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Home Individuals & Families Shop for Plans Plans Through Your EmployerHealth Maintenance Organization (HMO) Plans

Health Maintenance Organization (HMO) Plans

Includes global emergency and urgent care coverage* 24 hours a day, seven days a week.

What is an HMO Plan?

A Health Maintenance Organization (HMO) health plan offers a local network of doctors and hospitals for you to choose from.

Cigna Healthcare HMO Plans At-a-Glance

 
HMO
HMO Point of Service
HMO Open Access
HMO Open Access Point of Service
In-Network PCP Required?
Yes
Yes
Optional
Optional
Specialist Referrals Needed?
(Except for OB/GYN services)
(Except for OB/GYN services)
No referral needed
No referral needed
Out-of-Network Coverage Included?
Emergencies only*
Coverage included at a cost
Emergencies only*
Coverage included at a cost

What are Cigna Healthcare HMO Open Access and Point of Service Open Access Plans?

An HMO Open Access, or Health Maintenance Organization Open Access plan, is type of health plan that offers you flexible coverage along with tools and resources.

Cigna Healthcare HMO and HMO Point of Service Plan features

  • 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.
  • The PCP you choose will coordinate your health care needs and refer you to specialists as needed except for OB/GYN services. You don't need a referral for OB/GYN services. Cigna HealthcareSM may need to pre-certify hospitalizations and other outpatient care, but there's no paperwork for you when using in-network providers.

Cigna Healthcare HMO Open Access and HMO Point of Service Open Access Plan 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.
  • You don’t need referrals for in-network specialists however if you do see a PCP, they may refer you to a specialist after the initial exam. Cigna Healthcare may need to pre-certify hospitalizations and other outpatient care, but there's no paperwork for you when using in-network providers.

Cigna Healthcare HMO and HMO Open Access out-of-network services

  • Out-of-network services will only be covered if the treatment is considered emergency or urgent care as defined by your health plan documents.

Cigna Healthcare HMO Point of Service and HMO Point of Service Open Access out-of-network services

  • Out-of-network services may be covered but you will pay more out of pocket and you may need to file a claim.

Being offered a Cigna Healthcare HMO plan through work?

Use these helpful tools to help with your enrollment decisions.

Find in-network doctors

To find in-network providers, procedures, cost estimates, and more, search our provider directory.

Are your prescription drugs covered?

To find out which drugs are covered by your plan, use the Prescription Drug List.

Next steps for shoppers

You'll most likely enroll in your plan using your employer's enrollment tool/website. If not, check with your HR department.

Need help understanding how insurance plans work? To learn more, visit the Knowledge Center

Are you a new member?

If you've recently enrolled in a Cigna Healthcare plan through your employer, here are next steps:

Activate your myCigna account1

Check out member programs and services

Buying a plan on your own?

This page features plans you get through an employer. If you're looking for plans you can buy for yourself or your family, we can help get you there.

Find a plan that's right for you

View Cigna Healthcare Company Names

*Emergency and urgent care services as defined by your health plan documents will be covered at the in-network level.

1 Customers under age 13 (and/or their parent/guardian) will not be able to register at myCigna.com.

Cigna HMO plans are offered by Cigna HealthCare of Arizona, Inc., Cigna HealthCare of California, Inc., Cigna HealthCare of Colorado, Inc., Cigna HealthCare of Connecticut, Inc., Cigna HealthCare of Florida, Inc., Cigna HealthCare of Georgia, Inc., Cigna HealthCare of Illinois, Inc., Cigna HealthCare of Indiana, Inc., Cigna HealthCare of St. Louis, Inc., Cigna HealthCare of North Carolina, Inc., Cigna HealthCare of New Jersey, Inc., Cigna HealthCare of South Carolina, Inc., Cigna HealthCare of Tennessee (CHC-TN), Inc., and Cigna HealthCare of Texas, Inc. Plans contain exclusions and limitations and may not be available in all areas. For costs and details of coverage, see your plan documents. CHC-TN policy form: GSA-COVER, et al.

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Disclaimer

Product availability may vary by location and plan type and is subject to change. All health insurance policies and health benefit plans contain exclusions and limitations. For costs and details of coverage, review your plan documents or contact a Cigna representative.

All Cigna products and services are provided exclusively by or through operating subsidiaries of Cigna Corporation, including Cigna Health and Life Insurance Company, Cigna HealthCare of Arizona, Inc., Cigna HealthCare of Georgia, Inc., Cigna HealthCare of Illinois, Inc., Cigna HealthCare of North Carolina, Inc. and Cigna HealthCare of Texas, Inc. Group health insurance and health benefit plans are insured or administered by CHLIC, Connecticut General Life Insurance Company (CGLIC), or their affiliates ( see a listing of the legal entities that insure or administer group HMO, dental HMO, and other products or services in your state). Accidental Injury, Critical Illness, and Hospital Care plans or insurance policies are distributed exclusively by or through operating subsidiaries of Cigna Corporation, are administered by Cigna Health and Life Insurance Company, and are insured by either (i) Cigna Health and Life Insurance Company (Bloomfield, CT); (ii) Life Insurance Company of North America (“LINA”) (Philadelphia, PA); or (iii) New York Life Group Insurance Company of NY (“NYLGICNY”) (New York, NY), formerly known as Cigna Life Insurance Company of New York. The Cigna name, logo, and other Cigna marks are owned by Cigna Intellectual Property, Inc. LINA and NYLGICNY are not affiliates of Cigna.

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