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HSA Compatible
Cigna PPO Network

Cigna Ultra 8000 HSA

Cigna PPO Network

Cigna Ultra 8000 HSA — Deductible: $8,000 / $16,000; Max Out of Pocket: $8,000 / $18,400; After the deductible the plan pays 100% in-network; Rx: $0 after deductible; HSA-qualified.

Monthly premiums

Member
$857.00/mo
Member & Children
$1,388.00/mo
Member & Spouse
$1,563.00/mo
Member & Family
$2,060.00/mo

Plan details

Deductible (Individual)
$8,000
Deductible (Family)
$16,000
Out-of-Pocket Max (Individual)
$8,000
Out-of-Pocket Max (Family)
$18,400
Coinsurance (In-Network)
0%

Benefits

  • Deductible

    $8,000 / $16,000

    Individual / Family (in-network)

  • Max Out of Pocket

    $8,000 / $18,400

    Individual / Family (in-network)

  • After the Deductible

    $0, plan pays 100%

    Doctor, tests, imaging, hospital, ER (in-network)

  • Preventive Care

    $0

    Covered before the deductible

  • Rx Coverage

    $0 after deductible

    Generic, preferred and non-preferred; specialty 50%

  • HSA

    HSA-qualified

    Pairs with a Health Savings Account

  • Out-of-Network

    40% after deductible

    Deductible $16,000 / $32,000

  • Network

    Cigna PPO — National

    No referrals required

Plan documents

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