Does My Cigna Plan Have Cobra Coverage (2024)

COBRA is a law that allows eligible employees and their dependents to keep their former employer’s health insurance coverage when leaving a job. To begin a COBRA plan with Cigna, contact your COBRA administrator in the HR Department from the employer the Cigna insurance is through. COBRA can be significantly more expensive than what you paid under your employer’s plan because you pay 100 of the costs for the health plan, including any costs your employer previously helped pay. This extra cost can make this coverage more expensive for you, even though it’s the same coverage you had under your current health plan.

To be eligible for COBRA, you must satisfy three basic requirements: your current health plan must be subject to the COBRA law, not all health plans are, and you must be considered a qualified individual. COBRA offers several benefits, such as immediate coverage with no waiting period after the qualifying event and the same coverage you had under your current plan.

To begin a COBRA plan with Cigna, contact your COBRA administrator in the HR Department from the employer the Cigna insurance is through. You can keep your job-based coverage for up to 18 months with a COBRA plan or buy an individual plan through the Health Insurance Marketplace. If you choose to enroll in COBRA, your benefits will be retroactive as described above in Q5 if you meet the enrollment deadlines described in Q10.

Cigna Health Plans offer various plans, including My Medical, Neighborhood, Open Access Plus, Local Plus, Premium Local Plus, and Copay Plan. However, Cigna is only paying as secondary and not as primary coverage. COBRA coverage can become available to you when you would otherwise lose your group health coverage, as well as your spouse and children.

How much does Zepbound cost without insurance?

Zepbound is a prescription-only injectable medication used for obesity and chronic weight management. Its active ingredient, tirzepatide, is a dual glucose-dependent insulinotropic polypeptide (GIP) and glucagon-like peptide-1 (GLP-1) receptor agonist. Studies show significant weight loss in clinical studies. The average retail list price for Zepbound is $1, 515 per box, with no over-the-counter equivalents or comparable alternatives. Insurance coverage for Zepbound can be challenging for some, but there are ways to obtain it at a more affordable price.

The generic name for Zepbound is tirzepatide, while Mounjaro is marketed under the brand name Mounjaro for diabetes treatment. The FDA approved Zepbound in November 2023, but it may take years for a generic version to be available. Insurance coverage for Zepbound and other weight loss medications may require prior authorization, which may include documentation of other cost-effective weight loss strategies.

Does Cigna pay for adult diapers?

Adult diaper expenses are reimbursable. Health care, vision, and dental costs can be covered by an HSA, HSA, or Health Care FSA. The type of account determines coverage and eligibility. HSAs can be used to pay for eligible expenses for oneself, spouse, or eligible dependents. HRAs can be used to pay for medical, dental, or vision expenses for oneself or dependents enrolled in the HRA. Employers determine which expenses are eligible under HRAs. Plan documents provide more details.

How can I get my insurance to pay for Zepbound?

The majority of insurance plans mandate the submission of a prior authorization (PA) form for Zepbound coverage. This is a document that is completed by a physician on behalf of the patient and contains the necessary information required by the insurance company. The completion of this form is a prerequisite for obtaining Zepbound coverage. In the event that an employer does not opt in to Zepbound, the employee will not be afforded coverage for the medication in question. Further information on Zepbound and its associated requirements can be found in our comprehensive guide.

Does Cigna cover mastectomy bras?

Consumable medical supplies are non-durable items that are typically disposable, cannot withstand repeated use, are primarily used for medical purposes, and are not useful in the absence of illness or injury. They are typically ordered and prescribed by a physician. Most plans contain exclusions for consumable medical supplies, such as bandages, skin preparations, and test strips. These supplies are only reimbursed if they are covered under a customer’s medical benefit. Breast reconstruction and prostheses are covered under the EPA benefit.

Does Cigna cover weight loss injections?

It should be noted that weight loss medications are excluded from many Cigna Healthcare Coverage Policy plans, including those provided to employer groups and to individuals and families. The specific terms and conditions of coverage are to be determined by the pertinent plan document.

Does Cigna cover Zepbound?

GLP-1 agonists are pharmaceutical agents that have been approved by the Food and Drug Administration (FDA) for the treatment of type 2 diabetes and for the management of weight. Examples of these agents include Ozempic, Wegovy, Zepbound, and Mounjaro. It is standard practice for Cigna insurance plans to exclude coverage of these drugs unless prior authorization has been obtained. The extent of coverage afforded to Ozempic is contingent upon the patient’s medical history and the specifics of the prescription. In the event that Cigna does not provide insurance coverage, it may be advisable to utilize a SingleCare prescription discount card in order to reduce expenditure.

Does Cigna cover Ozempic for weight loss in 2024?

Ozempic, a drug prescribed by Cigna for Type 2 diabetes, is not approved for weight loss, diabetes prevention, or treating Type 1 diabetes or metabolic syndrome without a co-diagnosis of Type 2 diabetes. Prior authorization for Ozempic depends on the patient’s medical history and risk factors for cardiovascular disease. If the patient doesn’t have CV disease or risk factors, Cigna typically requires prior authorization for Ozempic, as metformin is the preferred treatment for Type 2 diabetes.

However, if metformin fails and Ozempic is allowed under the patient’s specific Cigna plan, the healthcare provider can request prior authorization. Ozempic and metformin are similar medications, but they have different benefits and risks.

Is Zepbound still hard to get?

A review of the FDA Shortages List indicates that all doses of Mounjaro and Zepbound are currently available, with Mounjaro appearing on the list since late 2022. The Mounjaro shortage was resolved in early August 2024, while Zepbound, produced by the same manufacturer and containing the same active ingredient, has been available since August 2024. Both Mounjaro and Zepbound are manufactured by the same company.

What doesn’t Cigna insurance cover?

The following medical equipment is excluded from this list: air purifiers, air conditioners, humidifiers, treadmills, spas, elevators, comfort and hygiene supplies, wigs, disposable sheaths, correction appliances, support appliances, stockings, and consumable medical supplies.

Does Cigna cover breast milk storage bags?

Cigna offers insurance coverage for a range of breastfeeding-related items, including breast pumps, storage bags, and other accessories. Members are entitled to receive high-quality, name-brand pumps free of charge and may be eligible for a breast milk storage bag resupply program. Acelleron, a contracted Cigna breast pump provider, assumes responsibility for the ordering process, thereby streamlining the process and eliminating potential inconveniences. To place an order, it is first necessary to select the appropriate insurance plan, breast pump, and to complete the order form.

Why won’t my insurance cover Ozempic for weight loss?

Ozempic, a medication approved by the FDA for the treatment of diabetes, can be prescribed for the purpose of weight loss. This is considered an “off-label” use, and insurance companies may deny coverage if the prescription indicates that the medication is intended for weight loss.