Open Access

Plan Highlights

  • Selecting and using a primary care physician is encouraged
  • May visit specialists without a referral
  • Health care professionals obtain precertification for in-network services when required
  • Includes in-network/out-of-network plan options
  • ID card shows most patient payment responsibilities and precertification requirements

Specialist Care Without A Referral

The Cigna Open Access (OA) plan provides referral-free access to our network of credentialed specialists for your patients covered by this Cigna administered plan. We encourage your patients in these plans to choose a primary care physician (PCP) as a valuable resource and personal health advocate. However, we don’t require them to have a PCP.

  • HMO Open Access/Network Open Access
    Patients with these Cigna administered plans can visit in-network specialists without a referral. There’s no out-of-network coverage, except in an emergency or urgent care situation. You are responsible for obtaining precertification for all in-network services when required.
  • Point-of-Service Open Access
    Patients with these Cigna administered plans can visit in-network or out-of-network specialists without a referral. You’re responsible for obtaining precertification for all in-network services when required.

Your patients may also have a Cigna Choice Fund® , in addition to their Cigna administered Open Access Plus plan. Cigna Choice Fund is an employer- or employee-funded account your patients can use to pay for qualified health care expenses.

Patients with a Cigna administered Open Access plan may be responsible for:

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

Payment responsibilities are listed on the member ID card.
Coinsurance/deductible should not be collected at the time of service unless you have accessed the Cigna Cost of Care Estimator® to obtain an estimate of the patient’s costs and provide a copy of the Explanation of Estimate to the patient.

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