Saturday, December 21st, 2024
Cigna Close Care |
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Cigna Close Care Health Insurance Plan offers cost-effective coverage for individuals who do not require global coverage and only require coverage in their country of residence and country of nationality when they return home for visits. Out of Area Emergency care benefit covers you for any unexpected medical needs when you are on a short trip outside your area of coverage.
How to create your plan:
1. Select your Core Plan: - You have three currencies to choose from: US Dollars, Euro or Sterling - Select your payment frequency: monthly, quarterly (3% discount) or annually (10% discount) - Select your deductible for the Core plan (this is the amount you must pay towards your cost of treatment until the deductible for the period of cover is reached). - Select your Core Plan: Close Care (coverage for essential hospital stays and treatment, including surgeons and specialist consultation fees, hospital accommodation, nursing and medicines. The plan also provides inpatient and outpatient mental health coverage and coverage for treatment, testing and vaccines as a result of a pandemic.) - You can also change the Cost Share of the Core Plan. Cost Share is the percentage you must pay toward your cost of treatment. It is subject to Out of Pocket Maximum (OOP Max). OOP Max is the maximum amount of cost share you have to pay per period of coverage.
2. Add optional modules: - Outpatient and Wellness Care (Consultations with medical practitioners and specialists; Prescribed outpatient drugs and dressings; Outpatient physiotherapy; Pre-cancer screenings, adult physical exams and vaccinations; Life Management Assistance Programme and Telephonic Wellness Coaching). - Dental Care and Treatment (Preventative, routine and major dental treatments).
3. Manage your premium: You have the flexibility to adjust your premium by choosing a Deductible and/or Cost Share. If you choose an annual or quarterly payment for your plan, your premium will be slightly lower than paying monthly.
CORE PLAN Inpatient and Daypatient Benefits:
Annual overall benefit maximum - per beneficiary per period of cover |
$500,000 €400,000 £325,000 |
Area of Coverage: The area of coverage is limited to your country of habitual residence and country of nationality. USA coverage is included if the country of habitual residence is the USA. USA nationals can choose to purchase USA coverage (if the policyholder does not elect to purchase USA coverage, then beneficiaries do not have coverage on visits home). USA area of coverage is not permitted if either of the options above do not apply |
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Condition limit: This is the annual amount Cigna will pay towards all costs of treatment following the diagnosis of a condition. This includes all claims paid across inpatient, daypatient and outpatient in relation to the primary condition. This applies to each beneficiary per period of cover |
$250,000/ €200,000/ £165,000 |
Out of area emergency cover: Emergency inpatient, daypatient and outpatient medical treatment during temporary trips outside your country of habitual residence or country of nationality. This is limited to 21 days per trip and a maximum of 45 days per policy year |
$40,000/ €29,600/ £26,600 |
Hospital charges: nursing and accommodation for inpatient and daypatient treatment and recovery room; operating theatre; prescribed medicines, drugs and dressings for inpatient or daypatient treatment; treatment room fees for outpatient surgery |
Semi-private room |
Pandemics, epidemics and outbreaks of infectious illnesses |
Included |
Inpatient cash benefit |
$100/€75/£65 Per night up to 30 days |
Intensive care: intensive therapy; coronary care; high dependency unit |
Included |
Surgeons’ and Anaesthetists’ fees |
Included |
Specialists’ consultation fees |
Included |
Kidney Dialysis |
$5,000/€3,700/£3,325 |
Pathology, radiology and diagnostic tests (excluding Advanced Medical Imaging) |
Included |
Advanced Medical Imaging (MRI, CT and PET scans) - As part of inpatient, daypatient or outpatient treatment |
$2,500/€1,850/£1,650 |
Physiotherapy and complementary therapies |
$2,000/€1,480/£1,330 |
Rehabilitation: Physical therapy; Occupational therapy; Speech therapy |
$2,000/€1,480/£1,330 Up to 30 days |
Mental Health Care - As part of inpatient, daypatient or outpatient treatment: Up to 60 days combined maximum total for inpatient and outpatient mental health care; Up to 30 days maximum for inpatient treatment |
$3,000/€2,200/£2,000 Up to 60 days |
Cancer care |
Included |
Cancer related appliances: includes wigs / headbands and mastectomy bras for cancer patients |
$125/€100/£85 per lifetime per cancer related appliance |
Hospice and Palliative care |
$2,500/€1,850/£1,650 |
Internal prosthetic devices |
Included |
External prosthetic devices |
$2,500/€1,850/£1,650 |
Local ambulance services |
Included |
Emergency inpatient dental treatment |
$2,500/€1,850/£1,650 |
Medical Evacuation |
$50,000/€37,000/£33,250 |
Medical Repatriation |
$100,000/€74,000/£66,500 |
Repatriation of Mortal Remains |
$25,000/€18,500/£16,500 |
GLOBAL TELEHEALTH |
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Global Telehealth with Teladoc - Video and phone doctor consultations via the Cigna Wellbeing App, or via a referral from our Customer Care team for non-emergency health issues |
Unlimited consultations |
Please note, this is a representation of the benefits available and does not contain the terms, conditions, and exclusions specific to each benefit. The benefits may be subject to change. Please see the Customer Guide for full details.
OUTPATIENT & WELLNESS CARE (OPTIONAL MODUL):
Annual overall benefit maximum - per beneficiary per period of cover |
$5,000 €3,700 £3,325 |
Consultations with medical practitioners and specialists |
$650/€500/£425 |
Telehealth consultations: Virtual doctor consultations with chosen healthcare provider. (Combined benefit limit with the consultations with medical practitioners and specialists benefit) |
$650/€500/£425
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Pathology, radiology and diagnostic tests (excluding Advanced Medical Imaging) |
$1,000/€740/£665 |
Physiotherapy |
$1,000/€740/£665 |
Osteopathy and chiropractic treatment |
$650/€500/£425 |
Acupuncture and Chinese medicine |
$650/€500/£425 |
Prescribed drugs and dressings |
$500/€370/£330 |
Rental of durable medical equipment |
$1,500/€1,100/£1,000 |
Adult vaccinations |
$250/€185/£165 |
Dental accidents |
$500/€370/£330 |
Child wellbeing tests |
$1,000/€740/£665 |
Child immunisations |
$1,000/€740/£665 |
Annual eye and hearing test for children aged 15 and younger |
Included |
YOUR WELLNESS CARE BENEFITS |
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Routine adult physical examination |
$100/€75/£65 |
Life Management Assistance programme: 24/7 access to counsellors for mental and behavioural health support |
Included |
Telephonic Wellness Coaching: Access to a personal wellness coach for lasting lifestyle changes |
Included |
Cervical cancer screening Prostate cancer screening Breast cancer screening Bowel cancer screening Skin cancer screening Lung cancer screening Bone densitometry |
Per screening limit of $225/€165/£150 Combined aggregate limit of $400/€300/£260 |
DENTAL CARE AND TREATMENT (OPTIONAL MODUL):
Annual overall benefit maximum - per beneficiary per period of cover |
$750 €550 £500 |
Preventative dental treatment (3 months waiting period) |
Included |
Routine dental treatment (3 months waiting period) |
80% refund per period of cover |
Major restorative dental treatment (12 months waiting period) |
70% refund per period of cover |
Why choose Cigna Global Health Plan:
- Experience: with roots in healthcare as deep as 225 years, Cigna is a globally recognised and trusted health services company.
- Global network: over 1.65 million partnerships, including 175,000 mental and behavioural health care providers, and 14,000 facilities and clinics in over 200 countries and jurisdictions , Cigna specialise in delivering international healthcare with leading medical providers across the globe to give you peace of mind.
- 24/7 Support: Customer Care team is available for you 24/7 and they aim to answer your call within 20 seconds. Multicultural team can assist you in many languages.
- Direct payments for eligible claims: Cigna can liaise directly with your treatment provider to arrange direct billing by issuing a guarantee of payment. If you’ve paid your hospital, clinic or medical practitioner yourself, submit your invoice online, via email, fax, or post. Claims usually are paid within 5 working days after receiving all necessary documentation. NOTE: You are responsible for paying any deductible or cost share directly to the hospital, clinic, medical practitioner or pharmacy at the time of treatment.
- Technology: With access to the secure online Customer Area, you will be able to: Access care and easily find local medical providers; Manage your policy and submit and track claims; Contact Cigna through a live chat, by messaging, or by arranging a callback. The Travel Information Portal offers global travel advice, country profile, real time alerts and health threats, including pandemic and epidemic.
- Predictable premiums: Cigna Global Health plans are designed for people living or working overseas long term. Be aware of low introduction premiums offered in other markets! Their price can escalate significantly at time of renewal and make your health plan unaffordable after the first year of enrollment. Cigna uses their scale and years of experience to secure affordable and predictable premiums at times of policy renewals.
- Out of Area Emergency Hospitalization - up to 21 days per trip to a maximum of 45 days per year when you travel outside your country of habitual residence or country of nationality.
- COVID-19 and other pandemics: Cover for medically necessary treatment for disease or illness resulting from a pandemic (including COVID-19), epidemic or outbreak of infectious illness at your selected area of coverage.
Cancellations and Refunds:
This policy is an annual contract. This means that, unless it is terminated earlier, the cover will end one (1) year after the start date. - If this policy ends before the normal end date, any premium which has been paid in relation to the period after cover has ended will be refunded on a pro rata basis, so long as no claims have been made or yet to be submitted and no guarantees of payment have been put in place during the period of cover. - If the policy ends before the normal end date and you have made claims under it or you have received treatment not reimbursed yet, you will be liable for the remainder of any premium in respect of the policy which are unpaid.
Free look period:
You have a statutory right to cancel your policy within 14 days from the date you receive this policy and receive a full refund (unless there is a claim paid or a guaranteed of payment has been issued). If you want to terminate this policy after the 14 days free look period, you may do so at any time by giving Cigna at least 14 days’ notice in writing. Termination will take effect 14 days after the request. If the policy is terminated, before the end date, and there is a claim paid or a guarantee of payment has been issued during the period of cover, you will be liable for the remainder of any premiums in respect of the policy which are unpaid. If your annual premium is collected at intervals throughout the policy year, you will be responsible for making these payments for the remainder of the period of cover or alternatively, settle the outstanding premium amount.
Claims:
Contact the Customer Care team prior to treatment. You can reach them 24 hours a day, 7 days a week via live chat on your secure online Customer Area on www.cignaglobal.com, email at cignaglobal_customer.care@cigna.com or phone: - International: +44 (0) 1475 788 182 - USA: 800 835 7677 (toll free) - Hong Kong: 2297 5210 (toll free) - Singapore: 800 186 5047 (toll free)
The easiest way to do this is via your secure online Customer Area. Claims forms and invoices should be submitted as soon as possible after any treatment. If they are not submitted within 12 months of the date of treatment, the claim will not qualify for payment or reimbursement.
How to submit claims: - Your secure online Customer Area on www.cignaglobal.com - Email: cghoclaims@cigna.com - Fax: +44 (0) 1475 492 113 (Outside the USA); 855 358 6457 (Inside the USA) - Post: For Treatment Incurred: • In the USA: Cigna International PO Box 15964 Wilmington Delaware 19850 USA • In Hong Kong: 16/F, International Trade Tower 348 Kwun Tong Road Kwun Tong Kowloon Hong Kong SAR • In Singapore: 152 Beach Road #33-05/06 The Gateway East Singapore 189721 • Outside of the USA, Hong Kong, or Singapore:1 Knowe Road Greenock Scotland PA15 4RJ
Exclusions:
The following exclusions apply to your policy. Please also refer to the list of benefits detailed in the Customer Guide, including the notes section for any further restrictions and exclusions that apply, in addition to the General Exclusions. Please also refer to your Certificate of Insurance for any special exclusions that may apply. 1. Treatment which is provided by: a) a medical practitioner who is not recognised by the relevant authorities in the country where the treatment is received as having specialist knowledge of, or expertise in, the treatment of the disease, illness or injury being treated; b) a medical practitioner, therapist, hospital, clinic, or facility to whom we have given written notice that we no longer recognise them as a treatment provider. Details of individuals, institutions and organisations to whom we have given such notice may be obtained by calling our Customer Care Team; or c) a medical practitioner, therapist, hospital, clinic, or facility which, in our reasonable opinion, is either not properly qualified or authorised to provide treatment, or is not competent to provide treatment. 2. Treatment for: a) a pre-existing condition; or b) any condition or symptoms which result from, or are related to, a pre-existing condition. We will not pay for treatment for a pre-existing condition of which the policyholder was (or should reasonably have been) aware at the date cover commenced, and in respect of which we have not expressly agreed to provide cover. 3. Preventative treatment, including but not limited to health screening, routine health checks and vaccinations (unless that treatment is available under one of the options under which a beneficiary has cover). We will pay for preventative surgery when a beneficiary: a) has a significant family history of a disease which is part of a hereditary cancer syndrome (such as ovarian cancer); and b) has undergone genetic testing which has established the presence of a hereditary cancer syndrome. (Please note that we will not pay for the genetic testing). 4. Treatment which is provided by anyone who lives at the same address as the beneficiary, or who is a member of the beneficiary’s family. 5. Treatment which is necessary as a result of conflict or disaster including but not limited to: a) nuclear or chemical contamination; b) war, invasion, acts of terrorism, rebellion (whether or not war is declared), civil war, commotion, military coup or other usurpation of power, martial law, riot, or the act of any unlawfully constituted authority; c) any other conflict or disaster events; where the beneficiary has: i) put him or herself in danger by entering a known area of conflict (as identified by a Government in your country of nationality, for example the British Foreign and Commonwealth Office); ii) actively participated in the conflict; or iii) displayed a blatant disregard for their own safety. 6. Any treatment outside your country of habitual residence or country of nationality (area of coverage), unless the treatment can be covered under the ‘Out of Area Emergency cover’ benefit as detailed in clause 8.3. 7. Travel costs for treatment including any fares such as taxis or buses, unless otherwise specified, and expenses such as petrol or parking fees. 8. Any expenses for ship to shore evacuations. 9. Treatment in nature cure clinics, health spas, nursing homes, or other facilities which are not hospitals or recognised medical treatment providers. Specifically, we would not cover the costs of nursing care (such as accommodations, meals and living expenses) or of any other form of treatment in a residential or elderly care facility even if the treatment is medically necessary and/or provided by a recognized medical practitioner. 10. Charges for residential stays in hospital which are arranged wholly or partly for domestic reasons or where treatment is not required or where the hospital has effectively become the place of domicile or permanent abode. 11. Costs of hospital accommodation for a deluxe, executive or VIP suite. 12. Any prosthetic device or appliance, including but not limited to hearing aids and spectacles, which is not medically necessary and/or does not fall within our definition of prosthetic device(s). 13. Incidental costs including newspapers, telephone calls, guests’ meals and hotel accommodation. 14. Costs or fees for filling in a claim form or other administration charges. 15. Non-medical admissions or stays in hospital which include: a) treatment that could take place on a daypatient or outpatient basis; b) convalescence; c) admissions and stays for social or domestic reasons e.g. washing, dressing and bathing. 16. Life support treatment (such as mechanical ventilation) unless such treatment has a reasonable prospect of resulting in the beneficiary’s recovery, or restoring the beneficiary to his or her previous state of health. 17. Foetal surgery, i.e. treatment or surgery undertaken in the womb before birth or treatment by way of the intentional termination of pregnancy, unless the pregnancy endangers a beneficiary’s life or mental stability, and any other maternity treatments including complications arising from maternity. 18. Footcare by a Chiropodist or Podiatrist. 19. Treatment for, or in connection with, smoking cessation. 20. Treatment that arises from, or is in any way connected with attempted suicide, or any injury or illness that the beneficiary inflicts upon him or herself. We will cover medically necessary mental health care and behavioural health services, including but not limited to counselling and therapy with specialists. 21. Developmental problems, treatment for personality and/or character disorders, including but not limited to: a) learning difficulties such as dyslexia; b) autism and attention deficit hyperactivity disorder (ADHD); c) physical development problems such as short height; d) affective personality disorder; e) schizoid personality disorder; or f) histronic personality disorder. 22. Disorders of the temporomandibular joint (TMJ). 23. Treatment for a related condition resulting from addictive conditions and disorders. 24. Treatment for a related condition resulting from any kind of substance or alcohol use or misuse. 25. Treatment needed because of, or relating to, male or female birth control, including but not limited to: a) surgical contraception, namely: vasectomy, sterilisation or implants; b) non-surgical contraception, namely: pills or condoms; c) family planning, namely: meeting a doctor to discuss becoming pregnant or contraception. 26. Treatment for sexual dysfunction disorders (such as impotence) or other sexual problems regardless of the underlying cause. 27. Treatment which is intended to change the refraction of one or both eyes, including but not limited to laser treatment, refractive keratotomy and photorefractive keratectomy. Note that we will pay for treatment to correct or restore eyesight if it is needed as a result of a disease, illness or injury (such as cataracts or a detached retina). 28. Gender reassignment surgery, including elective procedures and any medical or psychological counselling in preparation for, or subsequent to, any such surgery, unless state or federal law requires such coverage. We will cover medically necessary behavioural health services, including but not limited to, counselling for gender dysphoria and related psychiatric conditions (such as anxiety and depression) and medically necessary hormonal therapy. 29. Treatment which is necessary because of, or is any way connected with, any injury or sickness suffered by a beneficiary as a result of: a) taking part in a sporting activity at a professional level; b) taking part in a hazardous sporting activity or hobby, including but not limited to off-piste winter sports (including heli-skiing and heli-boarding), base or bungee jumping, sky diving, tombstoning or cliff jumping, mountaineering or rock climbing, free climbing (without harness or rope), potholing, fell or trail running, motorsports, equestrian sports (for instance horse racing, show jumping, or polo), hunting, bull riding or bull running, parkour, powerlifting, surfing or kitesurfing, white water rafting; c) solo scuba-diving; or d) scuba-diving at a depth of more than thirty (30) metres unless the beneficiary is appropriately qualified (namely PADI or equivalent) to scuba-dive at that depth. 30. Treatment which (in our reasonable opinion) is experimental, or has not been proven to be effective. This includes but is not limited to: a) treatment which is provided as part of a clinical trial; b) treatment which has not been approved by the relevant public health authority in the country in which it is received; or c) any drug or medicine which is prescribed for a purpose for which it has not been licensed or approved in the country in which it is prescribed. 31. Any form of cosmetic or reconstructive treatment and any complication thereof, the purpose of which is to alter or improve appearance even for psychological reasons, unless that treatment is medically necessary and is a direct result of an illness or an injury suffered by the beneficiary, or as a result of surgery. 32. Treatment that is in any way caused by, or necessary because of, a beneficiary carrying out an illegal act. 33. Organ transplants and any related treatment or supervision. In addition, we would not cover the costs related to any cells, organisms or tissue donations for transplant or implanting purposes (regardless of where the donation comes from), such as: a) mechanical or animal organs; b) purchase of a donor organ from any source; or c) harvesting and storage of stem cells, as a preventative measure against possible future disease. 34. Sleep disorders unless there are indications that the beneficiary is suffering from severe sleep apnoea. In these circumstances, we will only pay for: a) one (1) sleep study; and b) the hire of equipment such as a Continuous Positive Airway Pressure (CPAP) machine (only if the beneficiary has cover under the Outpatient and Wellness Care option). If it is medically necessary, we will pay for surgery. 35. Treatment for obesity, or which is necessary because of obesity. This includes, but is not limited to, slimming classes, aids and drugs. We will only pay for gastric banding or gastric bypass surgery if a beneficiary: a) has a body mass index (BMI) of 40 or over and has been diagnosed as being morbidly obese; b) can provide documented evidence of other methods of weight loss which have been tried over the past twenty-four (24) months; and c) has been through a psychological assessment which has confirmed that it is appropriate for them to undergo the procedure. 36. Treatment relating to infertility (other than investigation to the point of diagnosis), fertility treatment of any sort, or treatment of complications arising as a result of such treatment. This includes, but is not limited to: a) in-vitro fertilisation (IVF); b) gamete intrafallopian transfer (GIFT); c) zygote intrafallopian transfer (ZIFT); d) artificial insemination (AI); e) prescribed drug treatment; f) embryo transportation (from one physical location to another); or g) ovum and/or semen donation and related costs. We will pay for investigations into the cause of infertility if: a) the specialist wishes to rule out any medical cause; b) the beneficiary has been covered under this policy for two (2) consecutive years before the investigations have commenced; and c) the beneficiary was unaware of the existence of any infertility problem, and had not suffered any symptoms, when their cover under this policy commenced. 37. Treatment directly related to surrogacy. 38. Treatment directly or indirectly related to abnormalities, deformity, disease, illness or injury present at birth (congenital conditions) whether evident or not at the moment of childbirth.
Cigna will not offer cover or pay claims when it is illegal for them to do so under applicable laws. Examples include but are not limited to, exchange controls, local licensing regulations or trade embargo.
In accordance with clause 19, Cigna will not cover any beneficiaries or pay claims in jurisdictions when doing so would violate applicable trade restrictions, including but not limited to: restrictions imposed by the United States Department of Treasury’s Office of Foreign Assets Control; the European Union Commission, or; the United Nations Security Council Sanctions Committees.
IMPORTANT NOTE: The product-related information on this website is for illustration purposes only. For complete benefits, terms, conditions, limitations and exclusions, please see the policy booklet at the download section below. Please read and understand your policy before you travel.
Downloads:
Cigna Close Care Policy Rules PDF
Cigna Close Care Customer Guide PDF
Cigna Close Care Health Brochure PDF
Please, CONTACT US for more information or to apply for CIGNA Global Health plan.
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