Open Access Plus (OAP) are health plans that allow you to choose your health care providers.
These two plans have similar key features:
- 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.
- 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:
Open Access Plus
- You don't need referrals to see specialists.
- Out-of-network services are covered but you will have higher out-of-pocket costs and you may need to file a claim.
Open Access Plus In-Network
- You don't need referrals for in-network specialists.
- Out-of-network services are not covered unless it’s an emergency as defined by your plan documents.
*Emergency Services as defined by your plan documents are covered at the in-network level. In Texas, Open Access Plus plans are considered Preferred Provider plans, and Open Access Plus In-Network plans are considered Exclusive Provider plans, with certain managed care features.