what’s in the presentation? who is cigna what’s new who are covered nrs medical plan what are...
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What’s in the presentation?
Who is Cigna
What’s new
Who are covered
NRS Medical
Plan
What are
covered
What to do…
Out-patient
In-patient
Money back
myWellness.irri.org
NRS Medical
Plan
Safety at Work
Who is Cigna? 1958
10
60M
Expert in international
health insurance
4,222 CG members
Customers worldwide
IRRI NRS-CO
joined the plan
2011
What’s new in the plan?
NRS Medical
Plan
≈ PhP1.1M
Who are covered?
Member &Approved
Dependants
NRS
Spouse or domestic partner(over 65)
Children (below 21)
What medical services are covered?
Outpatient & Inpatient
Optical care
Annual checkup
HIV test
Lab test
Preventive screening
Psych treatment
Physical med & rehabPregnancy
& childbirth
Dental care
Pharma products
Outpatient services
Hemo-dialysis
Radio-therapy
Chemo-therapy
Outpatient surgery / day case
Inpatient services
Semi-privateroom
Children’s care
MMRPolio DPT
Chicken pox
Hepa B
New-born
Birth to age 1
Age 1 to 2
Age 3 to 6
Age 7 to 19
1 6/2mos 4/yr 6/2yrs3/6mos
Women’s care
Papsmear
Physical exam Mammo-
graphy
Men’s care
Urological exam
PSA screening
Psychiatric care
≈PhP26,000/ year
Treatment by
Psychiatrist
Optical care
1 exam / 2 years
≈ PhP2,500per lens / 2
yearsFrames
not covered
Dental care
≈PhP22,000per member/
year
Scaling Implants
Dentures
Orthodontic
Surgicaltreatmen
t
X-ray
Paramedical fees
Physio-therapy
Osteo-pathy
Wound dressing
Speech therapy
Chiro-practic
Pharmaceutical products
Medication treatment
Maintenance medicines
General
Diagnostic imaging
Ultra-sound
CT scan
MRI
Laboratory test
Uric acid
Blood sugar
CBC
Annual check up
Blood analysis
Chest x-ray
Stool test
Urine test ECG
HIV test
With approval of Cigna
consultant
Amniotic fluid test
(with approval of medical consultant)
Pregnancy & childbirth
Hospital care
Pre- and post-natal
care
Ambulance
Life threatening situations
Some exclusions
USA & Singapore
Where can I get more details?
myWellness.irri.org
Your CIGNA card
1
23
4
Cigna dedicated Web site that themembers can log in to for information related to the plan
Personal details of the plan member: name, gender, and date of birth
The RESNO is your Cigna personal reference numberthat needs to be mentioned in all correspondence with Cigna
Cigna contact details that the members can use to get in touch with Cigna
Your CIGNA card
55
Percentage of costs covered for outpatient treatment
Contact details to be used by health care providers
What to do: Inpatient (accredited)
Member Care Provider Cigna
Present Cigna card
Provide treatment
Accomplish cost estimate form
Provide guarantee of payment
Submit Philhealth documents
Pay excess, if any
Bill the patient for excess, if any, then send final billing to Cigna
What to do: In/OutpatientMember Care Provider Cigna
Go to hospital
Provide treatment
Submit PhilhealthPay bill
File claim Process claim
Receive reimbursement
(non-accredited)
What to do: Planned OutpatientMember Care Provider Cigna
Accomplish cost estimate form
Provide cost of procedure
Send cost estimate form
Provide GOP
Get treatmentSubmit Philhealth
Bill Cigna
(accredited)
www.cignahealthbenefits.com
How do I log in?
How do I log in?
How do I log in?
How do I log in?
How do I file a claim online? Step 1
Scan all your documents (.pdf, .jpeg, .jpg, .tif, .tiff, and .gif).
How do I file a claim online? Step 2 Log in to www.cignahealthbenefits.com and click “Online”.
How do I file a claim online? Step 3 Read the important reminders and click “Claim Online”.
How do I file a claim online? Step 4
Fill out the claim form.
How do I file a claim online? Step 5
Fill out the payment details.
How do I file a claim online? Step 6Attach the scanned documents, accept the terms and conditions, and click “Send”.
How do I file a claim online?
Your claim has been sent successfully.
Questions?
Who do I contact?
Janet Lazarte
Cheryll Mercado
cignaplanadmin@irri.orgCompensation, Benefits & Reporting ServicesFF Hill Buildingx2353
Kentjie Masaredo
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