MEDICARE PART D CUSTOMER HANDBOOK - Be at your best, body & mind 2020
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Cigna-HealthSpring® Rx (PDP)
Medicare Part D Prescription Drug Plans
2020
MEDICARE PART D
CUSTOMER HANDBOOK
Be at your best, body & mind.
903789 c 11/19 20_GHB_PDP_F INT_20_79789_C
Sondra, 68
strikes
and counting
WELCOME
to a whole new kind of care
Thank you for choosing Cigna. We believe you’re more than the number of years you’ve
lived. You’re the sum of your accomplishments, with so much more to see and do. And we
want you to be ready for it all – physically, emotionally, socially and financially. At Cigna,
our commitment to whole health means helping you be at your best – body and mind – for
whatever lies ahead.
Your 2020 Customer Handbook helps you get the most from your Cigna Medicare Part D
plan. We hope you find all of the information you need. If you still have questions, we’re
always here to help.
Call our customer service team at 1-800-558-9652 (TTY 711). We’re available October 1 –
March 31, 8 a.m – 8 p.m. local time, 7 days a week. Messaging service used on the weekends
from April 1 – September 30. As a Cigna customer, you can visit myCigna.com anytime for
additional information and assistance.
2
What’s inside
Important contact information 3
Cigna customer service 4
Using your plan is easy 5
Get your prescriptions delivered to your home 6
Healthy Rewards® discount program 7
How Medicare Part D works 8
Vaccination coverage 11
Understanding Part B versus Part D coverage 12
How to find a supplier for Part B equipment, drugs and supplies 13
Understanding prior authorizations 13
Managing your medications 14
Important contact information
Customer service Home delivery with
Express Scripts PharmacySM
1-800-558-9562 (TTY 711)
October 1 – March 31, 8 a.m. – 1-877-860-0982
8 p.m. local time, 7 days a week. myCigna.com
April 1 – September 30, Monday –
Friday, 8 a.m. – 8 p.m. local time. Healthy Rewards discount program
Messaging service used weekends,
after hours and on federal holidays. 1-800-292-0013
Customer service also has free myCigna.com
language interpreter services available
for non-English speakers. Paper claims address
Prescription Drug List Cigna-HealthSpring
Attn: Pharmacy Services
myCigna.com PO Box 20002
Nashville, TN 37202
Find a pharmacy
myCigna.com
3
Cigna customer service
Our customer service You can manage your personal health
representatives can answer 24 hours a day, 7 days a week, by visiting
questions such as: myCigna.com. Find helpful resources and
› How can I save on my information, including how to:
prescriptions? › View your benefits
› Is my pharmacy in the › View your drug list
network? › Find a network pharmacy
› Can I request an exception › Review pharmacy claim history and details
for my medication?
› Manage your prescriptions
› Can I get my money back if
› Access your Healthy Rewards
I paid out of pocket for my
discount programs
prescription?
Contact us at 1-800-558-9562 (TTY 711).
Note: 1.) Updated myCigna.com screenshot for page 4
If you have a Cigna-HealthSpring Rx
(PDP) plan and are also covered as a
dependent for other Cigna coverage,
you need to register using the ID
found on your Cigna-HealthSpring
Rx (PDP) ID card to view your
Medicare plan information on
myCigna.com. You will need to create
a new myCigna user ID and password
for your Cigna-HealthSpring Rx (PDP)
plan. You will use your existing user
ID for your other Cigna coverage
and for your prior Cigna pharmacy
coverage (if applicable).
If you need help registering
with myCigna.com, please call
our help desk at 1-800-853-2713.
4
Using your plan is easy
Keep your customer ID card in a safe place
You will need to take your card with you to the pharmacy. Your pharmacy will let you
know the amount that you owe, beyond what our plan pays. Use the same card from
year to year unless you change to a different plan.
Cigna-HealthSpring Rx This card does not guarantee coverage or paym
PDP Don’t forget to review your
prescription and talk with your
doctor about other medications
ID
Name
that may cost less. You’ll
Customer Service:find
PLE
your
(TTY
M
Health Plan (80840)
myCigna.com.
Drug List onPharmacy Help Desk:
SA
Pharmacy Claims: , , ,
Get your prescriptions delivered to your home
Filling a prescription using home Home delivery with
delivery pharmacy services Express Scripts Pharmacy
Home delivery provides the convenience
of having your medications delivered to
EXPRESS SCRIPTS PHARMACY
you. So you have one less thing to think
specializes in home delivery and
about. And with an ample supply of
is available to all Cigna Medicare
medications on hand, you are less likely
customers.
to miss a dose. You may also save on
your medications when you use a home › Express Scripts Pharmacy is the
delivery pharmacy. third-largest pharmacy in the
country.
You may use any in-network home
delivery service to fill prescriptions for › Serving more than
all Drug List medications. Generally, it 10.5 million Americans.
could take up to 14 days to process your
GETTING STARTED
order and ship it to you. If for any reason
your prescription order is delayed, you › Have your Cigna ID card and
will be contacted by the home delivery medication list ready.
pharmacy service and alternative › Call Express Scripts Pharmacy at
dispensing arrangements will be made. 1-877-860-0982 (TTY 711).
You are not required to use home
delivery services to get an extended
› Or go online and set up your
profile at myCigna.com, then
supply of any medication that is on your
call Express Scripts Pharmacy
Drug List.
when you are ready to discuss
your prescriptions.
6Healthy Rewards
Exclusive savings to help you live better, body and mind
Cigna gives you more ways to save money while improving your health. Our Healthy
Rewards* program offers discounts and savings toward:
Weight and nutrition Alternative medicine
Fitness and mind/body Wellness and health
products
Vision and hearing
To access Healthy Rewards, call 1-800-292-0013 or visit us online at myCigna.com.
Note: Not all programs are available by phone.
Hearing aids and exams Fitness clubs
Deeply discounted pricing on hearing aids, Choose from 9,000+ fitness centers
plus free batteries for two years and free nationwide for $25/month (plus a $25
follow‑up care for one year through our enrollment fee and applicable taxes).
partner Amplifon. More than 2,000 hearing The program offers:
aid models, from leading brands such as › A free guest pass to try out a
Miracle-Ear®, Oticon, Phonak and Starkey®. fitness center before enrolling
Low price guarantee – find a local quote (where available).
for less and Amplifon will beat it by 5%.
Plus, 40% off diagnostic services/testing at › The option to switch fitness centers
at any time.
thousands of locations nationwide.
Weight and nutrition
› Online fitness tracking from a wide
variety of popular wireless fitness
Savings up to 50% off weight and nutrition devices, apps and exercise equipment.
programs, including Jenny Craig®** and
more. Alternative medicine and therapy
Save up to 25% off services, including
Vision exams and eyewear
chiropractic care, acupuncture, massage
Discounts for routine vision services,
therapy, routine foot care and more.
including exam and eyeglasses, through
the Vision Network Savings Program. Over Yoga and wellness products
25,000 locations nationwide, including Save up to 25% off yoga mats, wellness
these national retail opticals: Pearle Vision®, and fitness accessories, instructional
Sears®, TargetTM and JCPenney®. yoga and fitness DVDs.
7How Medicare Part D works
Whether you’ve had a Medicare Part D plan before, or you’re enrolled for the
first time, understanding how Medicare Part D coverage works can be complicated.
We get that, so we’ve broken it down for you.
Costs and benefits
The amount you pay for a medication depends on:
› What drug tier your medication is grouped under. You will find drug tiers in your
plan’s formulary (drug list). Our plan groups each medication into one of four “tiers.”
TIER 1: PREFERRED GENERIC
TIER 2: PREFERRED BRAND
TIER 3: N
ON-PREFERRED GENERIC
DRUGS AND BRAND DRUGS
TIER 4: S
PECIALTY GENERIC AND
BRAND DRUGS
› Stages of the plan benefit. The chart on the next page highlights the
four stages of Medicare Part D coverage.
8How Medicare Part D works (continued)
Benefit stages
The amount you pay for a medication also depends on the benefit stage you have
reached. Medicare Part D coverage has four benefit stages. Not all customers will
reach every stage. Drug cost limits in each stage may change year to year.
Drug cost limits for 2020
1 2 3 4
Coverage Gap
Initial Catastrophic
Deductible (also called
Coverage Limit Coverage
“donut hole”)
What you pay: What you pay: What you pay: What you pay: The
100% of your A copay or 25% of brand- greater of 5% of
prescription costs name drugs/25% covered drug costs,
coinsurance
until you meet of generic drugs or $3.60 for generic
(percentage) for
your annual
your drugs, after (standard gap and $8.95 for all
deductible (if your
you have met your coverage). Your other drugs. Your
plan has one).
annual deductible. plan may provide plan may provide
If your plan
When it starts: additional coverage additional coverage
does not have a
deductible, you will After you meet the beyond Medicare’s beyond Medicare’s
begin at Stage 2. deductible (if your standard gap standard coverage.
When it starts: plan has one). coverage. What you What you pay in
January 1. pay in this phase this phase will be
When it ends:
will be based on based on your plan.
When your total
drug costs, including your plan. When it ends:
what the plan has When it ends: December 31.
paid and what you When your total
have paid, reach out-of-pocket costs
$4,020. (what you have
paid) reach $6,350.
9How Medicare Part D works (continued)
Richard, 70
beach trips
You will receive a monthly notification from Cigna-HealthSpring Rx (PDP) called an
Explanation of Benefits (EOB) that will show how your plan paid your prescription bills
during a given month. This monthly statement will show the billed charges, how much
the plan paid and the amount that you paid. You will only receive an EOB if you used
your Cigna-HealthSpring Rx (PDP) coverage recently.
You can manage prescription drug claims
and balances online at myCigna.com.
10Vaccination coverage
Take a shot at better health
Getting vaccinated against common illnesses can help you stay healthy.
Cigna-HealthSpring Rx (PDP) can help your wallet stay healthy by covering most
or all of the cost. But how these costs are paid depends on the type of vaccination,
where you get the vaccine, and who gives you the shot.
Vaccinations, like the ones against shingles (Shingrix® and Zostavax®) or tetanus,
are covered by Cigna-HealthSpring Rx (PDP) if you get the vaccine at your
pharmacy or doctor’s office.
IF YOU GET AND GET
YOU WILL PAY: THEN YOU NEED TO:
THE VACCINE: THE SHOT:
At a pharmacy* At a Your plan coinsurance No additional action
pharmacy or copay at a pharmacy is required.
(available for the vaccine and the
in certain charge to get the shot.
states)*
At a pharmacy* From a Your plan coinsurance or File a claim with Cigna
doctor copay at the pharmacy to be reimbursed for
for the vaccine itself, the amount your doctor
and you will need to charged for giving you
pay your doctor for the the shot.
total charge to give you
the shot.
From a doctor From a The entire cost of the File a claim with Cigna
doctor vaccine and the charge to be reimbursed for
to get the shot. the amount your doctor
charged for the vaccine
and for giving you the
shot.
* If you get the vaccine or have it administered at a pharmacy not in the Cigna-HealthSpring Rx (PDP) network,
you will have to pay a higher, out-of-network rate.
Vaccinations against the seasonal flu, hepatitis B virus and pneumonia are covered by your medical insurance,
not by your Cigna-HealthSpring Rx (PDP) plan. Vaccinations required for travel to foreign countries are not
covered by your Cigna-HealthSpring Rx (PDP) plan.
If you have questions about which vaccinations are right for you, talk with your doctor.
11Understanding Part B versus Part D coverage
Your Cigna-HealthSpring Rx (PDP) plan covers many of the medications you need to
help you make the most of your health. But how those medications are covered depends
on the type of medications you receive and where you receive them.
Medicare is made up of several parts The following types of medications,
Part B is your medical coverage. supplies or vaccines are usually covered by
This part pays for things such as doctor Part B, and will be paid under your medical
visits, lab tests and durable medical plan versus your Part D plan.
equipment (DME). › Antigens (allergy injections)
› Medicare requires that certain › Diabetic testing supplies
medications and DME, such as diabetic
test strips, neubulizers and wheelchairs, › Hepatitis B vaccines
be covered under Part B. If you are › Immunosuppressive medications
unsure about the extent of your
› Influenza (flu) vaccine
coverage, call customer service to find
out if your medication is covered under › Infusible/injectable medications that are
Part B. administered at home that require the
use of an infusion pump
› Other injectables or intravenous
Certain medications and medical medications that are provided and
equipment that you may buy in a administered by a doctor
pharmacy may be covered by your
medical plan, not your Part D plan.
› Inhaled nebulizer medications
› Insulin pumps and the insulin used
in the pumps
Part D is your pharmacy › Pneumococcal (pneumonia) vaccine
(or drug) coverage.
This part pays for medications you may
take regularly to manage heart disease,
high cholesterol or asthma, for example, or
for medications you may take for a short
time, such as antibiotics.
› Cigna-HealthSpring Rx (PDP) provides
your Part D prescription drug coverage.
If you need help or are unsure how your drugs will be covered,
call customer service at 1-800-558-9562 (TTY 711).
12How to find a supplier for your Part B equipment, drugs and supplies
› Go to Medicare.gov/supplierdirectory/search.html.
› Enter your zip code.
› Select up to five category types for the equipment, drug or supply you need.
› View your results or revise your search as needed.
› A list of suppliers will be provided.
For more information about Medicare benefits and services,
visit Medicare.gov. Or you can call 1-800-MEDICARE (1-800-633-4227)
24 hours a day, 7 days a week. TTY users can call 1-877-486-2048.
Understanding prior authorizations
For certain prescription drugs, Cigna requires prior authorization. You or your prescriber
may request a coverage decision or exception for the prescribed medication. Without prior
authorization, the drug may not be covered.
For more information, please refer to your Drug List or call our
customer service team at 1-800-558-9562 (TTY 711).
October 1 – March 31, 8 a.m. – 8 p.m. local time, 7 days a week.
April 1 – September 30, Monday – Friday, 8 a.m. – 8 p.m. local time.
Messaging service used weekends, after hours and on federal holidays.
13Managing your medications
We’re here to help
Do you ever forget to take your medication? Do you skip doses?
Here are some simple solutions.
I DON’T TAKE MY
HELPFUL TIPS
MEDICINE BECAUSE:
› I forget. Take your medicine at the same time(s) each day.
Set a reminder alarm on your watch or phone.
If you need help, ask someone to do it for you.
Put a reminder note on the bathroom mirror.
› I was supposed to Call your doctor or pharmacist and ask what you
take it on an empty should do. Depending on the medicine, the advice
stomach and I ate may be to take it anyway or wait until the next dose.
breakfast.
› I hate the side Talk with your doctor. Often, he or she can
effects. recommend ways to lessen side effects or offer you
other treatment options that don’t have the same
› It makes me feel
side effects. Medicines can have unpleasant side
worse.
effects, but skipping doses can make your condition
much worse.
› I don’t think I need it. Ask your doctor to explain why you need it at the
prescribed dose. Just because you can’t feel a
› It doesn’t work
difference doesn’t mean the medicine is not working.
anyway.
Skipping doses, over time, can make your symptoms
› I can get by with less. worse or allow new problems to develop.
› I can’t remember Ask your doctor or pharmacist what each medicine is
why I’m taking it. for. Ask for an information sheet on each medicine you
take, with the most important information circled.
› I can’t keep track of Get a weekly or monthly pill organizer at your pharmacy.
all my pills. Ask your pharmacy technician to fill it for you. Call
customer service and ask to be enrolled in Refill Reminders
to receive an email or text when your refill is due.
› If I skip doses, I can Ask your doctor if there is a less expensive option.
save money.
Adapted from: National Institutes of Health Senior Health; Agency for Healthcare Research and Quality.
14Managing your medications (continued)
Create your personal medication list
Example
Here’s all you have to do.
› Go to CignaMedicare.com/group/PDPresources MY MEDICATION LIST
to download the form.
› Scroll down to the “Information for Cigna Medicare Name:
Date of birth: Date prepared:
Part D group plan customers” section. PCP name: PCP phone #:
›
This medication list may help you keep track of your medications and how to use them the right way.
Select “Personal Medication List” to open the form. Instructions:
› Use this blank form to add prescription medications, over the counter drugs, herbal products,
vitamins, and minerals.
›
› Cross out medications when you no longer use them. Then write the date and why you stopped
Print the form and fill in your medications on ›
using them.
Ask your doctors, pharmacists, and other healthcare providers to update this list at every visit.
› If you go to the hospital or emergency room, take this list with you. Share this with your family or
the list. caregivers too.
Allergies to medications:
Then, keep it with you for reference when you Drug name: How I take it:
Doctor:
go to the pharmacy, visit your doctor or when What I use medication for:
you call Cigna customer service. Notes:
All Cigna products and services are provided exclusively by or through operating subsidiaries of Cigna
Corporation, including Cigna Health and Life Insurance Company. The Cigna name, logos, and other Cigna
marks are owned by Cigna Intellectual Property, Inc. Cigna-HealthSpring Rx (PDP) is a Medicare Prescription
Drug Plan (PDP) with a Medicare contract. Enrollment in Cigna-HealthSpring depends on contract renewal.
909830 a 06/19 © 2019 Cigna. Some content provided under license. Y0036_17_52812 Approved
15Help is always here.
If you have any questions, customer service is here to help.
We go above and beyond to make sure you have everything
you need to understand and get the most from your plan.
1-800-558-9562 (TTY 711).
October 1 – March 31, 8 a.m. – 8 p.m. local time, 7 days a week.
April 1 – September 30, Monday – Friday, 8 a.m. – 8 p.m.
local time. Messaging service used weekends, after hours
and on federal holidays. Customer service also has free
language interpreter services available for non-English
speakers.
*Healthy Rewards is a discount program. If your plan includes coverage for any of these services, this program
is in addition to, not instead of, your plan benefits. Healthy Rewards programs are separate from your
medical benefits. A discount program is NOT insurance, and you must pay the entire discounted charge.
Some Healthy Rewards programs are not available in all areas and programs may be discontinued at any time.
Healthy Rewards participating vendors are independent contractors and solely responsible for any products
or services provided. Before using any discount program, check with any other insurance or plan you may
have to determine the same or similar programs, products or services may be available to you at a lesser
charge. All savings amounts and provider counts are based on Cigna data as of the date of publication and
are subject to change. Actual savings may vary.
**Not valid with any other offer or discounts. Only available at participating locations and Jenny Craig
Anywhere. New members only. Restrictions apply.
This information is not a complete description of benefits. Call 1-800-558-9562 (TTY 711) for more information.
The formulary, pharmacy network and/or provider network may change at any time. You will receive notice
when necessary.
Express Scripts Pharmacy is a trademark of Express Scripts Strategic Development, Inc. Other pharmacies are
available in our network.
All Cigna products and services are provided exclusively by or through operating subsidiaries of Cigna Corporation,
including Cigna Health and Life Insurance Company. The Cigna name, logos, and other Cigna marks are owned
by Cigna Intellectual Property, Inc. Cigna-HealthSpring Rx (PDP) is a Medicare Prescription Drug Plan (PDP) with
a Medicare contract. Enrollment in Cigna-HealthSpring depends on contract renewal. All pictures are used for
illustrative purposes only. © 2019 Cigna. Some content provided under license.
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