Medical coverage, administered by Cigna, is bundled with dental/vision/hearing coverage under the Certificated Employee Health Plan. The medical plan covers a wide range of services, including preventive care, office visits, surgery, hospital stays and prescription drugs. The medical plan also includes benefits for mental/behavioral health; see the Mental Health Resource Guide. Your premiums (biweekly cost for coverage) is lowest when you take the Cigna health assessment by the deadline each year.

 

How the plan works

The medical plan centers around Cigna’s Open Access Plus (OAP) network of health care providers. When you use OAP network providers and facilities, you receive in-network benefits and generally pay less out of your own pocket.

 

You also have the flexibility to use providers outside the OAP network and still receive benefits; however, you will receive lower out-of-network benefits and likely pay more out of your pocket. Out-of-network benefits are also subject to Cigna’s maximum reimbursable charge (MAC); if your out-of-network provider’s charges exceed the MAC limit, you will be responsible for paying the difference.

 

Choosing a provider

You don’t have to select a primary care physician, and you don’t need a referral to see a specialist. However, you will pay the lowest out-of-pocket costs if you use Cigna in-network providers. To find network providers, call 1-800-24Cigna (1-800-244-6224) or:

• If currently enrolled in an MNPS Cigna plan, visit myCigna.com.

• If not yet enrolled, visit cigna.com and search for a provider under Open Access Plus.

 

How much you pay

The amount you pay depends on the service or product you receive, as shown in the chart below. Some services, such as office visits, are covered with a copay. Other services, such as outpatient surgery, require you to meet an annual deductible first, then you pay a percentage of the cost, called coinsurance. 

 

Copays do not count toward the deductible. Amounts paid toward the deductible, coinsurance and copays do apply toward your medical out-of-pocket maximum. Once you reach the out-of-pocket maximum in a calendar year, the plan will pay 100% for covered expenses for the remainder of that calendar year.

 

Medical benefits ... at a glance (effective 1/1/25)

Click on chart to view or download a pdf file.