What is a Medical Network Plan?

Medical Network plan is a health plan designed for you to work with your primary care provider (PCP) to treat you for a variety of conditions, help coordinate your care, as well as provide preventive care; all of which helps you stay healthy and get the most out of your health plan.

If you choose a Medical Network health plan through Cigna, it’s important to know the key features of the three plans:

Medical Network, Medical Network Point of Service, and Medical Network Open Access Point of Service

  • Cigna may need to pre-certify hospitalizations and some types of outpatient care, but there's no paperwork for you when using in-network providers.
  • The plans include global emergency and urgent care coverage* 24 hours a day, seven days a week.

It’s also important to know how they are different:

Medical Network

  • You will need to select an in-network primary care provider (PCP) for yourself and your covered dependents. You can change your PCP at any time.
  • You will need referrals from your PCP for specialists as needed, except for OB/GYN services. You don't need a referral for OB/GYN services.
  • Out-of-network care will only be covered in emergencies, as defined by your health plan documents.

Medical Network Point of Service

  • You will need to select a primary care provider (PCP) for yourself and your covered dependents. You can change your PCP at any time.
  • You will need referrals from your PCP for specialists as needed, except for OB/GYN services. You don't need a referral for OB/GYN services.
  • Out-of-network services are covered but you will have higher out-of-pocket costs and you may need to file a claim.

Medical Network Open Access Point of Service

  • You have the option of choosing a primary care provider (PCP) to serve as your personal health advocate and coordinate your health care. It’s recommended, but it is not required.
  • You don't need referrals to see specialists and your costs will be lower if you choose an in-network specialist.
  • Out-of-network services are covered but you will have higher out-of-pocket costs and you may need to file a claim.

In California, Medical Network health plans are insured by Cigna HealthCare of California, Inc. In other states, plans are insured or administered by Cigna Health and Life Insurance Company or Connecticut General Life Insurance Company. Plans may not be available in all areas.