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Page 1: 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
Page 2: 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

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

Page 3: 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

Page 4: 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

Who is Cigna? 1958

10

60M

Expert in international

health insurance

4,222 CG members

Customers worldwide

IRRI NRS-CO

joined the plan

2011

Page 5: 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

What’s new in the plan?

NRS Medical

Plan

≈ PhP1.1M

Page 6: 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

Who are covered?

Member &Approved

Dependants

NRS

Spouse or domestic partner(over 65)

Children (below 21)

Page 7: 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

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

Page 8: 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

Outpatient services

Hemo-dialysis

Radio-therapy

Chemo-therapy

Outpatient surgery / day case

Page 9: 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

Inpatient services

Semi-privateroom

Page 10: 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

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

Page 11: 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

Women’s care

Papsmear

Physical exam Mammo-

graphy

Page 12: 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

Men’s care

Urological exam

PSA screening

Page 13: 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

Psychiatric care

≈PhP26,000/ year

Treatment by

Psychiatrist

Page 14: 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

Optical care

1 exam / 2 years

≈ PhP2,500per lens / 2

yearsFrames

not covered

Page 15: 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

Dental care

≈PhP22,000per member/

year

Scaling Implants

Dentures

Orthodontic

Surgicaltreatmen

t

X-ray

Page 16: 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

Paramedical fees

Physio-therapy

Osteo-pathy

Wound dressing

Speech therapy

Chiro-practic

Page 17: 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

Pharmaceutical products

Medication treatment

Maintenance medicines

General

Page 18: 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

Diagnostic imaging

Ultra-sound

CT scan

MRI

Page 19: 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

Laboratory test

Uric acid

Blood sugar

CBC

Page 20: 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

Annual check up

Blood analysis

Chest x-ray

Stool test

Urine test ECG

Page 21: 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

HIV test

With approval of Cigna

consultant

Page 22: 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

Amniotic fluid test

(with approval of medical consultant)

Pregnancy & childbirth

Hospital care

Pre- and post-natal

care

Page 23: 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

Ambulance

Life threatening situations

Page 24: 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

Some exclusions

USA & Singapore

Page 25: 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

Where can I get more details?

myWellness.irri.org

http://mywellness.irri.org/
http://mywellness.irri.org/
http://mywellness.irri.org/
Page 26: 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

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

Page 27: 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

Your CIGNA card

55

Percentage of costs covered for outpatient treatment

Contact details to be used by health care providers

Page 28: 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

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

Page 29: 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

What to do: In/OutpatientMember Care Provider Cigna

Go to hospital

Provide treatment

Submit PhilhealthPay bill

File claim Process claim

Receive reimbursement

(non-accredited)

Page 30: 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

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)

Page 31: 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

www.cignahealthbenefits.com

How do I log in?

Page 32: 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

How do I log in?

Page 33: 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

How do I log in?

Page 34: 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

How do I log in?

Page 35: 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

How do I file a claim online? Step 1

Scan all your documents (.pdf, .jpeg, .jpg, .tif, .tiff, and .gif).

Page 36: 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

How do I file a claim online? Step 2 Log in to www.cignahealthbenefits.com and click “Online”.

http://www.cignahealthbenefits.com/
Page 37: 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

How do I file a claim online? Step 3 Read the important reminders and click “Claim Online”.

Page 38: 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

How do I file a claim online? Step 4

Fill out the claim form.

Page 39: 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

How do I file a claim online? Step 5

Fill out the payment details.

Page 40: 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

How do I file a claim online? Step 6Attach the scanned documents, accept the terms and conditions, and click “Send”.

Page 41: 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

How do I file a claim online?

Your claim has been sent successfully.

Page 42: 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

Questions?

Page 43: 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

Who do I contact?

Janet Lazarte

Cheryll Mercado

[email protected], Benefits & Reporting ServicesFF Hill Buildingx2353

Kentjie Masaredo


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