OUT-OF-NETWORK AND MULTIPLAN

OUT-OF-NETWORK

A health care provider that doesn't participate in your Cigna network is considered out-of-network. Cigna has a number of different networks and a health care provider that participates in one network may not participate in all. Using an out-of-network health care provider can cost you more--they can charge you the full price for all or part of their services. Log in or register for myCigna to help ensure you find the doctors, health care professionals and facilities that participate in your network.

WHY OUT-OF-NETWORK HEALTH CARE PROVIDERS CAN COST YOU MORE

Cigna can't control what an out-of-network health care provider charges for their services; and it's often higher than the rates that Cigna contracts with providers that agree to participate in your plan’s network. Because Cigna doesn’t have a network contract with out-of-network providers, out-of-network providers can bill you for the full price of their services.

You may be billed the difference (your responsibility, also called balance billing) between the health care provider’s bill and what your plan will pay.  This includes your out-of-network cost-sharing responsibility (such as any deductible or co-insurance) and any amounts that exceed the out-of-network benefits covered by your plan, referred to as the “Maximum Reimbursable Charge.” 

HOW CIGNA TRIES TO LOWER YOUR OUT-OF-NETWORK COSTS

Cigna may work with third party partners that attempt to achieve lower costs for you for out-of-network services, while also protecting you from balance billing when you seek services from health care providers that are not in your plan’s network. These programs include:

MULTIPLAN (NETWORK SAVINGS PROGRAM)
If the MultiPlan Savings Program logo appears on your Cigna ID card, you may be eligible to receive discounts when using an out-of-network, non-participating health care provider that participates in the Network Savings Program. These providers are still out-of-network for your plan, and discounts are not guaranteed.

BILL NEGOTIATION SERVICES
A suite of other services could also be used to attempt to get you discounts off a provider’s billed charges. This might include other supplemental networks or direct negotiations with the health care provider.  It may also include a technique called repricing that offers the out-of-network health care provider an amount based on a market-based rate as payment in full for the provider’s services (minus any out-of-network cost-sharing that you may owe). Providers that accept amounts offered through bill negotiation services should not balance bill you for any amounts other than your out-of-network cost-sharing responsibility. Please call the number on your Cigna ID card in the event that your EOB indicates that Cigna used a third-party vendor program to price your claim and you have been billed more than what is indicated on your EOB as the amount you owe.

STAY IN NETWORK

  • Save more when you use a health care provider that participates in your Cigna network.
  • Chances are, there's a participating network provider in your area.
  • It's easy to find quality, cost-effective care right where you need it.

Need to find a doctor, hospital or other care facility? Use the directory on myCigna.com or call the number on your Cigna ID card for assistance 24 hours a day, 7 days a week.

SEARCH THE MULTIPLAN/OUT-OF-NETWORK DIRECTORY