA)
Lupron Depot-PED (PA) Megace ES
Nilandron
Sandostatin LAR (PA) Somavert (PA) Synarel Uloric colchicine Egrifta (PA) Megace Mitigare Sandostatin (PA) Signifor LAR (PA) Signifor (PA)
GENERICS PREFERRED BRANDS NON-PREFERRED BRANDS eye CoNdItIoNs apraclonidine HCl atropine azelastine bimatoprost brimonidine bromfenac ciprofloxacin diclofenac dorzolamide dorzolamide/timolol epinastine flurbiprofen gatifloxacin ketorolac latanoprost levofloxacin pilocarpine timolol tobramycin/ dexamethasone trifluridine Alomide Alphagan P 0.10% AzaSite Azopt Betoptic S Ciloxan (ointment) Iopidine
Lotemax (drops & gel) Maxidex Moxeza Pataday Patanol Restasis Tobradex (ointment) Travatan Z Vexol Vigamox Acular LS Acuvail Alocril Alrex Bepreve Besivance Ciloxan (drops) Cosopt Cystaran Durezol Elestat Emadine Ilevro Lastacaft Lotemax (oint) Optivar Pazeo Rescula Simbrinza (ST) Timoptic Tobradex (drops) Tobradex ST Tobrex Trusopt Voltaren Xalatan Zioptan (ST)
GAstroINtestINAl (Not heArtBurN/ulCer)
alosetron balsalazide belladonna alkaloids/ phenobarbital budesonide cromolyn sodium (solution) dexamethasone metoclopramide HCl PEG 3350/potassium/ sodium bicarb/salt PEG 3350/potassium/ sodium bicarb/salt/ sodium sulf PEG-Prep prednisone prednisone sodium phosphate Apriso Asacol HD Canasa Creon Delzicol GoLytely Humira (PA) Lialda Pentasa Suprep Urso/Urso Forte Zenpep Amitiza Cholbam (PA) Cimzia (PA) Colazal Colyte Donnatal Entocort EC Giazo Movantik (PA) NuLytely Pancreaze Pertzye Prepopik Relistor (PA) Remicade (PA) sfRowasa Simponi (PA) Sucraid Uceris Ultresa Viokace Growth horMoNes Humatrope (PA) Saizen (PA) Serostim (PA)
GENERICS PREFERRED BRANDS NON-PREFERRED BRANDS heArtBurN/ulCer cimetidine esomeprazole magnesium famotidine lansoprazole lansoprazole/ amoxicillin/ clarithromycin metoclopramide misoprostol nizatidine omeprazole omeprazole/sodium bicarbonate pantoprazole rabeprazole HCl ranitidine sucralfate Dexilant Prevpac Aciphex (PA,ST) Aciphex Sprinkle (PA,ST) Nexium (PA,ST) Omeclamox-Pak Prevacid (PA,ST) Prilosec (PA,ST) Protonix (PA,ST) Zantac Syrup Zegerid (PA,ST) horMoNe replACeMeNt Androxy-fluoxymesterone estradiol estropipate ethinyl estradiol levothroid levothyroxine levothyroxine sodium Levoxyl liothyronine medroxyprogesterone medroxyprogesterone acetate norethindrone-ethinyl estradiol progesterone, micronized testosterone cypionate (PA) testosterone enanthate (PA) testosterone gel (QL) thyroid Unithroid Alora Anadrol-50 (PA) Androderm (QL) AndroGel (QL) Armour Thyroid Divigel Enjuvia Premarin Premphase Prempro Synthroid Vivelle-Dot Activella Cenestin Combipatch Cytomel Delatestryl Depot Testosterone Estrace Femhrt Femring Menest Minivelle Prefest Prometrium Provera Striant (QL) Vagifem
INFeCtIoNs acyclovir adefovir dipivoxil amantadine amoxicillin/clavulanate amoxicillin/ER atovaquone azithromycin bacitracin/polymyxin besifloxacin HCl cefaclor ER cefadroxil cefdinir cefditoren cefixime cefprozil ceftibuten dihydrate ceftriaxone cefuroxime axetil cephalexin ciclopirox ciprofloxacin clarithromycin clindamycin clindamycin phosphate cycloserine doxycycline doxycycline hyclate doxycycline monohydrate entacavir erythromycin famciclovir fluconazole (QL for 150 mg only) flucytosine ganciclovir gentamicin gentamicin sulfate griseofulvin itraconazole (QL) ketoconazole lamivudine levofloxacin (susp) linezolid metronidazole minocycline minocycline HCl Moderiba moxifloxacin HCl mupirocin nitrofurantoin nystatin ofloxacin penicillin v potassium Baraclude Cipro HC Otic Ciprodex Epivir HBV Gris-Peg Hepsera Intron A (PA) Mycostatin (tab) Pegasys (PA) PegIntron (PA) Primsol Qualaquin Ribapak Ribasphere Tamiflu (QL) Valcyte Vancocin HCl Ancobon Augmentin Augmentin ES 600 Augmentin XR Avelox Bethkis Biaxin Biaxin XL Cetraxal Ciclodan Cipro XR CNL 8 Coartem (QL) Copegus
Cresemba capsule (PA) Dificid (PA) Ery-Tab Famvir Flagyl ER Garamycin Grifulvin V Keflex Kitabis Pak Lamisil Levaquin Malarone (PA) Monurol Moxatag Noxafil Olysio (PA) Onmel (QL,ST) Penlac Priftin Rebetol Relenza (QL) Rocephin Sirturo Sitavig Sivextro (PA) Spectracef Sporanox Suprax Tobi/Tobi PodHaler Tyzeka Urelle Uribel UTA Valtrex Vfend (PA) Zithromax Zovirax Zyclara (ST) Zyvox (PA) INFeCtIoNs (continued) polymixin b sulf quinine sulfate ribavirin rifabutin rimantadine sulfamethoxazole/ trimethoprim terbinafine (QL) terconazole tetracycline tobramycin valacyclovir valganciclovir vancomycin vancomycin HCl voriconazole (QL) MIGrAINe acetaminophen/ caffeine/butalbital almotriptan malate (QL) dihydroergotamine mesylate (QL) isomethepten/caf/ acetaminophen naratriptan (QL) rizatriptan (QL) rizatriptan benzoate (QL) sumatriptan (QL) sumatriptan succinate (QL) zolmitriptan (QL) Cafergot
Treximet (QL) Alsuma (QL)Amerge (QL) Axert (QL) DHE 45 (QL) Frova (QL) Imitrex (QL) Maxalt (QL) Maxalt MLT (QL) Migranal (QL) Relpax (QL) Sumavel DosePro (QL) Zomig nasal (QL) Zomig/Zomig ZMT (QL) MultIple sClerosIs Glatopa-glatiramer
acetate Ampyra (PA)Avonex (PA) Avonex Pen (PA) Copaxone (PA) Rebif (PA)
Rebif Rebidose (PA) Tecfidera (PA)
Aubagio (PA) Extavia (PA) Gilenya (PA) Plegridy (PA)
NAuseA ANd voMItING
dronabinol granisetron ondansetron prochlorperazine promethazine trimethobenzamide Emend (QL) Akynzeo (QL) Anzemet (inj) (QL) Anzemet (tab) (QL) Diclegis Marinol Sancuso (QL) Zofran (tabs, sol) Zuplenz (QL,ST)
GENERICS PREFERRED BRANDS NON-PREFERRED BRANDS osteoporosIs alendronate etidronate (Fortical) calcitonin-salmon ibandronate raloxifene HCl risedronate Forteo Miacalcin Actonel (PA,ST) Atelvia (PA,ST) Binosto (PA,ST) Boniva (PA,ST) Didronel Evista Fosamax (PA,ST) Fosamax Plus D (PA,ST) Skelid (PA,ST)
pAIN relIeF ANd INFlAMMAtory dIseAse
buprenorphine butalbit/acetamin/caff/ codeine butalbital/ acetaminophen butorphanol nasal (QL) celecoxib (QL) codeine phos/ carisoprodol/asa codeine phosphate codeine phosphate/ aspirin codeine sulfate diclofenac dihy-cod tt/apap/ caffeine dihydroergotamine mesylate (QL) doxorubicin HCl etodolac fenoprofen fentanyl citrate
(lozenge on stick) (PA) fentanyl transdermal (QL) flurbiprofen hydrocodone bitartrate/ apap hydromorphone HCl ibuprofen ibuprofen/hydrocodone bit indomethacin ketoprofen ketorolac (QL) leflunomide levorphanol tartrate lidocaine meclofenamate mefenamic acid meloxicam meperidine HCl methotrexate migergot Actimmune (PA) Dilaudid-5 Dipentum Enbrel (PA) Fentora (PA) Humira (PA) Indocin (suppository) Lidorx Lyrica Nucynta (QL) Nucynta ER (QL) OxyContin (QL) Rheumatrex Roxicet Savella Trexall Abstral (PA) Actemra (PA) Actiq (PA) Adazin Anaprox (PA,ST) Ansaid (PA,ST) Arthrotec (PA,ST) Avinza (QL) Butrans (QL) Cambia (PA,ST) Capacet Celebrex (QL,ST) Cimzia (PA) Conzip (QL) Daypro (PA,ST) Demerol Dilaudid Durabec Duragesic (QL) Embeda (QL) Exalgo (QL) Feldene (PA,ST) Fioricet Flector (PA,ST,QL) Horizant (ST) Hycet Hysingla ER (QL) Kadian (QL) Kineret (PA) Lazanda (PA) Lidoderm Lidopin Lidovex Mobic (PA,ST) MS Contin (QL) Nalfon (PA,ST) Naprelan (PA,ST) Naprosyn/ EC Naprosyn (PA,ST) Norco Onsolis (PA) Opana Opana ER (QL)
GENERICS PREFERRED BRANDS NON-PREFERRED BRANDS pAIN relIeF ANd INFlAMMAtory dIseAse
(continued) morphine sulfate (QL) nabumetone naproxen opium opium/belladonna alkaloids orphenadrine/aspirin/ caffeine oxaprozin oxycodone ER (QL) oxycodone HCl oxycodone HCl/ acetaminophen oxycodone/aspirin oxymorphone oxymorphone HC pentazocine HCl/ naloxone HCl rizatriptan benzoate (QL) sulindac tolmetin tramadol ER (QL) tramadol HCl (QL) tramadol HCl/ acetaminophen (QL) zolmitriptan (QL) Otrexup (PA) Oxecta Pain Relief Pennsaid (PA,ST) Percocet Percodan Ponstel (PA,ST) Prodrin Rasuvo (PA) Rayos (ST) Relyyks Relyyt Remicade (PA) Roxicodone Scar Silvera Simponi (PA) Skelaxin Solaice Sprix (QL) Subsys (PA) Synalgos-DC Synvexia TC Tivorbex (PA,ST) Trezix Ultracet (QL) Ultram (QL) Ultram ER (QL) Velma
Vicodin/ Vicodin ES/ Vicodin HP Vicoprofen Voltaren Gel (PA,ST) Voltaren/ Voltaren XR (PA,ST) Xartemis XR (QL) Xodol Zipsor (PA,ST) Zohydro ER (QL) Zomig (QL) Zorvolex (PA,ST)
pArKINsoN’s dIseAse amantadine benztropine bromocriptine carbidopa/levodopa/ entacapone carbidopa carbidopa/levodopa carbidopa/levodopa CR entacapone pramipexole pramipexole ER ropinirole ropinirole XL selegiline tolcapone Apokyn (PA) Azilect Comtan Eldepryl Lodosyn Mirapex Mirapex ER Neupro Northera (PA) Parcopa Requip Requip XL Rytary Sinemet CR Stalevo Tasmar Zelapar prostAte
* Please check your enrollment materials to determine whether this medication is covered under your plan.
alfuzosin doxazosin finasteride
leuprolide acetate (PA) prazosin tamsulosin terazosin Avodart Cialis (PA,QL)* Jalyn
Lupron Depot (PA)
Firmagon (PA) Flomax Proscar Rapaflo Uroxatral Xtandi (PA) Zoladex (PA) Zytiga (PA) sChIzophreNIA aripiprazole clozapine haloperidol loxapine olanzapine olanzapine/fluoxetine HCl quetiapine risperidone thiothixene ziprasidone Seroquel XR Abilify Abilify Discmelt Clozaril (PA,ST) Fanapt (PA,ST) Fazaclo (PA,ST) Geodon (PA,ST) Invega (PA,ST) Latuda (PA,ST) Orap Rexulti (PA,ST) Risperdal/ Risperdal M (PA,ST) Saphris (PA,ST) Seroquel (PA,ST) Symbyax Versacloz (PA,ST) Zyprexa (PA,ST) Zyprexa Zydis (PA,ST)
seIzure carbamazepine clonazepam diazepam divalproex ethosuximide felbamate gabapentin lamotrigine levetiracetam oxcarbazepine phenobarbital phenytoin tiagabine HCl topiramate valproate sodium zonisamide Celontin Diastat Diastat Acudial Dilantin (30 mg only) Felbatol Gabitril Keppra Lamictal ODT Lyrica Peganone Vimpat Aptiom Banzel Carbatrol
Depakote (all forms) Dilantin Fycompa Keppra XR Lamictal Lamictal XR Neurontin Oxtellar XR Potiga Qudexy XR Stavzor Tegretol XR Topamax topiramate XR caps Trileptal Trokendi XR Zarontin Zonegran sexuAl dysFuNCtIoN
* Please check your enrollment materials to determine whether this medication is covered under your plan.
Cialis (PA,QL)* Muse (PA, QL)* Viagra (PA, QL)* Caverject (PA, QL)* Edex (PA, QL)* Levitra (PA, QL)* Osphena Staxyn (PA, QL)* Stendra (PA,QL)* sKIN CoNdItIoNs adapalene (AGE) alclometasone dipropionate amcinonide Amnesteem (QL) Apexicon E (diflorasone diacetate) cream benzoyl peroxide betamethasone betamethasone dipropionate betamethasone dipropionate/ propylene glycol Aczone Ala-Scalp HP (PA,ST) Benzaclin gel pump Benzamycin Pak Capex Shampoo (PA,ST) Carac Carmol HC (PA,ST) Cloderm (PA,ST) Cordran (PA,ST) Cordran SP (PA,ST) Differin (AGE) Enbrel (PA) Exelderm Fluoroplex Absorbica (QL) Acanya Aclovate (PA,ST) Alcortin A Aldara Aqua Glycolic HC (PA,ST) Atralin (AGE) Avar Avar LS Avita Bactroban Benoxyldoxy 30 Carb-O-Philic Clindacin Pac
GENERICS PREFERRED BRANDS NON-PREFERRED BRANDS sKIN CoNdItIoNs (continued)
betamethasone valerate calcipotriene calcipotriene-betamethasone Claravis (QL) clinicamycinphosphate/ benzoyl peroxide gel clobetasol propionate clobetasol propionate/ emoll clocortolone pivalate desonide desoximetasone diclofenac sodium diflorasone diacetate dipropionate fluocinolone acetonide fluocinonide fluocinonide/emollient fluorouracil topical fluticasone propionate halobetasol prop/ ammonium lac halobetasol propionate hydrocortisone hydrocortisone acetate/ aloe vera hydrocortisone acetate/ urea hydrocortisone butyrate hydrocortisone butyrate/emollient hydrocortisone valerate hydrocortisone/ iodoquinol/aloe imiquimod isotretinoin (QL) methoxsalen, rapid metronidazole mometasone furoate mupirocin calcium Myorisan (QL) naftifine podofilox prednicarbate salicylic acid Sotret (QL) sulfacetamide sulfacetamide sodium sulfacetamide sodium/ sulfur sulfacetamide/sulfur/ cleansr23 Humira (PA)
Kenalog aerosol (PA,ST) Klaron
Locoid lotion (PA,ST) Loprox shampoo Metrogel 1% Naftin Noritate Nucort (PA,ST) Tazorac Texacort (PA,ST) Clobex (PA,ST) Clodan (PA,ST) Condylox Cosentyx (PA) Cutivate (PA,ST) Derma-Smoothe/FS (PA,ST) Dermasorb AF Dermasorb HC (PA,ST) Dermasorb TA (PA,ST) Dermasorb XM Dermatop (PA,ST) Desonate (PA,ST) Desowen (PA,ST) Diprolene (PA,ST) Diprolene AF (PA,ST) Dovonex Doxycycline IR-DR Duac Ecoza Elidel (PA,ST) Elocon (PA,ST) Epiduo Fabior First Hydrocortisone (PA,ST) Halog (PA,ST) Iodosorb Jublia (ST) Keralac Kerydin (ST) Locoid cream, ointment, solution (PA,ST) Locoid Lipocream (PA,ST) Luxiq (PA,ST) Luzu Metrogel Metrolotion Neuac Olux (PA,ST) Olux-E (PA,ST) Onexton Otezla (PA) Ovace Plus cream,
foam, lotion and wash Pandel (PA,ST) Panretin Pediaderm HC/TA (PA,ST) Picato Plexion
GENERICS PREFERRED BRANDS NON-PREFERRED BRANDS sKIN CoNdItIoNs (continued)
tacrolimus ointment tretinoin (AGE) triamcinolone acetonide urea Prolensa Protopic (PA,ST) Regranex (PA) Remicade (PA) Retin-A cream (PA,
AGE)
Retin-A Micro (PA, AGE)
Retin-A Micro Pump (PA, AGE) Riax Rosula Scalacort DK (PA,ST) Solaraze Soolantra Soriatane Sorilux Stelara (PA) Sumadan XLT Synalar (PA,ST) Synalar TS (PA,ST) Taclonex Targretin gel Temovate (PA,ST) Topicort (PA,ST) Topicort LP (PA,ST) Tretin-X (PA) Ultrasal-ER Ultravate X (PA,ST) Ultravate/Ultravate PAC (PA,ST) Umecta Urevaz Vanos (PA,ST) Vectical Verdeso (PA,ST) Vytone Westcort (PA,ST) Xolegel Ziana Zyclara (ST) sleep eszopiclone midazolam HCl zaleplon zolpidem zolpidem ER
Silenor Ambien (PA,ST) Ambien CR (PA,ST) Belsomra (PA,ST) Edluar (PA,ST) Intermezzo (PA,ST) Lunesta (PA,ST) Rozerem (PA,ST) Sonata (PA,ST) Zolpimist (PA,ST)
trANsplANt azathioprine cyclosporine mycophenolate moefetil mycophenolate sodium sirolimus tacrolimus Azasan Cellcept Neoral Prograf Rapamune Sandimmune Astagraf XL Imuran Myfortic Zortress vItAMINs*
* All plans cover all generic prescription prenatal vitamins, even though not listed here. Available as generic where ^ is noted.
calcitriol cyanocobalamin folic acid
Active OB^
Bal-Care DHA Essential Cadeau DHA Citranatal Citranatal 90 DHA Citranatal Assure Citranatal B-Calm Citranatal DHA Citranatal Harmony^ Citranatal Rx Enbrace HR Folet DHA Folet One Infanate Balance Natachew Natelle One^ Neevo DHA Nestabs ABC Nestabs DHA^ Nestabs^ Nexa Plus OB Complete OB Complete DHA OB Complete One OB Complete Petite Prefera-OB One Prefera-OB Plus DHA PreferaOB Prenatal Vitamin Prenaissance Next-B Prenata Prenatal 19^ Prenate AM Prenate Chewable Prenate DHA Prenate Elite Prenate Enhance Prenate Essential Prenate Mini Prenate Pixie Prenate Restore Prenate Star Eligen B12 Feriva 21-7 Nascobal MaxFe vItAMINs* (continued)
* All plans cover all generic prescription prenatal vitamins, even though not listed here. Available as generic where ^ is noted.
Provida DHA Provida OB Select-OB Stuartnatal Plus Stuartnatal Plus 3 TL-Folate Tricare
Tricare Prenatal DHA One
Tristart DHA
MIsCellANeous
* Please check your enrollment materials to determine whether this medication is covered under your plan.
acamprostate calcium aminocaproic acid benzonatate buprenorphine cyclobenzaprine doxercalciferol hydrocodone/ chlorpheniramine suspension hydrocortisone ivermectin leucovorin levocarnitine lidocaine HCl/glycerin lidocaine-hydrocortisone-aloe lindane megestrol metaxalone methocarbamol naltrexone naltrexone HCl paricalcitol pentoxifylline pramoxine/ hydrocortisone promethazine-codeine pseudoephed/ hydrocodone/cpm pyridostigmine quinine sulfate riluzole sodium phenylbutarate sodium polystyrene sulfonate spinosad tizanidine tranexamic acid Analpram Advanced Aranesp (PA) Buphenyl Chantix* Epogen (PA) Fosrenol Harvoni (PA) Klor-Con M15 Leukine Metopirone Neupogen Pramosone Procrit (PA) Proctofoam-HC Renvela Sovaldi (PA) SPS Stromectol Suboxone film (PA) TussiCaps Zavesca (PA) Ana-Lex Analpram E Analpram HC Arcalyst (PA) Belviq* Brisdelle (QL) Bunavail (PA) Cerdelga (PA) Cortifoam Cuvposa Epifoam Evzio Feriva FA Ferric citrate Gattex (PA) Hectorol Hetlioz (PA) Ilaris (PA) Jadenu Kalydeco (PA) Kuvan (PA) Lupaneta Pack (PA) Lysteda Mircera (PA) Natpara (PA) Natroba Neo-Synalar Nuedexta Nuvessa Nymalize Obredon Orkambi (PA)
specialty medications
if your prescription drug plan includes exclusive Home Delivery Pharmacy for specialty medications, you’re required to fill certain specialty pharmacy prescriptions through Cigna Specialty Pharmacy ServicesSM.
Depending on your plan, you’re allowed one, two or three fills before you’re required to use Cigna Home Delivery Pharmacy. At that time, if you choose to not use Cigna Home Delivery Pharmacy, your plan will not cover the cost of your medication.
exclusive specialty home delivery pharmacy with Cigna
Medications marked with an asterisk (*) may be covered under your pharmacy or medical benefit, or covered under both benefits, depending on your plan. if you’re getting this medication through a retail pharmacy, you’ll need to switch to Cigna Specialty Pharmacy Services for this medication to be covered. if you’re getting this medication from a health care professional under your medical benefit, you’re not required to use Cigna Specialty Pharmacy Services.
For real-time drug pricing specific to your benefit plan, visit myCigna.com and use the Prescription Drug Price Quote tool to compare prices for your selected
medications. The tool will show you if you can save money by using Cigna Home Delivery Pharmacy. in addition to potential cost savings, Cigna Home Delivery Pharmacy offers valuable benefits, such as:
›
Customer service associates and licensed pharmacists available 24/7›
Free, standard delivery right to your door›
Capabilities to properly handle and ship medications that require refrigeration and/or overnight delivery›
Coordination of copay assistance programs with drug manufacturers›
Connection and referrals to Cigna’s health coaching servicesto get started with Cigna home delivery pharmacy today, call 1.800.351.3606.
The following is a list of specialty medications that apply to your exclusive Cigna Home Delivery Pharmacy plan. Please check your enrollment materials for more information on how your plan works, the medications covered under your plan and to see if there are any requirements such as prior authorization (PA) or quantity limits (QL). Some exceptions may apply. Please note, this list is subject to change.
GENERICS PREFERRED BRANDS NON-PREFERRED BRANDS MIsCellANeous (continued) Oxandrin (PA) Phoslo Phoslyra Procysbi (PA) Promacta (PA) Ravicti (PA) Rectiv Renagel Revia Revia Rilutek Sklice Tussionex Tuzistra XR Uceris Ulesfia Velphoro Viekira Pak (PA) Virtuz
Zanaflex Zemplar Zubsolv (PA) Zutripro
A
Abacavir Actemra Acthar H.P.* Actimmune Adcirca Adefovir Dipivoxil Advate* Afinitor Afinitor Disperz Agrylin Aldurazyme* Alferon N* Alphanate* Alprolix* Amevive* Amicar Aminocaproic Acid Ampyra Anagrelide Hcl Apokyn Aptivus Aredia* Astagraf Xl Atripla Aubagio Avonex Azasan AzathioprineB
Baraclude Baygam* Bebulin* Benefix* Betaseron Bethkis* Bexarotene Bicalutamide Bivigam* Boniva* Bosulif Botox*C
Capecitabine Casodex Cellcept (Oral) Ceprotin* Cerdelga Cerezyme* Cimzia Combivir Complera Copaxone Copegus Cosentyx Crixivan Cyclophosphamide Cyclosporine Cystadane Cytoxand
Daklinza Didanosine Docefrez* Docetaxel* Dysport*e
edurant egrifta elelyso* eligard* eloctate* emcyt emtriva enbrel entecavir entyvio* epivir epzicom erivedge esbriet etoposide* euflexxa* evotaz exjade extaviaF
Fabrazyme* Feiba Nf* Firazyr Flebogamma Dif* Flutamide Forteo* FuzeonG
Gamastan S-D* Gammagard* Gammagard Liquid* Gammagard S-D* Gammaked* Gamunex* Gel-One* Gengraf Genotropin Gilenya Gleevech
Harvoni Hecoria Helixate Fs* Hemofil M* Hepsera Hexalen Hizentra* Hp Acthar* Humate-P* Humatrope Humira Hyalgan* Hycamtin Hylenex*I
ibandronate* ibrance ilaris* imuran incivek infergen inlyta intelence intron* invirase iprivask* isentress ixinity*J
Jadenu Jevtana*K
Kaletra Kineret Koate-Dvi* Kogenate Fs* Kuvan*l
Lamivudine Lemtrada* LetairisLeucovorin Calcium (Oral) Leuprolide* Lexiva Lupaneta* Lupron*
M
Mekinist Moderiba Monoclate-P* Mononine* Monovisc* Mycophenolate Mycophenolate Mofetil Mycophenolic Acid Mycophenolic Acid Dr MyforticN
Neoral Neulasta* Nevirapine Nexavar Norditropin Norvir Novoeight* Novoseven* Nutropino
Octagam* Octreotide Acetate* Oforta Olysio Omnitrope Omontys* OpsumitOrencia Orthovisc* Otezla
p
Pamidronate* Panretin* Paricalcitol (Oral) Pegasys Pegasys Proclick Pegintron Pegintron Redipen Plegridy Pomalyst Prezcobix Prezista Privigen* Profilnine Sd* Prograf Promacta Pulmozymer
Rapamune Rebetol Rebif Rebif Rebidose Reclast* Recombinate* Remicade* Rescriptor Retrovir (Oral) Revatio Revlimid Reyataz Ribapak Ribasphere Ribatab Ribavirin Rilutek Riluzole Rixubis*s
Saizen Sandimmune (Oral) Sandostatin* Selzentry Serostim Sildenafil Simponi Sirolimus Sovaldi Sprycel Stavudine Stelara Stivarga Stribild Supartz* Supprelin* Sustiva Sutent Sylatron Synagis* Synarel* Synvisc*t
Tacrolimus Tafinlar Tarceva Targretin Tasigna Taxotere* Tecfidera Temodar (Oral) Temozolomide Tev-Tropin Thalomid Tivicay Tobi* Tobramycin* Topotecan* Tracleer Trelstar* Trexall Triumeq Trizivir Truvada Tybost Tykerb Tysabri* Tyzekav
vepesid* victrelis videx videx ec viekira viracept viramune virazole viread vitekta vivitrol* votrient vpriv*w
Wilate* Winrho Sdf*x
Xalkori Xeljanz Xeloda Xeomin* Xiaflex* Xolair Xtandi Xyntha* Xyntha Solofuse*z
Zelboraf Zemplar (Oral) Zerit Ziagen Zidovudine Zoladex* Zoledronic Acid* Zometa* Zortress Zykadia Zytiga1. Any medications available over-the-counter (OTC) that do not require a prescription by federal or state law, and any medication that is a pharmaceutical alternative to an OTC medication other than insulin [examples include OTC Benadryl, Maalox, Sudafed Pe, etc.].
2. Medications that are therapeutically equivalent as determined by the Cigna HealthCare Pharmacy and Therapeutics Committee in which at least one of the medications within the class is available over the counter [examples include Rx equivalents to OTC Allegra, Claritin and Zyrtec (Allegra D, Clarinex, Xyzal) and Rx equivalents to OTC Prevacid, Prilosec and Zantac (Aciphex, Kapidex, Nexium, Axid, Pepcid, Zantac)].
3. Any injectable infertility medications, and any injectable medications that require health care professional supervision and are not typically considered self-administered medications. The following are examples of health care professional-supervised medications: injectables used to treat hemophilia and RSv (respiratory syncytial virus), chemotherapy injectables and endocrine and metabolic agents.
4. Any medications that are experimental or
investigational within the meaning set forth in the summary plan description.
5. Food and Drug Administration (FDA) approved medications used for purposes other than those approved by the FDA unless the medication is recognized for the treatment of the particular indication in one of the standard reference
compendia (The United States Pharmacopoeia Drug information or The American Hospital Formulary Service Drug information) or in medical literature. Medical literature means scientific studies published in a peer-reviewed national professional medical journal.
6. Any prescription and non-prescription supplies (such as ostomy supplies), devices and appliances.
7. Any contraceptive medications and prescription appliances for contraception.
8. implantable contraceptive products. 9. Any fertility medication.
10. Any medications used for treatment of sexual dysfunction, including but not limited to erectile dysfunction, delayed ejaculation, anorgasmia and decreased libido.
11. Any prescription vitamins (other than prenatal vitamins), dietary supplements and fluoride products. 12. Medications used for cosmetic purposes, such as
medications used to reduce wrinkles, medications to promote hair growth, medications used to control perspiration and fade cream products.
13. Any diet pills or appetite suppressants (anorectics). 14. Prescription smoking cessation products.
15. immunization agents, biological products for allergy immunization, biological sera, blood, blood plasma and other blood products or fractions and
medications used for travel prophylaxis (the prevention of
travel-related diseases).
16. Replacement of prescription medications and related supplies due to loss or theft.
17. Medications used to enhance athletic performance. 18. Medications that are to be taken by, or administered
to, a customer while the customer is a patient in a licensed hospital, skilled nursing facility, rest home or similar institution which operates on its premises, or allows to be operated on its premises, a facility for dispensing pharmaceuticals.
19. Prescriptions more than one year from the original date of issue.Preventive prescription drug option Preventive medications are described as medications that are used to prevent a disease or condition in people with risk factors such as: high blood pressure, high cholesterol, diabetes, asthma, osteoporosis, heart attack and stroke, or to prevent the recurrence of the disease or condition in people who have recovered.
Preventive medications do not include drugs used to treat an existing illness, injury or condition. Some pharmacy plans require you to pay a certain amount (deductible) before the plan coverage begins, but preventive medications may be covered before you reach that amount. To be sure, you can read your enrollment materials to see how preventive medications are covered specific to your plan. Also, a list of all covered preventive medications is available on myCigna.com. Preventive medications are identified by a “PM” symbol within the drug list search.
Plans typically do not provide coverage for the following, except as required by law or by the terms of your specific plan:
AsthMA relAted
Accolate (zafirlukast) Accuneb (albuterol sulfate) Advair Diskus
Advair HFA Aerobid-M
albuterol sulfate inhalation solution, syrup, tablet Alvesco
aminophylline Arcapta Neohaler Asmanex
Atrovent inhalation solution (ipratropium bromide) Atrovent HFA
Breo Ellipta Broncomar-1 Brovana
Cafcit (caffeine citrate) cromolyn sodium Difil-G (guaifenesin/dyphylline) Dilex-G 200 Dilex-G 400 (guaifenesin/ dyphylline) Dulera Elixophylline (theophylline anhydrous) Elixophylline Sr (theophylline anhydrous) Flovent Flovent Diskus Flovent HFA Foradil guaifenesin/dyphylline ipratropium bromide Lufyllin (dyphylline) Lufyllin-400 Lufyllin-GG (guaifenesin/ dyphylline) metaproterenol sulfate Perforomist ProAir HFA Proventil HFA Pulmicort inhaler
Pulmicort inhalation solution (budesonide) Qvar S-2 Racepinephine Serevent Serevent Diskus Singulair (montelukast) Spiriva Symbicort terbutaline sulfate Theo-24 Theochron (theophylline anhydrous) Lotensin HCT (benazepril HCl/ HCTZ)
Lotrel (amlodipine besylate/ benazepril) Matzim LA (diltiazem) Mavik (trandolapril) Maxzide (triamterene/HCTZ) mecamylamine hcl methyclothiazide methyldopa methyldopa/hydrochlorothiazide metoprolol tartrate Micardis Micardis HCT Microzide (hydrochlorothiazide) Midamor (amiloride HCl) Minipress (prazosin HCl) Minizide (prazosin/polythiazide) minoxidil Moduretic (hydrochlorothiazide/ amilor hcl) Naturetin-5 Neptazane (methazolamide) Nexiclon XR nifedipine Nimotop (nimodipine) nisoldipine Normodyne (labetalol HCl) Norvasc (amlodipine besylate) Nymalize pindolol Prinivil (lisinopril) Prinzide (lisinopril/ hydrochlorothiazide) Procardia (nifedipine) Procardia XL (nifedipine) propranolol propranolol/HCTZ reserpine Saluron (hydroflumethiazide) Salutensin Demi (reserpine/
hydrochlorothiazide) Sectral (acebutolol HCl) Sular (nisoldipine) Tarka Tekamlo Tekturna Tekturna HCT Tenex (guanfacine HCl) Tenoretic 50 (chlorthalidone/ atenolol) Tenoretic 100 (chlorthalidone/ atenolol) Tenormin (atenolol) terazosin HCl
Teveten (eprosartan mesylate) Theo-Dur (theophylline
anhydrous)
theophylline anhydrous Tudorza
Uniphyl (theophylline anhydrous) Ventolin HFA
Vospire ER (albuterol sulfate) Xolair*
Xopenex inhalation solution (levalbuterol HCl) Xopenex HFA Zyflo Zyflo CR Blood pressure relAted Accupril (quinapril) Accuretic (quinapril HCl/HCTZ) Aceon (perindopril erbumine) acetazolamide Adalat CC (nifedipine) Aldactazide (spironolactone/ HCTZ) Aldactone (spironolactone) Aldomet (methyldopa) Altace (ramipril) Amturnide Apresoline-hydralazine HCl Atacand (candesartan cilexetil) Atacand HCT Avalide (irbesartan/ HCTZ) Avapro (irbesartan) Azor benazepril HCl benazepril HCl-HCTZ Benicar Benicar HCT Betapace (sotalol HCl) Betapace AF (sotalol HCl) Bumex (bumetanide) Bystolic Caduet (amlodipine/atorvastatin) Calan (verapamil) Calan SR (verapamil) Capozide (captopril/ hydrochlorothiazide) captopril Cardene (nicardipine HCl) Cardene SR Cardizem (diltiazem) Cardizem CD (diltiazem) Cardizem LA (diltiazem HCl) Cardura (doxazosin mesylate) Cardura XL Catapres (clonidine HCl) Catapres-TTS 1 (clonidine HCl) Catapres-TTS 2 (clonidine HCl) Catapres-TTS 3 (clonidine HCl) chlorthalidone Clorpres (clonidine HCl/ chlorthalidone) Coreg (carvedilol) Coreg CR Corgard (nadolol) Corzide (bendroflumethiazide/ nadolol) Covera-HS
Cozaar (losartan potassium) Demadex (torsemide) Demser
Diamox (acetazolamide) Diamox Sequels (acetazolamide) dibenzyline Dilacor XR (diltiazem) diltiazem HCl Diovan (valsartan) Diovan HCT (valsartan/HCTZ) Diuril (chlorothiazide) Dutoprol Dyazide (triamterene/HCTZ) Dynacirc CR Dyrenium Edarbi Edarbychlor Edecrin Eliquis Epaned Exforge Exforge HCT felodipine fosinopril sodium furosemide hydralazine HCl hydrochlorothiazide hydrochlorothiazide/reserpine Hydrodiuril (hydrochlorothiazide) Hygroton (chlorthalidone) Hytrin (terazosin HCl) Hyzaar (losartan/ hydrochlorothiazide) indapamide Inderal (propranolol HCl) Inderal LA (propranolol HCl) Innopran XL Inspra (eplerenone) isradipine Kerlone (betaxolol HCl) Lasix (furosemide) Levatol Liptruzet
Lopressor (metoprolol tartrate) Lopressor HCT (metoprolol/HCTZ) Lotensin (benazepril HCl)
Citranatal Assure^ Citranatal B-Calm Citranatal Harmony^ Duet DHA
Duet DHA Balanced^ Duet DHA EC Gesticare DHA Infanate Balance Natachew Natafort Neevo Neevo DHA Nestabs Nestabs ABC Nestabs DHA^ Nexa Plus OB Complete OB Complete DHA OB Complete One OB Complete Petite OB Complete Premier PNV Folic Acid-Iron PNV-DHA Plus Precare Premier Prefera-OB One
PreferaOB Prenatal Vitamin Prenata Prenatal 19 Prenate AM Prenate Chewable Prenate DHA Prenate Elite Prenate Enhance Prenate Mini Prenate Plus Prenate Restore Provida OB Stuart Prenatal Stuartnatal Plus Stuartnatal Plus 3 TL-Select DHA Tricare
Tricare Prenatal Compleat Tricare Prenatal DHA One^ Vinate Care Vita Fol-OB DH Vitafol Ultra VIVA CT Viva DHA VP-PNV-DHA Janumet Janumet XR Januvia Jentadueto Kazano Kombiglyze XR Lantus Lantus SoloStar Levemir Metaglip (glipizide/metformin HCl) Nesina Novolin 70/30 Novolin 70/30 Innolet Novolin N Novolin R Novolog Novolog Mix 70/30 Onglyza Oseni Prandimet Prandin (repaglinide) Precose (acarbose) Riomet Starlix (nateglinide) Symlin SymlinPen 60 SymlinPen 120 tolazamide tolbutamide Tradjenta Victoza osteoporosIs relAted Actonel Aredia Atelvia Binosoto
Boniva (ibandronate sodium) Didronel (etidronate disodium) Evista
Forteo*
Fosamax (alendronate sodium) Fosamax Plus D Fortical (calcitonin-salmon) Miacalcin (calcitonin-salmon) Reclast Skelid Prenatal Vitamins
ALL PRESCRIPTION STRENGTH PRENATAL VITAMINS QUALIFY AS PREVENTIVE MEDICATIONS.
(Available as generic where ^ is noted.)
Active OB
Bal-Care DHA Essential Citranatal
Lopid (gemfibrozil) Lovaza
Mevacor (lovastatin) Niacor
Niaspan (niacin ER)
Pravachol (pravastatin sodium) Questran (cholestyramine) Questran Light (cholestyamine
aspartame) Simcor Tricor
Tricor (fenofibrate, micronized) Triglide (fenofibrate)
Trilipix (fenofibric acid) Vytorin
Welchol Zetia
Zocor (simvastatin)
dIABetes relAted
Actoplus Met (pioglitazone/ metformin) Actoplus Met XR Actos (pioglitazone) Amaryl (glimepiride) Apidra Apidra SoloStar Avandamet Avandaryl Avandia Bydureon Byetta chlorpropamide Cycloset Diabeta (glyburide) Duetact (pioglitazone/glimiperide) Fortamet (metformin) glipizide/metformin Glucophage (metformin HCl) Glucophage XR (metformin HCl) Glucotrol (glipizide)
Glucotrol XL (glipizide ER) Glucovance (glyburide/metformin) Glumetza
Glynase (glyburide micronized) Glyset Humalog Humalog Mix 50/50 Humalog Mix 75/25 Humulin 50/50 Humulin 70/30 Humulin L Humulin N Humulin R Humulin U Invokana Teveten HCT Tiazac (diltiazem) timolol maleate
Toprol XL (metoprolol succinate) Trandate (labetalol HCl) triamterene/HCTZ Tribenzor Twynsta Uniretic (moexipril HCl/HCTZ) Univasc (moexipril HCl)
Vaseretic (enalapril maleate/HCTZ) Vasotec (enalapril maleate) Vecamyl (mecamylamine hcl) Verelan (verapamil)
Verelan PM (verapamil) Xarelto (15 and 20 MG only) Zaroxolyn (metolazone) Zebeta (bisoprolol fumarate) Zestoretic (lisinopril/ hydrochlorothiazide) Zestril (lisinopril) Ziac (bisoprolol/HCTZ) Blood thINNer Aggrenox Brilinta Coumadin (warfarin) Effient Eliquis Jantoven (warfarin) Persantine (dipyridamole) Plavix (clopidogrel) Pletal (cilostazol) Pradaxa Ticlid (ticlopidine HCl) Xarelto Cholesterol relAted Advicor Altoprev
Antara (fenofibrate, micronized) Caduet (amlodipine/atorvastatin calcium) cholestyramine Colestid (colestipol) Crestor Fenoglide
Fibricor (fenofibric acid) Lescol (fluvastatin) Lescol XL (fluvastatin XL) Lipitor (atorvastatin) Lipofen Liptruzet Livalo
Lofibra (fenofibrate, non-micronized)
Get 24/7/365 access to a doctor with MdlIve*
Now there’s a way to see a doctor whenever and wherever you need one. it’s called MDLive, and it’s available to you through your Cigna plan. MDLive connects you to a Board Certified doctor by phone or online video chat.
how it works
it’s easy to connect with an MDLive doctor:
›
Acne›
Allergies›
Bronchitis›
Cold and flu›
Fever›
Gout›
Headache›
infections›
Joint aches and pains›
Nausea and vomiting›
Pink eye›
Rashes›
Sinus infection›
Sore throat›
Sunburn›
Urinary tract infection›
Child medical conditions – Cold and flu– Constipation – ear infection – Fever
– Nausea and vomiting – Pink eye
when to use it
MDLive is available 24 hours a day, seven days a week, 365 days a year to conveniently help you find treatment for minor, non-emergency conditions. You can use it anytime, from anywhere. All you need is a phone or computer with webcam.
Use MDLive to talk to a doctor about: 1. Call 888.726.3171
2. Speak to a coordinator to find a doctor who meets your needs
3. Talk to the doctor
1. Go to
2. Find a doctor who meets your needs
3. video chat with the doctor
You can also download the MDLive App for an easier and more convenient way to visit with a doctor.
A doCtor
Is AlwAys IN
Be prepared and activate your account before you are sick.
OFFERED THROUGH
An MDLive doctor will give you a diagnosis. The doctor can even prescribe medications if needed.
This service and the MDLIVE website is provided exclusively by MDLIVE and not by Cigna. MDLIVE doctors are independent practitioners solely responsible for the treatment provided to their patients. They are not agents of Cigna.
mdlive.com/consumer/terms.html
All Cigna products and services are provided exclusively by or through operating subsidiaries of Cigna Corporation, including Cigna Health and Life Insurance Company, Connecticut General Life Insurance Company, Cigna Behavioral Health, Inc., and HMO or service company subsidiaries of Cigna Health Corporation. The Cigna name, logo, and other Cigna marks are owned by Cigna Intellectual Property, Inc.
Apple and the Apple logo are trademarks of Apple Inc., registered in the U.S. and other countries. App Store is a service mark of Apple Inc. | Android and Google Play are trademarks of Google Inc. *The downloading and use of the myCigna Mobile App is subject to the terms and conditions of the App and the online stores from which it is downloaded. Standard mobile phone carrier and data usage charges apply.
“Cigna” and the “Tree of Life” logo are registered service marks, and “Together, all the way.” and “Cigna Home Delivery Pharmacy” are 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 and not by Cigna Corporation. Such operating subsidiaries include Cigna Health and Life Insurance Company (CHLIC), Connecticut General Life Insurance Company (CGLIC), Tel-Drug, Inc., Tel-Drug of Pennsylvania, L.L.C., and HMO subsidiaries of Cigna Health Corporation, including Cigna HealthCare of Arizona, Inc., Cigna HealthCare of California, Inc., Cigna HealthCare of Colorado, Inc., Cigna HealthCare of Connecticut, Inc., Cigna HealthCare of Florida, Inc., Cigna HealthCare of Georgia, Inc., Cigna HealthCare of Illinois, Inc. (IL & IN), Cigna HealthCare of Indiana, Inc., Cigna HealthCare of St. Louis, Inc. (MO, KS & IL), Cigna HealthCare of North Carolina, Inc., Cigna HealthCare of New Jersey, Inc., Cigna HealthCare of South Carolina, Inc., Cigna HealthCare of Tennessee, Inc. (TN & MS), and Cigna HealthCare of Texas, Inc. “Cigna Home Delivery Pharmacy” refers to Tel-Drug, Inc. and Tel-Drug of Pennsylvania, L.L.C. OK Policy Forms: GM6000 C1 et al (CGLIC); HP-APP-1 et al (CHLIC).
MAKe MyCIGNA your
persoNAl heAlth plACe
enjoy a simple way to personalize, organize and access your important plan information.
›
Manage and track claims›
view iD card information›
Find doctors and compare cost and quality ratings›
review your coverage›
track your account balances and deductibles›
refill your prescription drugs online and check order status with Cigna Home Delivery PharmacySMregister on myCigna.
once you do, you can log in anytime, anywhere to:
register today! visit myCigna.com or download the myCigna Mobile App*.
Go to myCigna.com to go paperless!
After you register, you can set up paperless communications. Just log in to myCigna.com and select “Go Paperless”.Life can be busy and complicated. So, we created a simple-to-use tool that can help make your life easier (and healthier) while you’re on the go. The myCigna Mobile App helps you personalize, organize and access your important plan information on your phone or tablet. The app has a new look and feel and it’s
available in Spanish too! Use the myCigna Mobile App, to log in anytime, anywhere to:
Offered by: Cigna Health and Life Insurance Company, Connecticut General Life Insurance Company or their affiliates. The Apple logo is a trademark of Apple Inc., registered in the U.S. and other countries. App Store is a service mark of Apple Inc. | Google Play is a trademark of of Google Inc. *Available for Cigna Choice Fund® Health Reimbursement Account (HRA) and Flexible Spending Account (FSA) plans.
**Prescription savings opportunities may not be available for some medications.
** * The downloading and use of the myCigna Mobile App is subject to the terms and conditions of the App and the online stores from which it is downloaded. Standard mobile phone carrier and data usage charges apply.
All Cigna products and services are provided exclusively by or through operating subsidiaries of Cigna Corporation, including Cigna Health and Life Insurance Company, Connecticut General Life Insurance Company, Life Insurance Company of North America, Cigna Life Insurance Company of New York, Tel-Drug, Inc., Tel-Drug of Pennsylvania, L.L.C., and HMO or service company subsidiaries of Cigna Health Corporation and Cigna Dental Health, Inc. “Cigna Home Delivery Pharmacy” refers to Tel-Drug, Inc. and Tel-Drug of Pennsylvania, L.L.C. The Cigna name, logo, and other Cigna marks are owned by Cigna Intellectual Property, Inc.
your heAlth hAs
Met Its App
®
Get the myCigna Mobile App and access your
health plan anytime and anywhere you go.
›
Manage and track claims›
view, fax or email iD card information›
Find doctors and compare cost and quality information›
review your coverage›
Track your account balances and deductibles›
submit receipts for reimbursement from your Cigna HRA and/or FSA*›
refill your Cigna Home Delivery PharmacySM prescriptions online and view order history›
view medication costs based on your plan and see lower-cost alternatives**download the myCigna Mobile App for your mobile device.***
disponible en español.
The myCigna Mobile App is all about helping you stay
organized and in control of your health – anytime, anywhere – so you can get more out of life.
sAvINGs At
your FINGertIps
Now it’s easier than ever to find and compare health care costs.
Offered by: Cigna Health and Life Insurance Company, Connecticut General Life Insurance Company or their affiliates.
smarter searches. Better results.
it’s true. The more you know about the cost and quality of doctors and hospitals, the easier it is to make the best choices for you and your family. After all, no one wants to pay too much for health care.
The intuitive myCigna health care professional directory has plenty to offer, starting with simplified search tools that give you the results you need. You’ll also see integrated cost and quality information throughout the directory, helping you compare doctors and control health care spending.
We’ve put everything at your fingertips, ready to help you make the most confident, cost-effective decisions about your care.
It pays to plan ahead.
integrating cost and quality information into our online directory makes it easier for you to get the care you need.
For example, did you know that an MRi can cost anywhere from $400 to $1,400*, depending on where you go? it’s okay if you didn’t know, because we do. And we’ll tell you, even if you don’t think to ask before you start searching.
Apple and the Apple logo are trademarks of Apple Inc., registered in the U.S. and other countries. App Store is a service mark of Apple Inc. | Android and Google Play are trademarks of Google Inc. * The downloading and use of the myCigna Mobile App is subject to the terms and conditions of the App and the online stores from which it is downloaded. Standard mobile phone carrier and
data usage charges apply.
“Cigna” and the “Tree of Life” logo are registered service marks, and “Together, all the way.” is a service mark, 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 and not by Cigna Corporation. Such operating subsidiaries include Cigna Health and Life Insurance Company, Connecticut General Life Insurance Company, and HMO or service company subsidiaries of Cigna Health Corporation, including Cigna HealthCare of Arizona, Inc., Cigna HealthCare of California, Inc., Cigna HealthCare of Colorado, Inc., Cigna HealthCare of Connecticut, Inc., Cigna HealthCare of Florida, Inc., Cigna HealthCare of Georgia, Inc., Cigna HealthCare of Illinois, Inc. (IL & IN), Cigna HealthCare of Indiana, Inc., Cigna HealthCare of St. Louis, Inc. (MO, KS & IL), Cigna HealthCare of North Carolina, Inc., Cigna HealthCare of New Jersey, Inc., Cigna HealthCare of South Carolina, Inc., Cigna HealthCare of Tennessee, Inc. (TN & MS), and Cigna HealthCare of Texas, Inc.
Let’s say you need to find a knee doctor. Wouldn’t you want to know which doctors do their
outpatient knee surgeries at a hospital and which do the same procedures at a (more affordable) outpatient surgery center? We’ll show you those types of differences as part of your search, too.
Get the information you need to make the right decisions about your
health care. Visit myCigna.com or download the myCigna mobile app today.*
What will you have to pay? We don’t just do the math for you. We go one step further and show you the math. Not only do we call out the
estimated cost for each service, but we also show you how much your plan will pay and how much you’ll need to cover.
try it. you’ll love it!
From simpler searches to valuable cost comparison information, there’s so much to love about myCigna’s health care professional directory. Smarter searching is just the beginning.
myCigna is your one-stop source for managing your health plan whenever and wherever you like. On myCigna you can estimate health care costs, manage and track claims, learn how to live a healthier life, and so much more.
details that make a difference.
Your health is always important to us, so Cigna offers services that help you when you are sick or injured, as well as services that can help you stay healthy and make more informed health care decisions. Just call the toll-free number on your Cigna iD card.
›
Customer Service is ready to answer your questions and resolve your concerns 24 hours a day, 7 days a week.›
Our interactive voice response system helps you find what you need faster over the phone. Use the speech recognition feature to order an iD card, order a provider directory, update insurance information and check claims status.›
Se habla español – and more than 150 other languages. We provide bilingual representatives in Spanish-speaking areas; for other non-english speaking individuals, we offer Language Line Services that can translate virtually any language.the Cigna 24-hour health
information line
Find helpful health information – anywhere, anytime – when you call the toll-free number on your Cigna iD card. Registered nurses are available 24 hours a day, seven days a week with expert, reliable information to answer your health questions, help you find facilities and identify available options and treatments. in addition, there are hundreds of recorded audio programs in the Health information Library on topics ranging from injuries and illnesses to wellness and fitness.
Cigna healthy rewards*
health and wellness discountsSave money when you purchase health and wellness products and services through the Cigna Healthy Rewards® program.
Programs include:
›
Weight and nutrition management›
Fitness›
Tobacco cessation›
Mind and body›
vision and hearing care›
vitamins, health and wellness products›
Alternative medicine›
Find your savings at myCigna.com and click the My Health tab.Get rewarded for making smart choices
Are you expecting or plan to have a baby in 2016? if so, let the larry h. Miller healthy pregnancy/ healthy Baby program get you – and your baby – off to a great start! Whether you’re in your first trimester of pregnancy or later, you can enroll in this program through your insurance carrier. The program provides personalized attention, educational information and resources to help identify risks, improve pregnancy outcomes and offer support during andafter pregnancy.
Upon successful completion of the program, you will earn credit towards completing your Sonic Boom Healthy Lifestyle goal as well as earning a $200 credit toward your medical deductible.
CIGNA heAlthy preGNANCIes,
heAlthy BABIes
®
Call 888.992.4462 to enroll as soon as you know you are pregnant. Visit myCigna.com for tools to help you track your pregnancy week by week, prepare for delivery and care for your baby.
you’re expecting.
That means you’re going to be choosing a name. Looking for a pediatrician. And seeing big changes – to your body and your lifestyle.
where do you start?
Cigna employees who are enrolled in our medical plan can enroll in this program designed to help you and your baby stay healthy during and after your pregnancy.
Find support early and often
›
Tell us about you and your pregnancy so we can meet your needs.›
Ask us anything – your nurse is there to support you during your whole pregnancy.›
Get a pregnancy journal with information, charts and tools to help you have a happy nine months.learn as much as you want
Get live support 24 hours a day, seven days a week. Call 888.992.4462 to enroll.
›
When you enroll, you’ll be assigned to a nurse. Your R.N. will be your main go-to person during your pregnancy. Talk with your nurse about anything; how you can be more comfortable during pregnancy, what foods to eat, why it’s good to stay active, birthing classes, your maternity benefits or any other questions or concerns you may have.›
You will have access to an audio library of maternity and general health topics.do I have to choose a primary Care physician (pCp)? No. However, a PCP gives you and your dependents a valuable resource and a personal health advocate. what if my doctor isn’t on your list?
That means your doctor does not participate in the Cigna network. To receive your maximum coverage, you should select a doctor from the Cigna list of participating doctors. You can continue seeing your current doctor, even if he or she is not a participating doctor. However, in that case, you will pay higher out-of-pocket costs, and your care will be covered at the out-of-network coverage level.
do I need a referral to see a specialist?
Though you may wa
