The Practitioner Connection
Volume XXVIII, 4th Quarter

CIGNA MEDICARE ACCESS^SM PRIVATE FEE-FOR-SERVICE (PFFS)

Cigna Medicare Access plans will have new features and an expanded service area beginning January 1, 2009. Plans will be offered to employer groups nationwide, as well as directly to individuals, in over 1,500 counties in the following 28 states:

Cigna Medicare Access plans are Medicare Advantage Private Fee-for-Service plans authorized by the Centers for Medicare and Medicaid Services. Cigna Medicare Access plans can be offered with or without prescription drug coverage and replace original Medicare Parts A and B. These plans provide additional benefits beyond original Medicare such as preventive care, out-of-pocket maximums and unlimited hospitalization. Individual plans will now also include preventive dental coverage and some plans will include Part D prescription drug coverage. These plans do not require referrals or authorizations, although admission notification for all inpatient stays (hospitalizations, skilled nursing and rehabilitation) is requested.

Highlights of the 2009 individual Cigna Medicare Access plans include:
• Four standard plan designs available to individuals in over 1,500 counties in 28 states;
• Both Medicare Access and Medicare Access Plus Rx plans are available with $0 premium;
• Maximum out-of-pocket limits between $2,000 and $3,800;
• Hospital Inpatient copays as low as $30 for days one – six;
• Outpatient laboratory services and diagnostic tests with lower member cost share than original Medicare (10% - 15% co-insurance); and
• Preventive dental benefits covered at 75%.

Employer group plans provide the same benefits as original Medicare and are often customized to include lower copays, lower out-of-pocket limits and annual routine physicals.

Our members are required to notify you that they have a Cigna Medicare Access plan prior to receiving services. Their identification card will have the Cigna Medicare Access plan logo, and any applicable copay may be collected at the time of the service.

You do not need to sign a contract to see individuals with a Cigna Medicare Access plan. A beneficiary enrolled in these plans is free to use any physician who accepts both original Medicare payment and Cigna's Terms and Conditions of payment.

Cigna now offers two options to submit electronic claims for covered individuals with Cigna Medicare Access plans:
• Connect directly to Cigna systems using free software from Post-N-Track. Contact Post-N-Track at 1.860.257.2030, or log on to www.Post-N-Track.com and click ‘Enroll’.
• Through your clearinghouse. If you do not have an existing relationship with a clearinghouse, contact Emdeon at 1.877.469.3263 or www.transact.emdeon.com to register.

The Cigna Medicare Access payer ID is 86033.

Paper claims can be submitted to:
Cigna Medicare Access
PO Box 696018
San Antonio, TX 78269-6018

If you are enrolled to receive the Electronic Remittance Advice (ERA) for Cigna covered individuals, you will now receive them for Cigna Medicare Access covered individuals.

For more information about Cigna Medicare Access plans, visit www.cignaforhcp.com or www.cignamedicare.com, or call 1.800.577.9410.

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