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Cigna is here to support you.
We are committed to the health, well-being, and peace of mind of our clients and customers. Central to this commitment is making sure you feel comfortable and informed on how to keep your workforce and organization safe.
Below are answers to the most frequently asked questions we’ve received from employers during this time of uncertainty. Contact your Broker/Consultant or your Cigna representative if you need additional information.
Check back frequently as new updates will be posted as they come in.
Employee Care and Coverage
In the United States, there are currently three authorized vaccines to prevent COVID-19 that are FDA-approved for Emergency Use Authorization (EUA). These vaccines are manufactured by Pfizer-BioNTech, Moderna®, and Johnson & Johnson (J&J) Janssen Biotech. Any EUA-approved vaccine will be covered as a preventive service.
The federal government has purchased hundreds of millions of doses of the three vaccines and is providing these doses at no cost to distribution partners. Likewise, the federal government has mandated that non-grandfathered health plans pay 100% of the cost of administration of the vaccine, whether administered by medical HCPs or pharmacists. As such, customer out-of-pocket cost for the COVID-19 vaccine, through all legitimate distribution channels, will be $0.
For more information:
Diagnostic testing for COVID-19 (molecular or antigen diagnostic tests, including rapid tests, saliva tests, etc.) is covered without cost-share, prior authorization, or other medical management requirements through October 17, 2021. Diagnostic testing generally means a symptomatic or asymptomatic individual “seeks and receives” a COVID-19 test from a licensed or authorized health care provider, or when a licensed or authorized health care provider refers an individual for a COVID-19 diagnostic test (i.e., when an individual customer wants to be tested for any reason and seeks out a test on their own).
Non-diagnostic testing for asymptomatic individuals is generally not covered. Non-diagnostic tests are tests related to public health surveillance, general workplace health and safety, or for other purposes not primarily intended for individualized diagnosis or treatment of COVID-19 (i.e., when an employer, school system, or other entity requires repeatable or mass testing for surveillance or employment purposes). Plans and issuers are not required to provide coverage for this type of COVID-19 testing.
Please review our COVID-19: In Vitro Diagnostic Testing coverage policy for additional coverage criteria.
In all cases, providers should bill the COVID-19 test with the diagnosis code that is appropriate for the reason for the test. Cigna will determine coverage for each test based on the specific code(s) that the provider uses for billing.
Cigna covers medically necessary COVID-19 treatment with cost share as defined by the specific terms of the customer’s benefit plan.
We are waiving out-of-pocket costs for COVID-19 diagnostic tests and testing-related visits with in-network providers, whether at a provider’s office, urgent care center, emergency room, or via virtual care, through the Public Health Emergency (PHE) period, which currently runs through October 17, 2021.2
Cigna is waiving customer out-of-pocket costs for virtual care screenings for COVID-19 through the PHE period, which currently runs through October 17, 2021.
Cigna customers can also receive virtual medical care not related to COVID-19 by providers with virtual care capabilities through our new permanent virtual care policy. Out-of-pocket costs will typically be the same as a similar in-office visit.
Employees can get started with virtual care by contacting their Primary Care Physician (PCP). If their PCP is not offering virtual care visits, or if the employee wants to have a virtual visit after hours, they can log in to their myCigna account to receive 24/7 virtual care through MDLive.
Cigna is prepared to ensure we can meet the medication needs of our customers. Our sourcing teams map the origins of drug products around the globe and allow us to monitor supplies and adjust our inventory procurement to mitigate shortages. We have been monitoring this situation, and have made adjustments to our procurement to ensure we have adequate inventories to meet demand.
We understand our customers’ desire to be prepared. Standard refill policies, which allow members to refill or renew a prescription medication when 25%–35% of their current prescription is remaining, should help them stay on track with their medication during this time.
Your employees can also have peace of mind by using home delivery, which offers up to 90-day supplies of prescription maintenance medications and free delivery. They can call 1 (800) 835-3784 for more information on home delivery.
We will continue to monitor developments closely, abide by all requirements put forth by government agencies, and will update our information and policies as the situation changes.
Plan Cost Adjustments
Given the environment and its ever-changing dynamics, there is no single number we can provide which would be the same for all of our clients. We encourage you to reach out to your Broker/Consultant or your Cigna representative as they can work with our internal resources to provide a potential range for this expense.
Our internal teams have created a modeling feature which can provide a potential range based on a series of factors. Your Broker/Consultant or your Cigna representative can schedule a meeting with our Underwriting Team to get your input on the variables used in a calculation of any potential range of outcomes.
Mental Health and Wellness
If a client has Cigna's Employee Assistance Program (EAP), customers can use their allotted free sessions per issue to address the impact of COVID-19 on daily lives, at no additional cost. The number of free EAP sessions available depends on the client’s existing EAP session model and per issue use in the current plan year.
If a client has Cigna Total Behavioral Health® (CTBH), or smaller to mid-size clients with 25-499 employees with emotional well-being support services, customers get access to three free sessions with a licensed behavioral health provider in Cigna's EAP network. For CTBH and smaller to mid-size clients, these services are only available to customers also enrolled in medical coverage; it does not extend to other members of the employee’s household.
We also have a range of behavioral health programs including digital resiliency tools and peer support. Visit our wellness, mental health, and behavioral resources page to help your employees cope with pandemic-related stress brought on by social isolation, financial concerns, and other daily-life challenges.
Vaccine Hesitancy Videos
Watch these videos of Dr. Neema Stephens and Dr. Doris Munoz-Mantilla, National Medical Directors at Cigna, as they share facts about the development and safety of the vaccines.
1 Self-insured group health plans administered by Cigna have an opportunity to opt out of these benefits.
2 Families First Coronavirus Response Act requires ASO plans to cover diagnostic testing as well as items and services furnished during an office visit (including telehealth), urgent care center visit, and emergency room visit resulting in an order or administration of diagnostic testing, but only to the extent that the items/services relate to the testing or evaluating a person to determine if diagnostic testing is required.
*This COVID-19 treatment policy applies to customers in the United States who are covered under Cigna’s employer/union sponsored insured group health plans, insured plans for US based globally mobile individuals, Medicare Advantage and Individual and Family Plans (IFP). Cigna will also administer the waiver to self-insured group health plans and the company encourages widespread participation, although these plans will have an opportunity to opt-out of the waiver option.
This content is offered for informational purposes only. It does not constitute medical advice. Always consult your doctor for appropriate medical advice and care recommendations tailored to your specific medical condition.