Coverage Differences Between Aetna and Cigna International Health Services
1. There is no Cigna prescription drug network outside of the U.S. Prescription drug claims are paid at 80 percent after the medical deductible is satisfied, and are subject to the medical out-of-pocket limits, with no distinction between brand-name and generic drugs.
2. Within the U.S., Cigna participants can use CVS Caremark outlets just like Aetna participants, and will receive a CVS Caremark card. The prescription drug annual out-of-pocket limit applies (See Summary Plan Description for details).
3. The annual out-of-pocket limits, while identical between Aetna and Cigna International in total, are structured differently:
o Under Aetna, participants have a separate out-of-pocket limit for medical services versus prescription drug purchases at CVS Caremark-affiliated pharmacies.
o Under Cigna, there is a single higher out-of-pocket limit for medical expenses only.
o Cigna, Aetna, and CVS Caremark will coordinate expenses, and any Cigna participant who met the out-of-pocket maximums and also had CVS Caremark expenses will be reimbursed for those CVS Caremark expenses.
4. There is no Cigna dental network. All dental claims are administered subject to dental plan provisions, the annual dental deductible and the annual dental maximums. However, under Cigna, all routine preventive dental care is covered at 100 percent no deductible. Special periodontal surgery services are covered at 90 percent after deductible (except Retiree Plan 2).
5. There is no Cigna International network for mental health providers, although some psychiatry services are available through the Cigna medical network.
6. All cost limits, deductibles, etc., are denominated in USD. Cigna converts non-USD claims to USD based using the UN Operational Rates of Exchange on the date of service.
7. MIP Continuation for up to 36 months is also available for participants using Cigna and losing coverage due to divorce, children ending dependency, ending employment, etc. MIP Continuation will remain with the same administrator (Aetna or Cigna International), but all MIP Continuation billing is done by Aetna through its PayFlex affiliate.
8. Cigna International offers a two-year Conversion Policy for participants residing outside the U.S. who require medical insurance after MIP Continuation ends.
Cigna Advantages for Members Residing Outside the U.S.
1. A worldwide medical and hospital provider network (in over 100 countries) with streamlined direct billing arrangements that often result in no up-front fees for services from MIP participants and, in some cases, fee discounts for medical services.
2. An Antwerp-based multilingual (12 languages) call center.
3. International banking coordination, so you can receive your MIP reimbursements in local currency (or USD) via electronic funds transfer or check.
Familiarity with treatment protocols and billing procedures in many countries.