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FAQ/Choosing a Doctor

CHOOSING A DOCTOR


1. What is a primary care physician (PCP)?

A primary care physician, or PCP, is your first, or primary, source of medical care -- your personal doctor. The PCP you choose coordinates all of your medical care, from annual checkups to referrals to specialists, lab and x-ray services, and hospital admissions. PCP-based care is an effective way to maintain better health; regular physician visits build strong, secure doctor-patient relationships. When you enroll in the MILA CIGNA HealthCare network-based plan, you may choose a PCP from the network of participating physicians in your service area. Chances are good that your present doctor is already participating in a MILA CIGNA HealthCare network and you may not have to switch doctors to participate in the network. Under the MILA Plan, we do not require that you choose a PCP. You may go directly to a specialist. We are an Open Access Plan.

2. How do I select a doctor?

To see which physicians participate in MILA CIGNA HealthCare Open Access Plan in your area, check your MILA CIGNA HealthCare provider directory. You also may call Customer Service or look on the World Wide Web at www.mycigna.com. You may select a network or non-network doctor, but remember that using a participating doctor could save you money. In addition, you eliminate the hassle of claim forms when you choose in-network care. Your out-of-pocket costs will be higher if you see a non-network provider.

3. Can my doctor join the MILA CIGNA HealthCare provider network?

If your doctor meets the credentialing standards and is interested in becoming a MILA CIGNA HealthCare participating physician, he or she can call the MILA CIGNA Provider Relations department to obtain an application.

4. What if I am in the middle of treatment when I join a MILA CIGNA HealthCare plan and my current doctor is not in your network?

If you continue to be treated by your current doctor, that treatment will be covered as out-of-network care, subject to the Plan’s deductible and coinsurance provisions. You may ask your current doctor if he will apply to become a network physician but this application may take time and there is no guarantee that he will be accepted. Otherwise, you can look for another doctor who is a member of the network.

When MILA began operation on 1/1/2000, there was a special, one-time-only "transition of care" provision which operated to allow some people who were in care under their local Port plans with doctors outside the network to continue to receive that care for a limited period as if it were network care. That special provision will not be repeated.

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