Offered by Cigna Health and Life Insurance Company, or its affiliates. Your. Cigna. Journey. U.S. Inpatriate /14

Transcription

1 Offered by Cigna Health and Life Insurance Company, or its affiliates. Your Cigna Journey U.S. Inpatriate /14

2 Welcome Easy Access to Quality Health Care Around the World You are about to begin work your work assignment in the United States /7 Worldwide Cigna Envoy Frequently asked questions and answers Network of More Than 185,000 Health Care Professionals Around the World Seeking treatment outside of the United States Receiving medication when in the United States Receiving medication outside the United States All You Need to Do is Call Cigna Experience the Cigna kind of caring When to submit a claim and when it is not needed Around the clock support

3 to Cigna Global Health Benefits where our mission is to provide... You are about to begin your work assignment in the United States and whether it is your first or tenth time in the country, you know it has the potential to be an amazing experience both professionally and personally. This opportunity also brings changes, questions, and uncertainty, including a new health care legislation. But one thing you can be sure of is you have valuable health coverage. The U.S. health care system is unlike any other health care system in the world. It provides access to high quality care with thousands of doctors and hospitals throughout the U.S., but can be confusing for visitors. How Your Health Care Plan Will Work while in the U.S. You may be familiar with a public health system or a fee-for-service system in your home country. While you are in the U.S., your employer provides you with private insurance coverage from Cigna. Through Cigna you have access to a network of more than 6,230 hospitals, 744,000 primary and specialty care doctors and 39,700 other health care professionals and facilities in the United States 1. Healthcare professionals who participate in Cigna s network have agreed to charge lower fees and bill Cigna directly for services. At the time of your visit, you are only required to pay your share of the cost, such as a deductible, or co-insurance, if required by your benefits plan. You can find a list of network healthcare professionals in the Cigna Health Care Directory available on Cigna Envoy. Simply show your Cigna identification card to take advantage of the lower fees that network doctors and hospitals have agreed to charge Cigna. Alternatively, you can choose to receive care and services from professionals outside of Cigna s network. 1 Internal Cigna data as of January 2013 Deductible Amounts: This is the amount of covered expenses that you must pay before the plan pays any benefit. Once you meet this threshold, the plan will begin to pay benefits for covered expenses that you incur; this applies to both individual and family plans. Co-insurance: A percentage of the cost of covered expenses you must pay after you have met your plan deductible. 1

4 24/7 Worldwide Easily find the information you need... Cigna Envoy Cigna Envoy is your customized online health resource. The tools and information are developed specifically for globally mobile individuals so you can easily find the information you need. Register for Cigna Envoy as soon as you receive your Cigna identification card. Step 1: Go to and under I am a Customer select I have not registered yet. Step 2: Fill in your registration details using the relevant information as it appears on your Cigna ID card. Step 3: Answer the security questions and click Register. You will be issued with a one-time PIN, which you can then change to a password of your choice for all future log-ins. CignaEnvoy.com can help you: z the Service Center quickly and securely. zfind the right doctors and hospitals anywhere in the world. zsubmit and track claims. zmake changes to your enrollment. zlook up translations for medical terms. zmanage ongoing conditions like diabetes, asthma, heart issues, and more. zlearn more about the country you just moved to. zstay in shape or get in better shape while you re there. zread country guides for more than 200 countries around the world. zsign up for electronic funds transfer (EFT) to deposit and claim reimbursement. 2 Still have questions or want to know more? Just get in touch with our service center by phone or .

5 Frequently asked Questions and Answers In the United States Here are the basics: Understanding insurance and health care terms Out-of-network: You have the freedom to visit doctors or use facilities that are not part of the Cigna network, but your costs will be higher and you may need to file a claim. In-network: You ll receive care from doctors or other health care professionals who participate in the Cigna network, which keeps your costs lower and eliminates your paperwork. Out-of-Pocket Cost: Expenses not covered by your plan, such as coinsurance, deductibles, and any other charges not covered under your plan. Pre-Certified: Getting approval for a service prior to receiving care. No-referral specialist care: If you need to see a specialist, you do not need a referral to see a doctor who participates in the Cigna network just make the appointment and go! Pre-certification is necessary for hospitalizations, but there is no paperwork for you. You also do not need a referral to seek care out-of-network. Emergency and urgent care: When you need care, you re covered, 24 hours a day/7 days a week. Balance Billed: When receiving care from an out-of-network provider, they may bill you the difference between the payment they receive from Cigna and their usual fees. Q: What is covered under the Cigna plan? A: You and your family members have medical, pharmaceutical, dental and vision coverage. Q: Do I need a Cigna ID card? A: Yes. Your Cigna ID card is recognized by health care professionals around the world. By using your Cigna ID card, we can directly reimburse the doctor or hospital where you received care. When you receive your permanent ID card, please verify that your information is correct and call Cigna immediately if a change is required. Present your ID card whenever you receive services from a health care professional. Q: How can I locate a doctor? A: With a network of more than 1 million health care professionals worldwide, it s easy to locate a doctor or hospital. To locate an international health care professional, go to and click on the Find health care tab or call us using the number on the back of your ID card for assistance. Q: How do I confirm a direct pay arrangement or guarantee of payment? A: Visit or call at the time of service. Q: Is my Cigna ID card a credit or payment guarantee card? A: No. Your Cigna ID card is purely a means of identifying you. It has no payment capabilities. You should contact us for payment guarantees or questions. Q: Do I need a referral to see a specialist? A: Though you may want your personal doctor s advice and assistance in arranging care with a specialist, you do not need a referral to see an in-or out-of-network specialist. If you choose an out-of-network specialist, your cost will be higher. Q: What is the difference between in-network coverage and out-of-network coverage? A: Each time you seek medical care, you can choose to receive services from healthcare professionals who participate in the Cigna network. When you visit an in-network healthcare professional, you will have lower out-of-pocket costs. That s because Cigna s network health care professionals have agreed to charge lower fees. If you choose to visit a healthcare professional outside of Cigna s network, you could be responsible to pay a larger coinsurance, depending on your plan. You also may be balanced billed. Covered charges may be applied and/or subject to a higher out-of-network deductible. Additionally, reimbursements will be calculated by Cigna according to the maximum reimbursable charge based on your plan. Q: What if I need to be admitted into the hospital? A: In an emergency, your care is covered subject to your plan terms. Requests for non-emergency hospitals stays, other than maternity stays, must be approved in advance or precertified. This enables Cigna to determine if the services are covered by your plan. Q: Who is responsible for obtaining pre-certification? A: Your doctor will help you decide which procedures require inpatient hospital care and which can be handled on an outpatient basis. If your doctor participates in Cigna s network, he or she will arrange for pre-certification on your behalf. If you use an out-of network doctor, you are responsible for arranging the pre-certification with Cigna. Q: How do I find out if my doctor is in the Cigna network? A: It s quick and easy to search for participating doctors, specialists, pharmacies, hospitals, and facilities closest to your home and work. Go to and click on the Find a Provider tab or you can call our Service Center using the number on the back of your identification card for assistance. 3

6 Seeking treatment outside the United States Check your benefits highlights or schedule of benefits to confirm if your plan provides coverage of care received outside of the U.S., such as in your home country. If your plan covers care outside the U.S., Cigna s international network consists of more than 185,000 health care professionals 1. Refer to our healthcare professional 1 Internal Cigna data as of January 2014 directory when you return home for a visit, for a family member who is in your home country, or when you need to travel internationally on assignment. To locate an international health care professional, go to www. CignaEnvoy.com and click on the Provider tab or call our Service Center using the number of the back of your identification card for assistance. Covered Charges (Cover): Those charges which are considered medically necessary and that are within the terms and conditions of your benefit plan. Deductible Amounts: This is the amount of covered expenses that you must pay before the plan pays any benefit. Once you meet this threshold, the plan will begin to pay benefits for covered expenses that you incur; this applies to both individual and family plans. Co-insurance: A percentage of the cost of covered expenses you must pay after you have met your plan deductible. Network of more than185,000 health care professionals 4

7 Receiving medication when in the United States You have access to Cigna s network of more than 62,000 participating pharmacies 2, including those in the U.S. Virgin Islands. These pharmacies offer both brand and generic prescription medications, and you receive discounts by using your Cigna identification card at these pharmacies. Please refer to your benefits highlights or schedule of benefits for a complete list of your benefits. When you visit one of these pharmacies, Cigna will pay the pharmacy directly for our portion of a covered charge, which eliminates the need to file a claim. You are only responsible for paying your share based on your specific plan benefits. In addition, Cigna Home Delivery Pharmacy is a convenient way for you to receive your medications when in the United States. This service offers a number of advantages including a three-month supply of medication at one time, as well as having it delivered directly to your home at no additional cost. Not only does it save you time by skipping the lines in the store, but it may also save you money. Cigna will directly settle expenses with Cigna Home Delivery Pharmacy for covered expenses, eliminating the need to file a claim. You will only be responsible for your portion of the expenses at the time the order is filled based on your plan benefits. Cigna Home Delivery Pharmacy can deliver prescriptions only to U.S. addresses. 2 Internal Cigna data as of January 2014 Receiving medication outside the United States If you need to fill your prescription from the United States while you are abroad, please contact our Service Center at the number on the back of your Cigna identification card. Note that prescriptions must be filled locally in the country where the prescription was written. For example, a prescription written in China cannot be filled by a pharmacy in the United States. Likewise, a prescription written in the United States cannot be filled by a pharmacy outside the United States. For medications obtained from a pharmacy outside the U.S., you will need to pay for the prescription at the time of purchase and then submit a claim form to Cigna. Claim instructions are included in this kit. 5

8 Experience the Cigna kind of caring If you or a covered family member experience a complex medical situation in the United States, Cigna s case management team is here to help. Our case managers work closely with the patient, family, and health care professionals to coordinate access to care, explore service alternatives, monitor progress, and assist with discharge planning and follow-up. All you need to do is call the number on the back of your identification card and we will connect you with a case manager to assist you with your particular needs. all you need to do is call Cigna 6

9 When to submit a claim and when it is not needed... While in the United States In the United States, if you receive care from one of Cigna s in-network health care professionals, you do not need to submit a claim for reimbursement because our in-network health care professionals have direct pay arrangements in place with Cigna. You would only be responsible for paying any deductible or coinsurance amounts that are part of your plan. If you choose to seek care from an out-of-network provider you may need to file a claim. Cigna is there to support you, 24 hours a day, 7 days a week, 365 days a year. When you need to reach out, contact us anytime by phone or fax. You can also send us an through Cigna Envoy. Outside the United States Outside the United States, you may need to file a claim unless you visit a health care professional that has a direct pay arrangement or has obtained a guarantee of payment from Cigna. You will find this in the provider directory page on To find out if a health care professional has a direct pay arrangement with Cigna, look below their contact information in the directory for a note that says direct settlement may be available. If so, all you need to do is present your Cigna identification card. Reimbursement Options zdirect payment to a U.S. or Canadian bank zelectronic funds transfers zchecks to you in a variety of currencies zwire transfer to bank account around the world Please note that your bank, or intermediary banks, may assess a fee for the receipt of wire transfers. If your doctor or hospital accepts direct settlement from Cigna, it will be noted in your search. If you do need to submit a claim for reimbursement, follow these tips to speed up the process zsubmit your claims through Cigna Envoy. It s the fastest way to get your claims to Cigna. zmake sure your claim or form is filled out completely. And don t forget to sign! zfill out a separate form for each doctor or hospital visit. zbe sure to add a diagnosis or explain your treatment. zhang on to copies of your bills, receipts, and claim forms. zclearly state how you would like to be reimbursed. zif you can t submit your claim online, remember that even faxes are faster than regular mail. epayment Plus is a robust, integrated and accurate process that includes automatic notification of payments directly into a bank account you maintain in a given country, regardless of where you are on assignment. You can quickly and easily self-enroll in epayment Plus on Cigna Envoy. epayment Plus complements the existing array of electronic payment options, such as wire transfer and Electronic Funds Transfer (EFT), available in the U.S. After you enroll in epayment Plus, charges often applied by your bank, for wire transfers or other deposits, are removed or minimized. To sign up, go to Direct Pay arrangements: Direct payment to your health care professional, which helps reduce the amount you need to pay for covered services at the time of treatment. Guarantees of payment (GOP): Assures payment directly to a doctor or hospital for covered services. This helps prevent you from having to pay for services that would normally be covered under your plan. Have your health care professional call Cigna to arrange using the number on the back of your identification card. 7

10 Around the clock support Contacting Cigna Website: Cigna toll-free telephone number: Direct (collect calls accepted): Toll-free facsimile number: Direct facsimile number: ConocoPhillips Benefits Center toll-free international telephone numbers: (eligiblity and enrollment questions) Monday - Friday, 8 a.m. to 6 p.m. (CST) Mail Delivery: Cigna P.O. Box Wilmington, DE U.S.A. Courier Delivery: Cigna 300 Bellevue Parkway Wilmington, DE U.S.A. all you need to do is call Cigna 8

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12 Easy Access to Quality Health Care Around the World. This material is provided for informational purposes only, is believed accurate as of the date of publication, and is subject to change. It is not a contract. The plan sponsor reserves the right to amend or terminate the plan at any time, at its sole discretion, according to the terms of the plan. Terms and conditions of coverage are set forth in your policy. If there are any differences between this material and the plan documents, the information in the plan documents takes precedence. This material should not be relied upon as legal or medical advice. As always, we recommend that you consult with your independent legal and/or medical advisors. Products and services may not be available in all jurisdictions and are expressly excluded where prohibited by applicable law. Cigna Global Health Benefits web-based tools, such as Cigna Envoy, are available for informational purposes only. Cigna Global Health Benefits web tools are not intended to be a substitute for proper medical care provided by a physician. References to third-party organizations or companies, and/or their products, processes or services, do not constitute an endorsement or warranty thereof. Cigna, the Tree of Life logo, and Cigna Envoy are service marks of Cigna Intellectual Property, Inc., registered in the U.S. and other countries. Healthy Rewards and epayment Plus are U.S. registered service marks, and Cigna Home Delivery Pharmacy and Cigna Global Health Benefits are service marks, of Cigna Intellectual Property, Inc. All products and services are provided by or through operating subsidiaries of Cigna Corporation, including Cigna Health and Life Insurance Company, Cigna Life Insurance Company of Canada, Tel-Drug, Inc., Tel-Drug of Pennsylvania, LLC, and vielife Limited, and not by Cigna Corporation. Cigna Home Delivery Pharmacy refers to Tel-Drug, Inc. and Tel-Drug of Pennsylvania, LLC. All pictures are used for illustrative purposes only / Cigna. Some content provided under license.