Cigna 3500 High Deductible Health Plan (HDHP)
The Cigna 3500 High Deductible Health Plan (HDHP) pairs lower-per-paycheck cost, high-deductible medical coverage with the ability to open a tax-free Health Savings Account (HSA), which can also help you save for future expenses. This combination gives you more control over your money and rewards you for making healthy, cost-conscious choices. With this plan, you can choose any in-network or out-of-network provider each time you receive care. But keep in mind: You will generally receive higher benefits when you use in-network providers.
Key Features of a High Deductible Health Plan
- Lower premiums, higher deductible. Your deductible is higher, but you also have lower premiums.
- You may elect to participate in a Health Savings Account (HSA). See Tax-Advantaged accounts for details.
- Qualified in-network preventive care at no cost to you. For example, you pay nothing out-of-pocket for eligible in-network annual physicals, immunizations, routine cancer screenings, and more.
How it works
- You pay your initial medical care costs until you meet the annual deductible (with the exception of eligible in-network preventive care, which has no out-of-pocket costs).
- Once the deductible is met, you and the plan share costs for eligible expenses until you meet your out-of-pocket maximum. This is your coinsurance.
- If you meet the out-of-pocket maximum, the plan pays 100% of your eligible expenses for the rest of the year.
How the HDHP Works
Fund your HSA
You can set aside tax-free money from your paycheck to help cover your costs — now, or in the future.
| 2022 HSA Contribution Limits | ||
|---|---|---|
| Medical Plan and Coverage Tier | IRS Maximum HSA Contributions | 55+ Catch Up Contribution |
| Employee only | $3,650 | $1,000 |
| Employee plus any dependents | $7,300 | |
Deductible
You pay 100% of costs until you meet the annual deductible. You can use your HSA to pay your deductible.
Coinsurance
After meeting the deductible, you and the plan share the cost of certain services, with the plan paying the majority. You can use your HSA to pay your coinsurance.
Out-of-Pocket Maximum
You’re protected with an annual limit on costs — the plan pays 100% of any further covered expenses for the rest of the year.
Keep in mind
You pay nothing for in-network preventive care — it’s covered in full.
Contact Info
Documents
Budgeting for your costs with a Health Savings Account (HSA)
With the HDHP, you pay less in per-paycheck costs and assume more financial responsibility when you receive care. So, it’s important to plan ahead for your out-of-pocket expenses. Here are some ideas to consider:
- Think about your costs. Contribute at least enough to your HSA to cover your expected out-of-pocket costs, such as your annual deductible and coinsurance. Remember — because you’re keeping more of your paycheck by paying lower medical plan per-paycheck costs, you may have extra money available to put in your HSA.
- Plan ahead. You can only spend HSA money that’s actually been deposited into your account. Adjust your contributions as necessary during the year to make sure you have money available when you need it. And if you don’t, remember to reimburse yourself later so you take full advantage of your HSA’s tax savings.
- Look long term. You will never forfeit any money left in your HSA — it rolls over year after year. If you know about future expenses — or if you want to save for your health care costs in retirement — set aside a little extra each paycheck so your balance can grow over time.
Money-saving Tips
Use your HSA to budget for deductibles and other out-of-pocket expenses while also saving money – your HSA contributions are tax-free! Make the most of your coverage. Take advantage of these resources to manage your care and your costs.
Cigna 3500 (HDHP)
| Cigna 3500 | ||
|---|---|---|
| In-Network | Out-of-Network | |
| Annual Deductible | ||
| Individual | $3,500 | $7,000 |
| Family | $10,500* | $21,000* |
| Out of Pocket Maximum | ||
| Individual | $6,000 | $12,000 |
| Family | $14,000 | $28,000 |
| Coinsurance | 20% | 50% |
| Services | ||
| Preventive Care | Covered 100%; deductible waived | 50%; after deductible |
| Office Visit - PCP | 20%; after deductible | 50%; after deductible |
| Office Visit - Specialist | 20%; after deductible | 50%; after deductible |
| X-ray | 20%; after deductible | 50%; after deductible |
| Laboratory | 20%; after deductible | 50%; after deductible |
| Diagnostic Complex Imaging | 20%; after deductible | 50%; after deductible |
| Inpatient Hospitalization | 20%; after deductible | 50%; after deductible |
| Outpatient - Ambulatory Surgical Center | 20%; after deductible | 50%; after deductible |
| Outpatient - Hospital | 20%; after deductible | 50%; after deductible |
| Urgent Care | 20%; after deductible | 20%; after deductible |
| Emergency Room | 20%; after deductible | |
| Ambulance | 20%; after deductible | |
| Physical Therapy | 20%; after deductible | 50%; after deductible |
| Chiropractic | 20%; after deductible | 50%; after deductible |
| Pharmacy - Retail | ||
| Generic | 20%; after deductible | Not covered |
| Preferred | ||
| Non-Preferred | ||
| Pharmacy - Mail Order | ||
| Generic | 20%; after deductible | Not covered |
| Preferred | ||
| Non-Preferred | ||
| Specialty Drugs | ||
| 20%; after deductible | Not covered | |
| *Family amount can be satisfied by any combination of family members but an Individual would never be greater than their own Individual amount ($3,500 In-Network) | ||