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Cigna Connect 4750

Overview
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Cigna Connect 4750 is an individual health health plan issued by Cigna Health and Life Insurance Company and is available for the year 2019. This health plan is offered by the federal government through HealthCare.gov and the Affordable Care Act (ACA).

Where Do I Need to Live to Quality for this Plan?

This plan is available for qualifying individuals who live in Jefferson county, Tennessee.

What Type of Health Plan Is This?

This plan is an EPO plan, which is also known as an "Exclusive Provider Organization." An EPO is a managed care plan where services are covered so long as the the hospitals, dentists, and other health providers in the plan's network are used.

Where Can I Buy This Plan?

You can purchase this plan at HealthCare.gov.

About
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Issuer
Cigna Health and Life Insurance Company
Plan ID
99248TN0060053
Coverage area
Jefferson County, Tennessee
Phone
Local Phone: 1-877-900-1237
Toll-Free: 1-877-900-1237
TTY: 1-800-676-3777
Plan type
EPO
Coverage type
Medical deductible
$4,750
Out-of-pocket maximum
$7,900
Generic drug co-pay
$25
Preferred brand drug co-pay
$75
Primary care physician visit cost
$35
Specialist doctor visit cost
40% Coinsurance after deductible
Doctor Visits
Primary Care Visit $35
Specialist Visit 40% Coinsurance after deductible
Emergency Room Visit $1000 Copay after deductible
Inpatient Facility Visit 40% Coinsurance after deductible
Inpatient Physician Visit 40% Coinsurance after deductible
Prescription Drugs
Generic Drugs $25
Preferred Brand Drugs $75
Non-preferred Brand Drugs 50% Coinsurance after deductible
Specialty Drugs 40% Coinsurance after deductible
Medical Deductible
Medical Deductible (Individual) $4,750
Medical Maximum Out Of Pocket (Individual) $7,900
Medical Deductible (Family) $9,500
Medical Maximum Out Of Pocket (Family) $15,800
Drug Deductible
Drug Deductible (Individual) Included in Medical
Drug Maximum Out Of Pocket (Individual) Included in Medical
Drug Deductible (Family) Included in Medical
Drug Maximum Out Of Pocket (Family) Included in Medical
Premium Rates
EHB Percent of Total Premium 100.00%
Premium Child Age 0-14 293.79
Premium Child Age 18 350.62
Premium Adult Individual Age 21 384.03
Premium Adult Individual Age 27 402.47
Premium Adult Individual Age 30 435.88
Premium Adult Individual Age 40 490.79
Premium Adult Individual Age 50 685.88
Premium Adult Individual Age 60 1,042.27
Premium Couple 21 768.06
Premium Couple 30 871.76
Premium Couple 40 981.58
Premium Couple 50 1,371.76
Premium Couple 60 2,084.54
Couple+1 child, Age 21 1,061.85
Couple+1 child, Age 30 1,165.55
Couple+1 child, Age 40 1,275.37
Couple+1 child, Age 50 1,665.55
Couple+2 children, Age 21 1,355.64
Couple+2 children, Age 30 1,459.34
Couple+2 children, Age 40 1,569.16
Couple+2 children, Age 50 1,959.34
Couple+3 or more Children, Age 21 1,649.43
Couple+3 or more Children, Age 30 1,753.13
Couple+3 or more Children, Age 40 1,862.95
Couple+3 or more Children, Age 50 2,253.13
Individual+1 child, Age 21 677.82
Individual+1 child, Age 30 729.67
Individual+1 child, Age 40 784.58
Individual+1 child, Age 50 979.67
Individual+2 children, Age 21 971.61
Individual+2 children, Age 30 1,023.46
Individual+2 children, Age 40 1,078.37
Individual+2 children, Age 50 1,273.46
Individual+3 or more children, Age 21 1,265.4
Individual+3 or more children, Age 30 1,317.25
Individual+3 or more children, Age 40 1,372.16
Individual+3 or more children, Age 50 1,567.25
Reference
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  • HealthCare.gov. U.S. Centers for Medicare and Medicaid. Accessed June 11, 2019. https://www.healthcare.gov
  • The 'metal' categories: Bronze, Silver, Gold & Platinum. U.S. Centers for Medicare and Medicaid. Accessed June 11, 2019. https://www.healthcare.gov/choose-a-plan/plans-categories
  • Health insurance plan & network types: HMOs, PPOs, and more. U.S. Centers for Medicare and Medicaid. Accessed June 11, 2019. https://www.healthcare.gov/choose-a-plan/plan-types