Individual Health Insurance FAQs

What should I consider when choosing a health plan?

When you choose a health plan, it helps to know:

  • How often you expect to use health care services. Consider how often you see a doctor, if you receive on-going treatments or if you are planning to have surgery.
  • Your network of doctors. Keep in mind that some of Cigna’s plans let you visit any doctor, in- or out-of-network. It usually costs less to see in-network doctors. Check if your doctor is in-network using our online directory.
  • Your health care budget. Consider monthly plan premiums, your annual deductible, copays, coinsurances and other possible expenses.
  • Your eligibility for a federal premium tax credit or cost-sharing reductions to help pay for health care costs.
  • The health services and expenses different plans cover, such as surgeries or prescription drugs. Check the plan's exclusions and limitations to see what isn't covered.
Can I purchase medical coverage outside of Open Enrollment?

Outside of Open Enrollment, you may still have options for health coverage. You can change your plan or purchase insurance within 60 days of a qualifying life event such as:

  • Lost coverage at work (or other) health coverage.
  • Gained or became a dependent through marriage, birth, adoption, or placement for adoption.
  • Insurance company made a major mistake in your insurance contract.
  • Eligibility for financial assistance has changed.
  • You moved and need to pick another plan based on the coverage area.
Who should I call if I have questions regarding application and payment?

For questions regarding your application and payment, please call Cigna at 1.866.438.2446.

After enrolling, if you have questions, please call:

On Marketplace: 1.877.900.1237

Off Marketplace: 1.877.484.5967

Who should I call for questions or if I need help completing the Cigna HealthCare Individual Plan enrollment application?

Please call Cigna at 1.866.438.2446. 8:00 am – 10:00 pm (ET), Monday - Friday.

Do I have to enter my payment information to submit the application?

Yes, you will need to enter your payment information to submit the application. However, there is no application fee. Payment is due when your application is processed so that your coverage will begin on the date specified. Your account will not be charged until your application is processed. Cigna accepts most major credit/debit cards, as well as direct bank debits for medical coverage. Coverage begins once the payment is accepted and on the date you choose.

How do I obtain health insurance for my minor child?

Children are eligible for all plans—there is no age restriction. You can use our simple online quote tool, or call one of our helpful licensed agents at 1.866.438.2446.

If you are adding a dependent child to your plan, call:

On Marketplace: 1.877.900.1237

Off Marketplace: 1.877.484.5967

Do I need to select a primary care doctor before my coverage begins?

No. Choosing a primary care doctor is encouraged, although you are not required to choose one.

Which hospitals can I use?

To find a doctor, dentist, pharmacy or hospital, search our directory.

Do I need a referral to see a specialist?

Referrals are not required to visit a specialist.

Do I need to see a doctor within the Cigna network for my expenses to be covered?

If you choose a plan with the Cigna Open Access Plus or LocalPlus provider network, you are free to see doctors outside of Cigna's network. However, you will pay less for services provided by a doctor within our network. If you reside in Arizona and choose an HMO plan, you will need to see a doctor in the Cigna Medical Group, except for emergency services. See if your doctor is in our network.

When will my Cigna plan start?

Effective dates are assigned to the 1st of the month. You will receive written confirmation of your policy’s effective date when your payment is processed.

Will I be covered if I am in an accident and Cigna has not finished processing my application?

No, your coverage cannot begin until your application has been processed and your selected effective date arrives.

Am I covered outside of the service area and outside of the country?

For emergencies, you're covered out of the service area—even outside of the U.S. For all non-emergency/non-urgent care, you can receive care from the doctor of your choice. However, you will experience a better value if you visit a doctor that is in our network.

Is there a contract, or can I cancel at anytime?

Individual plans are annual and dropping a plan could result in a tax penalty if you do not have other coverage, such as a group plan through an employer. If you do not have other coverage, you may not be able to repurchase a plan before open enrollment for the next plan year begins, unless the change is due to a qualifying event.

Could I change my Cigna plan mid-year?

A change in plans can only be made during the annual Open Enrollment Period, unless there is a qualifying life event:

  • You or any of your dependents lost minimum essential coverage
  • You gained or became a dependent through marriage, birth, adoption or placement for adoption
  • You experienced an error in enrollment
  • You have adequately demonstrated that the plan or issuer substantially violated a material provision of the contract in which you are enrolled
  • You became newly eligible or ineligible for advance payments of the premium tax credit or are experiencing a change in eligibility for cost-sharing reductions
  • You made a permanent move and new coverage is available

The plan change must occur within 60 days of the qualifying life event.

If you have questions, please call one of our licensed agents at 1.877.484.5967. If you are already enrolled in a Cigna plan and you would like to make changes to your coverage, please call:

On Marketplace: 1.877.900.1237

Off Marketplace: 1.877.484.5967

Are Cigna plans less expensive than COBRA?

It may be worthwhile to explore if a Cigna plan could be more cost effective than paying COBRA rates for your former plan. With an employment status change, you may become eligible to purchase a marketplace plan if your income has been affected. To find out how you can save with a Cigna plan, or get a price quote, call one of our licensed agents at 1.866.438.2446.

Search Cigna health care reform plans in your state

How much does a Cigna plan cost?

Cigna plan costs vary by plan design, where you live, your age, the number of people in your family and their ages. It’s easy to get a personalized online quote from Cigna anytime— Review and compare affordable plans based on your needs. You may be eligible for a federal premium tax credit or cost-sharing reductions to help you pay for health care costs. You can also call one of our licensed agents at 1.866.438.2446.

Will my monthly premium change if I have a birthday that puts me into a different age category?

Your monthly premium will automatically adjust the next open enrollment following a birthday.

If a dependent turns 26 during the plan year, he or she will be offered a Cigna plan at open enrollment and be removed from his or her parent’s policy. Learn more about the rules for dependent coverage in our health care reform FAQs.

Who do I call if I have a question about my monthly premium?

If you’re already a Cigna Individual or Family Plan customer and you have a question about your monthly premium simply call 1.877.484.5967. If you have a Cigna marketplace plan, please call 1.877.900.1237.

When are my payments due?

Your initial payment is due when you apply. After that, Cigna will bill you monthly.

Who should I call if I have questions about a bill that I received?

For premium billing questions and payments call 1.877.484.5967, for off marketplace plans and 1.877.900.1237 for on marketplace plans, please call Cigna at 1.866.438.2446. 8:00 am – 10:00 pm (ET), Monday - Friday.

For questions on a bill or claim from a health care professional call us anytime at 1.800.244.6224.

How much will my copays be?

Copays are different depending on the Cigna plan design you select. With Cigna, you can choose a plan design with fixed copay levels that work for you. The fastest way to find out how much your copay will be is to use our simple Online Quote Tool. Or, you can call one of our helpful licensed agents anytime at 1.866.438.2446.

How does coinsurance work?

Coinsurance is the amount a person must pay (for example, 20 percent) for the health services that a health plan covers once the deductible is met. With Cigna, you can choose a plan design with monthly premium, deductible and coinsurance levels that balance your needs for affordability and access to care. Once you have met your out-of-pocket maximum, your Cigna plan pays the rest, as long as services are covered. You may pay more for out-of-network care if the provider’s charges exceed the amount Cigna reimburses for billed services.

If you are purchasing a Cigna marketplace plan, you may qualify for cost sharing reductions that could help lower out-of-pocket costs for copays, deductibles and coinsurances for doctor’s visits, prescriptions and other covered services.

What is the deductible?

A deductible is the amount a person or family needs to pay each plan year, before the Cigna plan pays for covered services.

How does the deductible work?

This is the amount of your health care costs that you pay before Cigna begins to cover all, or part of the costs, depending on your plan design. Some of our plans have no deductible to meet before the plan starts covering costs, or if there is coinsurance, part of the costs of service.

What is covered before I have met my deductible?

The details will depend on which Cigna plan you choose. However, Cigna covers routine, in-network preventive care for you and your family at no additional cost, as defined in your plan documents. Get a price quote, or call one of our licensed agents at 1.866.438.2446.

When does the deductible reset?

Deductibles are reset every year on January 1st.

What is preventive care?

Medical and dental services that keep you healthy and detect and treat health problems early are considered preventive care. Preventive care services are defined in the plan documents. Examples include immunizations, teeth cleaning and routine physical exams.

If I'm traveling, can I go to any doctor?

If you are travelling within the U.S., you can receive care from the doctor of your choice. However, you will experience a better value if you access health care professionals and facilities in-network. In the event you are travelling outside the U.S., you are covered for emergencies only. Check to see if a doctor is in our network using the Health Care Professionals Directory.

Do I have to go to a specific pharmacy?

No, you can go to any pharmacy. However, you will experience a better value if you visit a pharmacy that is in the Cigna network or use Cigna Home Delivery Pharmacy.

Can I just have a dental plan and not a health plan?

Yes, Cigna offers a variety of dental plans without health plans in many states.

What is your maternity coverage?

Maternity coverage is considered an Essential Health Benefit by PPACA (otherwise known as Health Care Reform), though coverage may vary by state.

To find out what kinds of maternity coverage Cigna offers in your state, please call one of our licensed agents at 1.866.438.2446.

Learn more about Health Care Reform

Where can I get information on the Federal Marketplace?

Visit the Health Insurance Marketplace website at www.healthcare.gov or call 1.800.318.2596.

Where can I get information on Connect for Health Colorado?

Visit the Connect for Health Colorado website at www.ConnectForHealthCO.com or call 855.752.6749.

Arizona Residents — FAQs for Individualized HMO Plans
I'm an Arizona resident interested in an individual HMO plan. What is the difference between the Cigna Medical Group and the Arizona Provider Network?

When you enroll with Cigna for your Arizona health insurance coverage, you can select which doctors and/or facilities you would like to use. By selecting the Cigna Medical Group, you’ll receive all of your primary and specialty care through the Cigna Medical Group (CMG), a network of full-service health care centers and other medical facilities located throughout the greater Phoenix area. The CMG provider network is available to customers in the Phoenix service area only.

The Arizona Provider Network includes a wide selection of private practice doctors in the Cigna of Arizona contracted network. The Arizona Provider Network is available in the Phoenix and Tucson/Southern Arizona service areas.

You can search Cigna's Provider Network on this website.

If I enroll in an individual HMO plan in Arizona, can I select a primary care physician (PCP) from the Cigna Medical Group for myself and a PCP from the Arizona Provider Network for my spouse?

Yes, the benefits and services provided are the same for both networks; however, the monthly premium amount differs. If you choose different networks for family members, two separate applications must be completed.

If I enroll in an individual HMO plan in Arizona, what should I do if I want to change my primary care physician?

Changing your PCP can be done by logging in to myCigna. Please note that your monthly premium rate will be adjusted if you change to a Primary Care Physician in a different network. For example, if you change your physician from one in the Arizona Provider network to one in the Cigna Medical Group network, your monthly premium rate will change. For more information, contact Customer Service at the number listed on the back of your ID card.