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Knowledge Base – Cigna Global Group Insurance

Your Cigna Global Group Insurance Information

Table of Contents

1. Member Portal
2. Pre-certification
3. Claims
4. Understanding Your Cigna Global Employer Group Medical Insurance Benefits
5. Understanding your Explanation of Benefits (EOB)
6. Using your Global (Outside the U.S.) Medical Network
7. Using your U.S. Medical Network
8. Emergency Medical Evacuation
9. Preventative and Immunization Benefits
10 .Telehealth and other insurance benefits

Welcome To Your Cigna Global Group Insurance Plan

Your Cigna Global employer group insurance plan comes with incredible medical benefits including emergency evacuation, telehealth coverage, a vast international network, and self-service through the Cigna Envoy member portal. 

On this page you’ll find information about your GNI team, your member portal, claims and benefits, and much more. This knowledge base was developed specifically to help you navigate any questions or challenges you may have.

We want you to make the most of the benefits of your Cigna global employer group insurance plan. 

Don’t forget to bookmark this page so that you can easily find the answer to your future insurance questions. 

GNI Contact Information

Your Group Insurance Advisors: Karen, Kirk, & Doug.

telephone icon 480-813-9100
envelope icon [email protected] (attn: Karen)
building icon 690 E Warner Rd Ste. 117   Gilbert, AZ 85296
  1. Envoy user guide on Submitting a claim
  2. Understanding your Explanation of Benefits.

Understanding Member Portal

All covered employees should register on Cigna Envoy or on the Cigna Global app. You will save time by having a wealth of information at your fingertips. You can access and print ID Cards and forms, file and view claim status, obtain copies of certificates, find a hospital or doctor, and more. Access to interactive online tools to help with health, fitness, and lifestyle are included. Just go to: www.cignaenvoy.com and click the “Register” button. This will take you to a page where you can enter in your Cigna ID number and create a user name and password for access to the site. This can be done on the App as well.

Question: Do I need to carry my ID card with me at all times?

Answer:  Your ID card contains important information including contact information for Cigna should a medical emergency arise. We recommend that you carry it with you at all times.

 

Question: How may I obtain a new ID Card?

Answer: Download a PDF version of your ID Card from the Cigna Envoy website. Once logged in, locate the Print ID Card link. To obtain a replacement for your hard plastic ID Card, contact customer service through your Cigna Envoy account to request a new one.

 

Question:  Where are my 1095s for my tax return?

Answer: Cigna supplies members with PDF copies of their 1095 forms within CignaEnvoy.com. They should be available by the end of January on the following year. From the homepage of the portal, the member should click on “My Documents,” and then on the next page, click on “Your US Tax Return Forms.” From there, click on the 1095 option to print or download the file.

Dependents over age 18 can have their own Cigna Envoy profile. From your Cigna Envoy account, you can send an “Invite to Register” e-mail to your dependents. We recommend that you do that especially for your adult children who are enrolled.

You and your dependents can access Telehealth through Cigna Envoy, either through your computer or the app.

 

 

Videos

  1. How does my Deductible Work
  2. Why is my Deductible Higher in the U.S.
  3. Top 5 things to remember when you start your international employer medical group insurance
  4. Top 8 things to remember before, during, and after going to your medical appointment on your global employer group medical insurance

Key Notes

Cigna Global is known for its large international network. Find a doctor near you with their fantastic “Find Health Care” tool in your CignaEnvoy portal.

Understanding Pre-Certification

Pre-certification is needed for surgeries and other expensive procedures. Direct Pay providers overseas and in the US, will do this for you. For other providers, it can be initiated through your Cigna Envoy account or by calling in to Cigna.

You can also call Cigna’s 24/7 customer service number on your ID card: 1-800-441-2668 in the US or 1-302-797-3100 abroad. (You can call collect.)

Question – In the U.S., who is responsible for getting the precertification?

Answer 1 – In-network services: Your doctor is responsible.

Answer 2 – Out-of-network services: You are responsible if you choose to see an out-of-network doctor and your plan covers out-of-network services. To get precertification, call the toll-free number on your Cigna ID card. You’ll need the name of the doctor or facility, the procedure or procedure code and the date of service when you call. Remember, when you go out-of-network, your out-of-pocket costs may be higher and your claim could be denied if not medically necessary.

 

 

Pre-certification is the process of determining in advance whether a procedure, treatment or service will be covered under your health care plan. The Cigna team evaluates whether the treatment proposed is medically necessary and covered by your plan.

It also helps ensure you get the right care in the right setting- potentially saving you from costly and unnecessary services.

IN THE U.S.  – Who needs to get the pre-certification? Your doctor will help you decide which procedures require you to be admitted to the hospital and which can be handled on an outpatient basis. If your doctor is in the Cigna OAP network, he or she will arrange for pre-certification. If you use an out-of-network doctor, you are responsible to see that the pre-certification is completed.  

 

 

Videos

  1. General information on global medical insurance precertification
  2. Do I need to pre-certify before a hospital admission or surgery?

Key Notes

If in doubt, pre-certify.

Understanding Claims

Filing Claims

When you pay for covered services, you can file claims through Cigna Envoy at www.cignaenvoy.com, or on the Mobile app.

Just sign into your account, click on the claims tab and click submit new claim.

You’ll be able to fill out an online form and upload your documents to submit with your claim.

Claims submitted online are usually processed within 10 business days of receipt, as long as the form is completed and the proper proof documents are uploaded.

How do I file a claim?

Use the online claim submission within Cigna Envoy website or App (www.CignaEnvoy.com)

  • Select the “My Claims” tab
  • Click the “Submit a New Claim”

Click here to see the instructions on submitting a claim

Question – How long does it take for a claim to be processed?

Answer – If all the required information is submitted, the claim should be processed in 10 business days with an Explanation of Benefits in your account. If something is missing, Cigna should inform you via secure messaging in Cigna Envoy or by an Explanation of Benefits (EOB) telling why the claim was denied.

 

Question:  How will I know when my claim has been paid?

Answer: You will see the deposit in the bank account that you specified or see the EOB in your member account.  You can be reimbursed in U.S. dollars or in many local currencies into your bank account.  Or you can also request a physical check to be mailed to you. We recommend direct deposit as a faster and usually a more secure method.

Having a problem connecting online or with any of the features available?  You can call the Cigna International Helpline at +1-800-441-2668 any time, from anywhere.

Question: How do I track the status of my claim?

Answer: In Envoy, again select “My Claims”.  You will have the option here to search by date, by family member’s name or by the type of claim. 

Claims: ***Online: www.cignaenvoy.com (we recommend online submission)

Fax: 800-243-6998 or 1-302-797-3150

Mail: PO Box 15050, Wilmington, DE 19850-5050

Videos

  1. How do I submit my claim?
  2. What’s the reimbursement time for claims on our international group insurance?

Key Notes

Question – How to file an online Claim?

Answer – Go to Cigna Envoy: www.cignaenvoy.com

Understanding Your Group Insurance Benefits

Understanding your Cigna global group medical insurance benefits is sometimes confusing, but we’re here to help.

The best place to start is downloading the Certificate of Coverage found in your Cigna Envoy account. This covers all the details. You can find a lot of information doing a word search for Key words.

Question: Who do I contact at Cigna Global?

Answer: Here are the different contacts at Cigna Global:

Customer service representatives are available 24/7/365 to provide assistance when needed.

  1. Send a secure email through Cigna Envoy, leave a local number where they can call you.
  2. Call direct: Outside the US: 1.302.797.3100 In the US: 1.800.441.2668
  3. Call collect – charges will be accepted by Cigna (this may not work in all locations).

If sending a secure e-mail, always leave a local number where Cigna can reach you.

FOR EMERGENCIES ALWAYS CALL CIGNA DIRECTLY, as soon as possible. If an evacuation is needed, the sooner they get started the better. Customer service representative are available 24/7/365 to provide assistance when needed.

FOR EMERGENCIES ALWAYS CALL CIGNA DIRECTLY, as soon as possible. If an evacuation is needed, the sooner they get started the better.

Customer service representative are available 24/7/365 to provide assistance when needed.

Videos

  1. What does Cross-Accumulate Deductible Mean?
  2. What is covered and what is not?
  3. What Does “Co-Insurance” Mean?
  4. Exploring Family Counseling Benefits
  5. Navigating your Global Insurance
  6. Excess vs. Deductible

 

Key Notes

  1. Is Telehealth Included in Our International Employer Group Medical Insurance?
  2. Navigating Ambulance Claims
  3. What ‘Usual, Reasonable, and Customary’ Means for Your Global Employer Group Insurance
  4. Global travel intelligence benefit
  5. Mental Health Benefits

Understanding Your Explanation of Benefits (EOB)

Once the claim is processed, there will be an Explanation of Benefits (EOB) available on your account. This will tell you what has been paid for by Cigna. If anything is not being paid for, the explanation is found in the Remark Codes found towards the bottom of the document.

If you have questions about the EOB, there is a glossary of terms available online.  And if you still need help, you can contact us here at Good Neighbor for help figuring it all out. We can also help in the happenstance that there has been an error.

 

 

Question – What is Explanation of Benefits?

Answer – Your Explanation of Benefits is a summary of how your claims were processed and what you may owe, not a bill. Your health care professional or the facility may bill you directly for the remainder of what you owe.

 

Question – What is the summary page of my EOB?

Answer – The Summary page gives an overview of how your benefits are working for you – quickly see how much was submitted, how much has been paid, and what may be your responsibility.

In addition to asking for help from GNI, if you feel that there has been an error on your claim, you have the right to appeal a denial. GNI can advise you on how to best do that.

As much as we love to serve you, please be aware that due to privacy laws, we do not have access to your claims. We only know what you tell us.

Your GNI team is here to serve, if you are having trouble getting through to Cigna, please let us know how we can help.

Videos

  1. What do these different levels of deductibles mean?
  2. What does “out-of-pocket maximum” mean?
  3. Understanding my Explanation of Benefits (EOB)

Key Notes

  1. Part 1 of 2 – Your out-of-pocket maximum
  2. Part 2 of 2 – Your out-of-pocket maximum
  3. How do I know if I have a co-pay when I visit a doctor’s office on my international employer group medical insurance?

Using your Global (Outside the U.S.) Medical Network

Through your Cigna Envoy account, select “Find Health Care” and begin your search.

You can search by country and city. In some cases, you may need to visit an international doctor or health care facility that is not directly contracted. In this case, you may have to pay upfront and then submit a claim for reimbursement.

However, you can have the doctor or hospital call the International Service Center and request a “Guarantee of Payment” letter.

Cigna can work with the facility to arrange a Direct Payment. Cigna cannot compel a provider to accept their guarantee of payment

Question – What is “Guarantee of Payment (GOP)?

Answer –  A Guarantee of Payment (GOP) outlines what Cigna will pay for the specified services that a provider is offering. If accepted by the provider, it may reduce or even eliminate your out-of-pocket expenses.

 

Question – What does a GOP include?

Answer – Schedule and dates of service, services to be performed, cost of service, deductible & coinsurance (if applicable) and more.

 

Question – Why is a GOP important?

Answer – (1) Reduces your out-of-pocket expenses where a direct billing relationship has not already been set up.
(2) Enables the hospital to bill Cigna directly. (3) Allows Cigna’s Medical Review Team to consult on the services being rendered, providing you the best care possible.

Please note that not all prescription medications are covered. Drugs considered to be “egregiously” priced are not eligible for coverage. Please see Cigna’s drug list effective 7/1/2022

Cigna Mail Order allows you to purchase a 90-day supply of drugs in the U.S. to take with you internationally. You can access the form in Cigna Envoy by clicking on the “Find health Care” tab and selecting mail order pharmacy. You would then complete the form and mail it in with your written prescriptions.

Cigna allows you to get an exception to the 90-day supply and get a one year supply before departing the US. Please note this will be subject to US benefits, not international benefits. This must be scheduled through Customer Service. You must have a full year prescription from your doctor in order to do this.

By using doctors and hospitals contracted with Cigna in the U.S. and abroad, you will avoid having to file claims. All you need to do is go online to www.cignaenvoy.com or use the mobile app. Sign in and click on providers.

Videos

  1. Part 1 of 3 – Two key medical insurance network models
  2. Part 2 of 3 – Some key differences in comparing your your medical networks
  3. Part 3 of 3 – How does my U.S. and interntional medical network stack up to others?

Key Notes

Prescriptions overseas are covered 100%. They are not subject to the deductible.

Cigna is always happy to assist you, let Cigna know if there is anything else you need. Their Service Center is available 24/7 toll-free at 1.800.441.2668, direct at 1.302.797.3100 or at www.CignaEnvoy.com.

 

Using your U.S. Medical Network

Go to Cignaenvoy.com and click on “Find Health Care.” You can review a doctor’s background, languages spoken and hospital affiliations, and get directions.

In-network – Choose to see doctors or other health care providers who are in the Cigna OAP network to keep your costs lower and to eliminate paperwork.

No-referral specialist care – If you need to see a specialist, you don’t need a referral.

When using US in-network health care providers, they handle all of the pre-certifications that may be required.

Out-of-network – You have the freedom to see doctors or use facilities that are not part of the Cigna OAP network, but your costs will be significantly higher and you may need to file a claim.

Emergency and urgent care – In-Network is always preferred to save you money. You can find them through your Cigna Envoy App. You can also call in to the number on your ID card, if you need help finding a provider.

Question – What is the difference between in-network and out-of-network coverage?

Answer – Each time you seek medical care, you may choose either your own doctor, or a doctor who is in the Cigna OAP network. Because Network providers have a contracted price that they can charge, their charges are subject to a lower deductible and co-insurance.

If it’s an office visit, you may only have a co-pay. Out-of-Network providers, are not contracted, and can charge whatever price they want; therefore, their charges are subject to a higher deductible and co-insurance and their entire charge may not be covered.

 

Question – How do I find out if my doctor is in the Cigna OAP network before I enroll?

Answer – It’s quick and easy to search for in-network doctors, specialists, pharmacies and hospitals close to home and work. Go to https://hcpdirectory.cigna.com/web/public/consumer/directory/search

In the US, in-network prescriptions are covered at 100% after a $15 co-pay for generic drugs, $40 co-pay for brand name drugs, and a $60 co-pay for non-preferred brand drugs. The deductible does not apply. In the U.S., outside the network, prescriptions are covered at 60% after the deductible.

Do I need a referral to see a specialist? You do not need a referral to see an in-network specialist. If you choose an out-of-network specialist, covered services will be reimbursed at the out-of-network level.

To find providers in the U.S., click on quick access in Cigna Envoy to find provider directories.” And then, you can search by zip code, by city and state, and also by specialty.

Videos

  1. Dealing with Out-Of-Network Expenses on a Group Medical Plan
  2. Employer Insurance: “In-Network” Benefits 101
  3. Your Deductible

Key Notes

What if I need to be admitted to the hospital?

In an emergency, you have coverage. Requests for nonemergency hospital stays, other than maternity stays, must be approved in advance or pre-certified. This lets Cigna determine if the services are covered by your plan. Precertification is not required for maternity stays of 48 hours for vaginal deliveries or 96 hours for caesarean sections. Any hospital stay beyond the first 48 or 96 hours must be approved.

Emergency Medical Evacuation

You have Emergency Medical Evacuation benefits. In order to use them, you must call Cigna and ask them to make arrangements.

Immediately call the number on the back of your Cigna ID card, 1-302-797-3100. (You can call collect), and state that you have an emergency. Be prepared to give Cigna the contact information of your providers (Doctor and Hospital).

Benefits include:

  1. Emergency evacuation and transportation to the nearest center of medical excellence when there is an immediate threat to life or limb
  2. Helping immediate family members coordinate travel
  3. Transportation back to your home country if your condition has stabilized, but you are unable to return to work
  4. Assisting with the coordination of travel for unaccompanied children in the event of an emergency.
  5. Return of Mortal Remains.

Question: Will my family be notified and updated?

Answer: Yes. Your family members will be told where you are going and what travel options are available to them. If transportation is urgently required, your doctor will discuss the options with you and your family.

 

Question: Will travel costs for anyone else be covered if I get evacuated?

Answer: If you are hospitalized for more than seven days, transportation of one family member may be covered. For family members who aren’t covered, Cigna can help coordinate travel plans.

 

Question: Are there exclusions and limitations I should be aware of?

Answer – Yes, there are limitations for use of the benefit. (Please review your Certificate of Insurance for all limitations and exclusions).

Medical Evacuation cannot be self-arranged and then submit a claim for reimbursement. Arrangements must be made by Cigna or their designated provider.

Only serious illnesses/conditions where there is significant and/or imminent risk of death or permanent injury are eligible for evacuation.

Your plan covers Emergency Medical Evacuation coordinated by Cigna and executed by International SOS. Roundtrip airfare paid at economy rates to the place of hospitalization for 1 family member for a hospitalization lasting longer than 7 days will be reimbursed.

FOR EMERGENCIES ALWAYS CALL CIGNA DIRECTLY, as soon as possible. If an evacuation is needed, the sooner they get started the better. Customer service representatives are available 24/7/365 to provide assistance when needed.

Videos

  1. Who Should I Call in a Medical Emergency on my Cigna Global Employer Group Insurance?
  2. Understanding your international emergency medical evacuation benefits

Key Notes

In the event of an emergency, call for local medical help first. Then, once you are stable, call Cigna’s global service center to tell them about the emergency situation or if you are diagnosed with a serious condition. You can call collect. To contact the global service center, just call the number on the back of your Cigna ID card. Staff are prepared to help you 24/7. 

Please note that –

  • Medical Evacuation cannot be self-arranged and then submit a claim for reimbursement. Arrangements must be made by Cigna or their designated provider.
  • Only serious illnesses or conditions where there is significant and/or imminent risk of death or permanent injury are eligible for evacuation.

Preventative and Immunization Benefits

Your health care plan includes coverage for preventative care at 100% when overseas and In-network in the USA. This includes the doctor’s appointment and age-appropriate tests and labs. It also includes immunizations including travel immunizations when needed.

Question – What is Preventive Care?

Answer – Preventive care services are provided during an annual wellness exam or check-up, in the absence of symptoms. You and your doctor will determine what tests and health screenings are right for you based on your: age, gender, personal and family health history.

 

Question – What is Not Preventive Care?

Answer – When you have a positive result in one of the screenings and the doctor orders additional screenings and tests to determine the cause. These services are covered under your plan’s medical benefits, not your preventive care benefits. For example, a lump is noted on a mammogram and a more detailed scan is requested. Even if the result is negative, the second scan is still considered diagnostic (subject to deductible & coinsurance) rather than preventative.

What is Your Share of the Cost? 

Your Cigna global group insurance plan covers preventive care services at 100% – no additional cost to you – when visits and tests are International or In-Network. Check Cigna Envoy to find network services near you.

Even when your appointment is for preventive care, if you happen to receive other services during that exam that are not preventive, these could be billed according to medical benefits rather than preventative. You may be responsible for paying a portion or all of the cost, such as a co-pay.

So that you don’t get a surprise bill, it’s important for you to know:

  1. What is considered preventive care and
  2. Services that are covered but not preventative.

Videos

  1. Difference of an Annual Preventative vs. Sick Benefits 

Key Notes

You and your children are eligible for wellness visits and routine screenings once every 12 months. Please take advantage of these benefits. These are meant to catch serious illnesses in the early stages so that treatment has the best outcome.

Telehealth and Other Insurance Benefits

Telemedicine or telehealth, is having an appointment with a provider remotely by phone or via an App. This may or may not include video.  

Question: What is covered by Cigna Global Group Health Insurance Benefits?

Answer: Telemedicine services are covered at the same coverage level and cost share as if the service was rendered through in-person consultation or contact – subject to the same medical necessity criteria.

  • Must be provided by an appropriately licensed and credentialed health care professional.
  • Coverage is provided per the terms and conditions of the policy and the health care professional’s or vendor’s contracting status: In- or out-of-network.
    • If your provider is billing from the U.S., then it will be subject to U.S. benefits and costs, even if you are overseas.

 

Question:  Are there other Value-added Services

Answer: In addition to providing quality health care, Cigna takes care of you around the world by providing assistance by calling the number on you card for:

  • Advice on how to Recover or replace lost documents like passports and credit cards
  • Coordinating emergency travel arrangements for minors left alone
  • Providing emergency translation services
  • Help finding or replacing prescription medication
  • Help in obtaining necessary documents for medical insurance claims.

MyConsult Online – Second Opinion Program: Through Cigna Envoy, you can access the Cleveland Clinic’s MyConsult Online Medical Second Opinion program. You can access this option by signing into your Cigna Envoy account, clicking on the health and well-being tab, clicking on “Clinical Support Services”, then clicking on “Online Second Opinion.”

Once a request is initiated, they will let you know if you or your family member is a candidate for an online second opinion. Once you are accepted, you will complete the requested information and a specialist will review the medical information and give an expert second opinion.

Health and Well-being Assessment: This service, provided through Cigna Envoy, assists individuals to assess their health and receive a customized report to help you know what areas that you are doing well in, and what areas need improvement. Click on the Health and Wellbeing link in the “You might be interested in” section at the bottom of the web page.

Videos

  1. How to Find Out if Your Cigna Global Group Insurance Plan Offers Telehealth 
  2. Do I have vision benefits on my international employer group medical insurance?
  3. Can our children have their own account online on my international employer group insurance?
  4. Direct Pay Explained: Maximizing Your Global Employer Group Insurance Benefits

Key Notes

Check with your employer to see if they have a Hospital Indemnity program in place that will pay you, when being hospitalized outside the U.S. rather than in the U.S.