944341 09/23
North Carolina
2024
Health
Insurance
Plans
What to know before
making your choice.
Individual and Family Plans
Insured by Cigna HealthCare of North Carolina, Inc.
North Carolina
Questions? Call us: 855.756.8490
Compare our plans online: Cigna.com/NCplans
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It’s not just about when you’re sick.
Health is a lifelong journey, and enrolling in a health plan plays an important part. That’s why at
Cigna Healthcare
SM
, we give you the tools and support you need to make the best choice for your
health and your budget. Use this brochure as a guide, or call 855.756.8490 for help with important
plan considerations. Here are just some of the budget-saving benets a Cigna Healthcare
individual and family health plan can oer:
1. Availability of $0 preventive care (no cost-share) by plan may vary. Includes eligible in-network preventive care services. Some preventive care services may not be covered, including most
immunizations for travel. Reference plan documents for a list of covered and non-covered preventive care services.
2. $0 virtual care (no cost share) for eligible preventive care and Dedicated Virtual Urgent Care for minor acute medical conditions. Not available for all plans. HSA plans and non-minor acute
medical care may apply a copay, coinsurance or deductible. Cigna Healthcare provides access to Dedicated Virtual Care through a national telehealth provider, MDLive located on myCigna, as
part of your health plan. Providers are solely responsible for any treatment provided to their patients.
3. Health benefit plans may be different, but in general to be eligible for coverage a drug must be approved by the Food and Drug Administration (FDA), prescribed by a health care professional,
purchased from a licensed pharmacy and be medically necessary. If your plan provides coverage for certain prescription drugs with no cost-share, you have to use an in-network pharmacy to
fill the prescription. If you use a pharmacy that does not participate in your plan’s network, your prescription may not be covered or reimbursement may be limited by your plan’s copayment,
coinsurance or deductible requirements. Look at your plan documents for more information about your plan’s prescription drug coverage.
4. Pediatric dental is not available in all states. Some states have stand-alone dental plans with pediatric services. Additionally, some states have a bundled pediatric dental option for off-Exchange consumers.
Coverage for these 10 essential
health benets.
• Ambulatory patient services
(outpatient services)
• Emergency services
• Hospitalization
• Maternity and newborn care
• Mental health and substance
use disorder services, including
behavioral health treatment
• Prescription drugs
• Rehabilitative and habilitative services
(those that help patients acquire,
maintain or improve skills necessary
for daily functioning) and devices
• Laboratory services
• Preventive and wellness services
and chronic disease management
• Pediatric services, including oral
and vision care
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Price Transparency Tools
help you estimate costs ahead of time
and avoid surprise bills
24/ 7/365
access to a doctor, nurse or customer service
representative by phone or at myCigna.com
®
$0
preventive care
1
$0-$3
preferred generic prescription
drugs
3
(for most plans)
The care and service you need.
Cigna One Guide
®
which gives you personalized support and
help with answers to all your plan questions
Virtual care from
$0
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North Carolina
Questions? Call us: 855.756.8490
Compare our plans online: Cigna.com/NCplans
3
5. The Cigna Take Control Rewards program is available in all states to all primary subscribers who are active Cigna Healthcare medical Individual and Family Plan policyholders and who are
18 years of age or older. All rewards may be considered taxable income. Contact your personal tax advisor for details. Program participation along with reward redemption is dependent on
qualifying premiums being current and fully paid.
6. Healthy Rewards programs are NOT insurance. Rather, these programs give a discount on the cost of certain goods and services. The customer must pay the entire discounted cost.
Some Healthy Rewards programs are not available in all states, and programs may be discontinued at any time. Participating providers are solely responsible for their goods and services.
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Rewards for healthy actions.
Cigna Take Control Rewards®
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Earn up to $325 in reward points for completing simple, educational online activities. You can then
redeem your points for merchandise or a Reloadable Reward Card to help make health care costs
more aordable.
Cigna® Healthy Rewards®
With Healthy Rewards,
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you can save time and money on a wide variety of health products, wellness
programs and other services, including:
Hearing and vision care
Nutrition Fitness and exercise
North Carolina
Questions? Call us: 855.756.8490
Compare our plans online: Cigna.com/NCplans
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1. Cost
Choose a plan that fits your budget.
Each plan has a variety of costs. These include:
• Premium. This is the payment you make
each month to keep your coverage.
• Deductible. This is the set amount you pay out
of pocket for covered medical services before
your insurance starts sharing the cost.
• Coinsurance. Once you’ve met your annual
deductible, you pay for a percentage of covered
medical services and your health plan pays the rest.
• Copays. This is the fixed amount you
pay for doctor visits, prescriptions
or other medical services.
Cigna Healthcare offers a variety of plans,
including some with a $0 deductible and some
with $0 copays.
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When choosing a plan, consider
what’s best for your budget and your needs.
Three things to think about before
making your choice.
Bronze
60% 40%
Silver
70% 30%
Gold
80% 20%
Plans are available in three metal levels.
Each is available on the Exchange and pays different
amounts of the total cost of an average person’s
care. The higher the metal level, the more expenses
your plan covers. To learn more, be sure to read
the Summary of Benefits and Coverage found
on each plan page or visit HealthCare.gov.
Average amount your health plan pays
Average amount you pay
7. $0 deductible and $0 copay are available on
select Cigna Healthcare individual and family
health care plans. Reference plan documents
for more information.
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North Carolina
Questions? Call us: 855.756.8490
Compare our plans online: Cigna.com/NCplans
5
8. Based on internal data on Exchange applications during the 2023 Open Enrollment Period.
9. Federal financial assistance can only be applied to the purchase of a Qualified Health Plan (QHP),
which is an insurance plan that’s certified by the Health Insurance Marketplace®, provides
essential health benefits, follows established limits on cost-sharing (including deductibles,
copayments and out-of-pocket maximum amounts) and meets other requirements under the
Affordable Care Act (ACA).
10. US Department of Health and Human Services (HHS). “Biden-Harris Administration Announces
Record-Breaking 16.3 Million People Signed Up for Health Care Coverage in ACA Marketplaces
During 2022–2023 Open Enrollment Season.” [Press release.] January 25, 2023. https://www.
hhs.gov/about/news/2023/01/25/biden-harris-administration-announces-record-breaking-
16-3-million-people-signed-up-health-care-coverage-aca-marketplaces-during-2022-2023-
open-enrollment-season.html
In-network
means the doctor or facility meets certain requirements and
agrees to accept a discounted rate for services under your plan.
Out-of-network
means the doctor or facility is not contracted with your
health plan and can charge you full price for services.
We offer Cigna Healthcare
individual and family health
plans in the following
North Carolina counties:
Alamance, Anson, Avery, Beaufort,
Bertie, Bladen, Brunswick,
Buncombe, Cabarrus, Camden,
Carteret, Chatham, Cherokee,
Chowan, Clay, Columbus, Craven,
Cumberland, Currituck, Dare,
Davidson, Davie, Duplin, Durham,
Edgecombe, Forsyth, Franklin,
Gates, Graham, Granville, Greene,
Guilford, Halifax, Harnett, Haywood,
Henderson, Hertford, Hoke, Hyde,
Jackson, Johnston, Jones, Lee,
Lenoir, Macon, Madison, Martin,
McDowell, Mecklenburg, Mitchell,
Montgomery, Moore, Nash, New
Hanover, Northampton, Onslow,
Orange, Pamlico, Pasquotank,
Pender, Perquimans, Person, Pitt,
Polk, Randolph, Richmond, Robeson,
Rockingham, Rowan, Rutherford,
Sampson, Scotland, Stokes, Swain,
Transylvania, Tyrell, Union, Vance,
Wake, Warren, Washington,
Wayne, Wilson, Yadkin, Yancey.
2. Financial assistance
Nearly 9 out of 10 Cigna Healthcare customers receive federal
financial assistance when buying a plan on the Exchange.
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• Premium tax credits can reduce your monthly payment when you
enroll in a qualified health plan (QHP).
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• Inflation Reduction Act helped 4 out of 5 new customers enroll in
a plan for $10 or less per month after federal financial assistance.
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• Cost-sharing reductions on Silver plans can lower the amount
you pay out of pocket when you get care. Household size
and income requirements determine the reduction amount.
Cost-sharing reductions may be combined with a premium
tax credit.
Native Americans and Alaska Natives may qualify for tax credits and
special cost-sharing reductions if specific requirements are met.
3. Care and coverage
The Cigna Connect Network is a Health Maintenance
Organization (HMO), which gives you access to local providers
selected with cost and quality in mind. To avoid extra expenses,
make sure your current doctor is in-network or consider
switching to one who is. To find out if your current doctor is
in-network, visit Cigna.com/ifp-providers.
North Carolina
Questions? Call us: 855.756.8490
Compare our plans online: Cigna.com/NCplans
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Find more answers.
We hope you have a better understanding of your health plan options and consider
a Cigna Healthcare Individual and Family Plan for 2024. For more information, visit
Cigna.com/NCplans or call 855.756.8490.
Frequently asked questions.
Q Does the plan require a primary care provider (PCP)?
A
No, Cigna Healthcare individual and family health plans do not require a PCP to be a part of your care
team, but it is encouraged. Your PCP acts as your team leader, helping keep you healthy and
coordinating your care.
Q What if I need urgent care but my PCP can’t see me?
A
If your PCP is not available, you can still access quality care through another in-network
PCP, at an in-network urgent care center, at a convenience care clinic or through virtual care. If you have
a life-threatening emergency, go to your nearest emergency room (ER).
Q How do I know if my prescriptions are covered?
A
You can nd a plan-approved prescription drug list at Cigna.com/ifp-drug-list.
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North Carolina
Questions? Call us: 855.756.8490
Compare our plans online: Cigna.com/NCplans
7
2024 Important Plan Disclosures
Medical plan rates vary based on plan design, age, family size, geographic location (residential zip code)
and tobacco use.
Rates for new medical policies/service agreements with a start date on or after 01/01/2024 are guaranteed
through 12/31/2024. Thereafter, medical rates are subject to change on 60 days’ prior notice.
Insurance policies/service agreements have exclusions, limitations, reduction of benets and terms under which the policies/
service agreements may be continued in force or discontinued. Medical applications are accepted during the annual Open
Enrollment Period or within 60 calendar days of a qualifying life event. Benets are provided only for those services that are
medically necessary as dened in the policy/service agreement and for which the insured person has benets.
Form Series for Cigna HealthCare of North Carolina, Inc.:
Health Maintenance Organization: NC: INDHMONC01-2024
The policy/service agreement may be canceled by Cigna Healthcare due to failure to pay premium, fraud, ineligibility, when
the insured no longer lives in the service area, or when Cigna Healthcare ceases to oer policies/service agreements of this
type or ceases to oer any plans in the individual market in the state, in accordance with applicable law. In the event of
entry of a nal judgment by a court declaring all or part of the Patient Protection and Aordable Care Act (P.L. 111-148)
invalid, unconstitutional, or otherwise ineective, and the state not providing alternative and sucient means of funding
advanced-Premium tax credits, this policy shall be subject to cancellation consistent with applicable federal and state law.
You may cancel the policy/service agreement on the rst of the month following our receipt of your written notice. We
reserve the right to modify the policy/service agreement, including plan provisions, benets and coverages, consistent with
state or federal law. Policies/service agreements renew on a calendar-year basis.
Cigna Healthcare does not intentionally discriminate on the basis of race, color, national origin, disability, age, sex,
gender identity, sexual orientation or health status in the administration of the plan, including enrollment and benet
determinations.
For costs and additional details about coverage, contact Cigna Healthcare at 900 Cottage Grove Road, Hartford, CT 06152
or call 866.Get.Cigna (866.438.2446).
No-cost language services are available. You can have an interpreter. You can get documents read to you and some sent to
you in your language. For help, call us at 866.494.2111.
Servicios de idiomas sin costo. Puede obtener un intérprete. Le pueden leer documentos y que le envíen algunos en español.
Para obtener ayuda, llámenos al 866.494.2111.
Note to North Carolina Residents: Your actual expenses for covered services may exceed the stated coinsurance
percentage or copayment amount because the actual provider charges may not be used to determine plan and member
payment obligations.
Product availability may vary by location and plan type and is subject to change. All health insurance policies and health benefit
plans contain exclusions and limitations. For costs and details of coverage, review your plan documents or contact a Cigna
Healthcare representative. Cigna Healthcare products and services are provided exclusively by or through operating subsidiaries
of The Cigna Group, including Cigna Health and Life Insurance Company (Bloomfield, CT), Cigna HealthCare of Arizona, Inc., Cigna
HealthCare of Georgia, Inc., Cigna HealthCare of Illinois, Inc., Cigna HealthCare of North Carolina, Inc., Cigna HealthCare of South
Carolina, Inc., and Cigna HealthCare of Texas, Inc.
944341 09/23 © 2023 Cigna Healthcare. Some content provided under license.
