Transcript Document

CIGNA Medicare Services
2009 Product Overview
All CIGNA Medicare 2009 plan designs described in this document are pending government approval and are therefore subject to change.
For producer use only. Distribution to consumers, other insurers, or any other person or company is strictly prohibited.
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Contents
• Medicare Advantage Service Area
3
• Medicare Advantage Premiums & Benefits
5
• Medicare Advantage Recruitment Messaging
7
• Medicare PDP Service Area
8
• Medicare PDP Benefits
9
• Medicare PDP Premiums
10
• Medicare PDP Recruitment Messaging
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All CIGNA Medicare 2009 plan designs described in this document are pending government approval and are therefore subject to change.
For producer use only. Distribution to consumers, other insurers, or any other person or company is strictly prohibited.
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Medicare Advantage Service Area, by State
For 2009, CIGNA has
NH
VT
WA
2 benefit packages,
MT
MA
MN
OR
ID
each containing
SD
PA
IL
CO
KS
IN
0H
DE
WV
VA
KY
MO
MD
NC
AZ
OK
NM
SC
AR
MS
2 MA-PD plans.
2009 service area are
DC
TN
2 MA-Only plans and
The 28 states in the
NJ
IA
NV
CA
CT
MI
NE
4 standard plans—
RI
NY
WI
WY
UT
ME
ND
AL
GA
LA
TX
FL
AK
HI
Benefit Package 1
shown here.
Benefit Package 2
All CIGNA Medicare 2009 plan designs described in this document are pending government approval and are therefore subject to change.
For producer use only. Distribution to consumers, other insurers, or any other person or company is strictly prohibited.
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Medicare Advantage Service Area, by County
For 2009, CIGNA has
4 county types,
A, B, C & D.
1512
counties
Type
A
B
C
D
Counties
405
152
192
763
Addressable Pop
3.8 million
1.6 million
1.8 million
7.0 million
Premiums are lowest
and benefits are
richest in A counties.
2009 counties are
shown here.
Double click
here for county
level details
(two tabs)
All CIGNA Medicare 2009 plan designs described in this document are pending government approval and are therefore subject to change.
For producer use only. Distribution to consumers, other insurers, or any other person or company is strictly prohibited.
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Medicare Advantage 2009 Premiums & Benefits
Benefit Package 1
Benefit Package 2
Benefit Package
&
Plan Name/Type
Plan One
Plan Two
Plan Three
Plan Four
Plan One
Plan Two
Plan Three
Plan Four
MA-Only
MA-PD
MA-Only
MA-PD
MA-Only
MA-PD
MA-Only
MA-PD
A County Premium
$0
$0 or $10
$55
$93 or $100
$0
$18 or $25
$55
$93 or $100
B County Premium
$20
$38 or $45
$75
$113 or $120
$20
$38 or $45
$75
$113 or $120
C County Premium
$40
$58 or $65
$95
$133 or $140
$40
$58 or $65
$95
$133 or $140
D County Premium
$70
$88 or $95
$125
Not Offered
$70
$88 or $95
$125
Not Offered
$3000
$3500
$2500
$2000
$3600
$3800
$3400
$3000
$10/$35
$10/$40
$10/$20
$5/$10
$15/$40
$15/$45
$10/$20
$10/$20
$175 days 1-6
$250 days 1-6
$50 days 1-6
$30 days 1-6
$250 days 1-6
$0/day
$0/day
$0/day
$0/day
$0/day
$0/day
$0/day
$0/day
SNF, days 21-100
$125/day
$125/day
$50/day
$30/day
$125/day
$125/day
$100/day
$50/day
Emergency Room
$50
$50
$50
$50
$50
$50
$50
$50
$10/$35
$10/$40
$10/$20
$5/$10
$15/$40
$15/$45
$10/$20
$10/$20
World-wide Cvrg
$50
$50
$50
$50
$50
$50
$50
$50
World-wide Max
$50,000/yr
$50,000/yr
$100,000/yr
$100,000/yr
$50,000/yr
$50,000/yr
$100,000/yr
$100,000/yr
Lab Services
15%
15%
15%
10%
15%
15%
15%
10%
Diagnostic Tests
15%
15%
15%
10%
15%
15%
15%
10%
Hospital OP
$35
$40
$20
$10
$40
$45
$20
$20
Outpatient Surgery
$175
$250
$50
$30
$250
$250
$100
$50
$150/trip
$150/trip
$100/trip
$100/trip
$150/trip
$150/trip
$100/trip
$100/trip
15%
15%
15%
10%
15%
15%
15%
10%
Plan Benefits
Out of Pocket Max
Co-pays
Hospital Inpatient
SNF, days 1-20
Urgent Care
Ambulance
DME
$250 days 1-6 $100 days 1-6
All CIGNA Medicare 2009 plan designs described in this document are pending government approval and are therefore subject to change.
For producer use only. Distribution to consumers, other insurers, or any other person or company is strictly prohibited.
$50 days 1-6
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Medicare Advantage 2009 Benefits Continued
Benefit Package
&
Plan Name/Type
Benefit Package 1
Benefit Package 2
Plan One
Plan Two
Plan Three
Plan Four
Plan One
Plan Two
Plan Three
Plan Four
MA-Only
MA-PD
MA-Only
MA-PD
MA-Only
MA-PD
MA-Only
MA-PD
$0
$0
$0
$0
$0
$0
$0
$0
Nursing Hotline
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Dental, Medicare
$35
$40
$20
$10
$40
$45
$20
$20
Dental, Other*
25%
25%
25%
25%
25%
25%
25%
25%
Eye, Routine
Not covered
Not covered
$20
$10
Not covered
Not covered
$20
$20
Eye, Medical
$35
$40
$20
$10
$40
$45
$20
$20
Hearing, Routine
Not covered
Not covered
$20
$10
Not covered
Not covered
$20
$20
Hearing, Medical
$35
$40
$20
$10
$40
$45
$20
$20
Drugs, Part B
20%
20%
20%
20%
20%
20%
20%
20%
Drugs, Part D
Not covered
Covered
Not covered
Covered
Not covered
Covered
Not covered
Covered
Blood
Tier 1
$7
$7
$7
$7
Tier 2
$33
$33
$33
$33
Tier 3
$70 or $80
$70 or $80
$70 or $80
$70 or $80
Tier 4
33%
33%
33%
33%
* 2 oral exams, 2 cleanings, & 1 x-ray per year
Note that this is a representation of all plans available in all 1512 counties. In a single state, a producer/
beneficiary would only be presented a single Benefit Package and a single premium for each MA-PD plan and
a single Tier 3 co-pay for the MA-PD plans.
All CIGNA Medicare 2009 plan designs described in this document are pending government approval and are therefore subject to change.
For producer use only. Distribution to consumers, other insurers, or any other person or company is strictly prohibited.
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The CIGNA Medicare Access Advantage
 Plans available in over 1500 counties in 28 states.
 4 Standard plan designs across all counties in each of 28 states.
 Both MA-Only and MA-PD plans available.
 $0 premium MA-Only and $0 premium MA-PD plans available.
 Maximum Out-of-Pocket limits between $2000 and $3800.
 Hospital Inpatient co-pays as low as $30 for days 1 - 6.
 Outpatient Lab Services and Diagnostic Tests lower than Original
Medicare (10% - 15% co-insurance).
 Dental benefit* covered at 75%–and, members can use their own
dentists.
* Member pays 25% co-insurance for 2 oral exams, 2 cleanings, and 1 x-ray per year.
All CIGNA Medicare 2009 plan designs described in this document are pending government approval and are therefore subject to change.
For producer use only. Distribution to consumers, other insurers, or any other person or company is strictly prohibited.
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Medicare PDP Service Area
In 2008, CIGNA has plans with premiums under the state Low-Income-Subsidy benchmark in 24
states—and is within $1 of the LIS benchmark in another 4. We expect similar results in 2009.
CIGNA’s Three simple,
NH
VT
WA
affordable, and easy-
MT
MA
ND
MN
OR
ID
to-use Prescription
PA
IL
CO
KS
IN
0H
DE
WV
VA
KY
MO
MD
NC
DC
TN
available in all 50
AZ
OK
NM
SC
AR
MS
states and the District
of Columbia.
NJ
IA
NV
CA
CT
MI
WY
NE
Drug Plans are
RI
NY
WI
SD
UT
ME
AL
GA
LA
TX
FL
AK
HI
All CIGNA Medicare 2009 plan designs described in this document are pending government approval and are therefore subject to change.
For producer use only. Distribution to consumers, other insurers, or any other person or company is strictly prohibited.
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Medicare PDP Benefits, 2009
Three Simple Plans
Annual Deductible
Initial Coverage:
Tier 1
Tier 2
Tier 3
Tier 4
Tier 5
Coverage Gap:
Plan One
Plan Two
Plan Three
$295
No Deductible
No Deductible
30-day1
$2 - $3 †
$25 - $33 †
$60 - $95 †
25% Co-insurance
N/A
30-day1
$0
$6
$33 - $48 †
$75 - $88 †
33% Co-insurance
30-day1
$6
$35
$60
33% Co-insurance
N/A
After yearly drug costs
reach $2700, member
pays 100% of
discounted drug price
After yearly drug costs
reach $2380 - $2700*,
member pays 100% of
discounted drug price
Member pays 5% of
covered drug costs 2
Member pays 5% of
covered drug costs 2
* ICL differs by Medicare Region
After Coverage Gap:
After out-of-pocket drug
costs reach $4,350
After yearly drug costs
reach $2530 - 2630*,
member pays 25% for
select generics and
100% of discounted
drug price for all other
drugs
Member pays 5% of
covered drug costs 2
†
Co-payments differ by Medicare Region—consult the CIGNA Medicare website or CIGNA Medicare Rx Information Guide for specific co-pay levels.
Co-payments are for a 30-day supply at an in-network retail pharmacy. 90-day co-payment is three (3) times the 30-day levels. 90-day mail-order
co-payment at our preferred pharmacy is two-and-a-half (2.5) times the 30-day levels.
2 Or a co-payment of $2.40 for generic (including brand drugs treated as generic) and $6.00 for all other drugs if co-payment is higher than 5% of cost.
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All CIGNA Medicare 2009 plan designs described in this document are pending government approval and are therefore subject to change.
For producer use only. Distribution to consumers, other insurers, or any other person or company is strictly prohibited.
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Medicare PDP Premiums, 2009
Medicare
Region
Plan
One
Plan
Two
Plan
Three
NH/ME
$29.50
$36.10
$66.60
CT/MA/RI/VT
$29.50
$41.70
NY
$26.30
NJ
Medicare
Region
Plan
One
Plan
Two
Plan
Three
MI
$31.90
$38.40
$75.20
$78.60
OH
$40.00
$40.40
$64.50
$44.00
$77.70
IN/KY
$32.50
$40.10
$33.90
$42.80
$87.40
WI
$33.80
DE/DC/MD
$30.50
$39.60
$70.20
IL
PA/WV
$28.90
$38.40
$71.60
VA
$29.80
$38.70
NC
$34.00
SC
Medicare
Region
IA/MN/MT/ND
SD/NE/WY
Plan
One
Plan
Two
Plan
Three
$50.60
$44.90
$79.90
NM
$28.70
$37.60
$65.10
$65.10
CO
$52.70
$47.80
$87.80
$39.70
$70.60
AZ
$22.20
$46.70
$85.50
$29.20
$42.80
$68.00
NV
$32.40
$43.50
$79.40
MO
$40.70
$41.50
$67.80
OR/WA
$35.30
$48.80
$79.10
$60.60
AR
$26.10
$39.20
$66.50
ID/UT
$37.40
$43.10
$72.20
$44.50
$67.10
MS
$30.10
$43.20
$62.60
CA
$41.30
$47.10
$78.50
$30.50
$34.90
$65.40
LA
$27.40
$38.70
$68.90
HI
$26.60
$43.90
$87.70
GA
$30.30
$44.40
$70.30
TX
$24.80
$37.20
$65.40
AK
$37.40
$38.80
$68.20
FL
$41.00
$40.70
$65.10
OK
$34.10
$43.60
$73.60
AL/TN
$28.00
$40.40
$70.70
KS
$44.70
$51.80
$75.90
All CIGNA Medicare 2009 plan designs described in this document are pending government approval and are therefore subject to change.
For producer use only. Distribution to consumers, other insurers, or any other person or company is strictly prohibited.
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The CIGNA Medicare Rx Advantage
 Plans available in all 50 states and the District of Columbia.
 Three simple, affordable, and easy-to-use plans in each state.
 Broad national network of over 55,000 pharmacies.
 Plan One has low premiums—premiums that were under the LIS
benchmark in 24 states in 2008.
 Plan Two has $0 co-pay for select generic drugs, including drugs used
to treat High Blood Pressure and High Cholesterol—high frequency
conditions in the Medicare population.
 Plan Three has a broad formulary with select generic coverage in the
doughnut hole.
 Online enrollment available to producers.
All CIGNA Medicare 2009 plan designs described in this document are pending government approval and are therefore subject to change.
For producer use only. Distribution to consumers, other insurers, or any other person or company is strictly prohibited.
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