What’s the difference between an in-network and out-of-network provider?
In-network provider: To help you save money, most plans provide access to a network of doctors and facilities. These doctors and facilities must meet certain requirements and agree to accept a discounted rate for covered services under your plan. These health care professionals are considered “in-network.”
Out-of-network provider: If a doctor or facility is not contracted with your health plan, they are considered “out-of-network” and can charge you full price for their services.
How to search for an in-network provider
- Log in to the myCigna® website to search for an in-network provider. The provider directory on myCigna.com shows you results based on your health plan network and your location.
- Know before you go. Before you visit any provider or facility, we recommend you call ahead to be sure they are in your plan’s network, as well as confirm their address, office hours, and that they are accepting new patients.
- Meet the provider in person. Ask to schedule an introductory appointment. This appointment can help you decide if the provider is a good fit for you.
How to choose a primary care doctor
A primary care provider (PCP) serves as a "home base" for your basic health care. They help to coordinate your care, from your annual check-up and other preventive care, to routine care. Even if your plan doesn't require one, your primary care provider is an important member of your health care team.
If you are purchasing your own coverage through an individual and family plan, use the provider directory to find an in-network PCP. If you are purchasing an individual and family plan in Illinois, a primary care provider will be assigned to you. You may change your PCP after your planned start date if you would like to. Your PCP may be an internal or family medicine doctor, a pediatrician or an OBGYN, who acts as a "team leader".
If you are purchasing a health plan through your employer, please review your employer’s plan details to see if you’re required to select a PCP or if choosing a PCP is optional, and to see if there are any network requirements for your plan.
- Network status. Choose a primary care provider that is in-network to save on out-of-pocket costs when you go to the doctor.
- Quality designations and board certifications. These show that the provider has taken extra steps to provide quality care.
- Location. Look for an office that's convenient to your home or work. Make sure there is public transportation or parking nearby.
- Hospital affiliation. If there's a hospital you prefer, it can be helpful to find a provider who's affiliated with that hospital. If you have a hospital stay, this can make it easier for the hospital to share information with your doctor. You can also confirm that the hospital is in your plan’s network.
How to change your primary care provider
- Search for a new PCP in the provider directory on myCigna.
- Find a new primary care provider from the results list.
- Click "Add to My Health Team" or "Make this doctor my PCP" from the list of search results.
Depending on your plan, we will send you a new Cigna ID card that shows the name of your primary care provider. You can change your doctor as needed, up to once per month. If you need a more immediate change, please call the Customer Service number on your Cigna ID card.
Transition or Continuity of Care
If you are transitioning to a Cigna plan and need to receive services for specified medical conditions with health care providers who are not in the Cigna plan’s network, you can apply for Transition of Care benefits to receive coverage at in-network levels.
If you are a current Cigna customer and your health care provider leaves your plan’s network, and you need to continue seeing them for a specified amount of time, you may need Continuity of Care.
*Some plans require obtaining a referral for visiting a specialist.