Point of Service (POS)
Plan Highlights
- Care coordinated by a primary care physician
- Referrals required for in-network coverage level
- Health care professionals obtain precertification for in-network services when required
- In-network and out-of-network coverage (in-network use encouraged)
- ID card shows most patient payment responsibilities and precertification requirements
One Plan, More Options
Patients covered by Point of Service (POS) plans have the opportunity to receive 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 (doctor) 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
- Filing their 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
See the member ID card for payment responsibilities.
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.
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.