Cigna Connect 5900 Plan Details for 2021- HealthPocket

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Zip Code63129
Applicant12/3/1985 Male

Benefits & Coverage

Insurance TypeACA (Obamacare)
Plan NameCigna Connect 5900
Plan IDqhp-74483MO0040012
Plan Year2020
Insurance ProviderCigna
Metal LevelExpanded Bronze
Plan TypeEPO
Deductible$5,900
Out-of-Pocket Maximum$8,150
Plan Highlights

Costs for Medical Care

Primary Care Visit to Treat an Injury or Illness$50 Copay
Specialist Visit50% Coinsurance after deductible
Laboratory Outpatient and Professional Services50.00% Coinsurance after deductible
X-rays and Diagnostic Imaging50.00% Coinsurance after deductible
Deductible - Family$11800
Out-of-Pocket Maximum - Family$16300

Prescription drug coverage

Generic Drugs$10 Copay
Preferred Brand Drugs50% Coinsurance after deductible
Non-Preferred Brand Drugs50% Coinsurance after deductible
Specialty Drugs50% Coinsurance after deductible

Access to doctors and hospitals

Provider directory URLhttp://www.cigna.com/ifp-providers

Hospital services

Emergency Room Services50% Coinsurance after deductible
Inpatient Hospital Services (e.g., Hospital Stay)50% Coinsurance after deductible
Inpatient Physician and Surgical Services50% Coinsurance after deductible

Maternity

Prenatal and Postnatal Care0.00%

Mental Health

Mental/Behavioral Health Outpatient Services0.00%
Mental/Behavioral Health Inpatient Services0.00%

Vision Coverage

Routine Eye Exam for ChildrenNo Charge
Eye Glasses for ChildrenNo Charge

Exclusions and Limitations

More Included BenefitsTransplant
Accidental Dental
Dialysis
Allergy Testing
Chemotherapy
Radiation
Diabetes Education
Prosthetic Devices
Infusion Therapy
Treatment for Temporomandibular Joint Disorders
Nutritional Counseling
Reconstructive Surgery
Tier 2 Generic Drugs
Other Practitioner Office Visit (Nurse, Physician Assistant)
Outpatient Facility Fee (e.g., Ambulatory Surgery Center)
Outpatient Surgery Physician/Surgical Services
Hospice Services
Private-Duty Nursing
Urgent Care Centers or Facilities
Home Health Care Services
Inpatient Physician and Surgical Services
Skilled Nursing Facility
Outpatient Rehabilitation Services
Habilitation Services
Chiropractic Care
Durable Medical Equipment
Hearing Aids
Imaging (CT/PET Scans, MRIs)
Preventive Care/Screening/Immunization
Routine Foot Care
Rehabilitative Speech Therapy
Rehabilitative Occupational and Rehabilitative Physical Therapy
Well Baby Visits and Care
More Excluded BenefitsAbortion for Which Public Funding is Prohibited
Infertility Treatment
Long-Term/Custodial Nursing Home Care
Bariatric Surgery
Cosmetic Surgery
Acupuncture
Weight Loss Programs
Dental Check-Up for Children
PremiumPlan NameDeductible
from $448
Balance by Medica Silver Copay
$6,000.00Select
from $465
Cigna Connect 5750
$5,750.00Select
from $515
Select by Medica Silver Copay
$6,000.00Select
from $524
Cox HealthPlans Silver Connect 3
$6,000.00Select
from $533
Ambetter Balanced Care 11 (2021) + Vision + Adult Dental
$6,000.00Select
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Elise, Finnerty
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Danielle, Sellers
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Cory, Heslin
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Allison, Arehart
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Elizabeth, Miotti
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Laura, Flanigan
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Taylor, Barker
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Maureen, Moore
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Jaime, Mathieu
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Nick, Livasy
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Marina, Clements
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Jennifer, Marr
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Susan, Grogan
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Stephen Staten, MD
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  • Phone Number
    (314) 543-5996
  • Office Locations
    4438 Telegraph Rd
    Saint Louis, MO 63129
4438 Telegraph Rd Saint Louis MO, 63129

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HealthPocket is a free information source designed to help consumers find medical coverage. Whether you are looking for Medicare, or an individual and family health insurance plan, we will help you find the right healthcare option and save on your out of pocket healthcare costs. We receive our data from government, non-profit and private sources, and you should confirm key provisions of your coverage with your selected health plan. If you select a plan presented on our site, you will be directed (via a click or a call) to one of our partners who can help you with your application. Our website is not a health insurance agency and not affiliated with and does not represent or endorse any health plan. HealthPocket, Inc. is part of the Benefytt Technologies, Inc. family of companies.