CIGNA Choice Fund® Features
Here’s more information about each plan component:
Health Reimbursement Arrangement (HRA) “Fund”
- If you choose CIGNA Choice Fund, Metro will establish a fund with tax-free dollars you use to pay for covered medical and prescription expenses
- Extra dollars will be credited to your HRA fund upon completion of certain incentive programs
- You decide how and where to spend your fund dollars on covered medical and prescription expenses. You have the option to see out-of-network providers, but your fund dollars will go further when you visit in-network providers
- The fund pays for all covered medical expenses first before you pay your share
- This fund may only be used for medical and pharmacy expenses covered by the plan
Your Share of Deductible
- Your share is the amount you pay out-of-pocket after your fund is spent and before the medical plan starts paying any expenses
- If you spend all the money in your fund, you are responsible for paying for covered expenses until you satisfy the plan deductible
- If you do not spend all the dollars in your fund, those remaining dollars are added to your fund at the start of the next year
HRA “Fund” + Your Share of Deductible = Annual Deductible
Plan Pays 90% for most services
- Once you meet the annual deductible, the medical plan starts to pay expenses
- The plan works like a PPO with in-network and out-of-network providers; however, there are no copays
- You can visit in-network providers anywhere in the United States
- For medical expenses, you pay 10% of the discounted cost, called coinsurance, up to the annual out-of-pocket maximum. The plan pays 90% of the cost of covered services received from in-network doctors. *Once you meet your out-of-pocket maximum, you will not have to pay any deductible or coinsurance for the remainder of the calendar year. All covered services and prescription drugs will be paid 100% by the plan through the end of the year.
- For generic drug expenses, you pay 10% of the discounted cost and the plan pays 90% ; for brand prescription drug expenses the plan pays 70% and you pay 30%. *Once you meet your out-of-pocket maximum, you will not have to pay any deductible or coinsurance for the remainder of the calendar year. All covered services and prescription drugs will be paid 100% by the plan through the end of the year.
- When the annual out-of-pocket maximum is met, the plan pays 100% of covered expenses. This protects you and your family from any medical expenses for the remainder of the year
Preventive Care
- At any time during the year, you can take advantage of in-network preventive care services at no cost to you
- Covered preventive care services may include:
- Annual physical exams
- Immunizations
- Mammograms
- Colonoscopy
- Pap smear
- Prostate screenings
- And certain other healthcare screenings
- In-network preventive care services will not reduce your HRA fund, but out-of-network preventive services will be charged like any other expense