AGA Cigna PPO 5000

Cigna PPO Network

AGA Cigna PPO 5000 — Deductible: $5,000 / $10,000; Max Out of Pocket: $8,150 / $16,300; Copay: $20 / $60 / $20; Coinsurance: 30% after deductible; Emergency Room: Deductible & coinsurance.

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Monthly premiums

Member: $925.00/mo
Member & Children: $1,543.00/mo
Member & Spouse: $1,800.00/mo
Member & Family: $2,246.00/mo

Plan details

Deductible (Individual): $5,000
Deductible (Family): $10,000
Out-of-Pocket Max (Individual): $8,150
Out-of-Pocket Max (Family): $16,300
Coinsurance (In-Network): 30%
Primary Care Copay: $20
Specialist Copay: $60
Urgent Care Copay: $20

Benefits

Deductible
$5,000 / $10,000
OON: $10,000 / $20,000
Max Out of Pocket
$8,150 / $16,300
OON: Unlimited
Copay
$20 / $60 / $20
PCP / Specialist / Urgent Care
Coinsurance
30% after deductible
OON: 50% after deductible
Emergency Room
Deductible & coinsurance
Rx Coverage
$0 / 25% / 50%
Generic / Preferred / Non-Preferred — no deductible
X-Ray & Bloodwork
Deductible & coinsurance
Pregnancy
Covered
Mental Health
Covered
Deductible & coinsurance
Chiropractic Care
Covered
30 visits per year
Child Eye Exam & Dental
No charge in-network
Work Requirement
Work Required
20+ hrs/week

Plan documents

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