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Cigna Plan G HDHP 3

Unless stated otherwise, percentages reflect proportion of cost covered by insurance plan.

GENERAL INFORMATION

Who's covered?

Family

In Network?

Yes

Annual Deductible

$4000

Out of Pocket Max

$4000

NON-EMERGENT SERVICES

Outpatient

100% after deductible

Preventative Care

Primary Care

100% after deductible

100% after deductible

Specialist Visit

100% after deductible

Telemedicine Visit

100% after deductible

EMERGENT SERVICES

Inpatient

100% after deductible

Urgent Care

100% after deductible

Emergency Room

100% after deductible

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