Your Preferred Provider Access Plan (PPA Insurance) provides convenient, low-cost coverage in our network plus the option to go out of network when you wish.
Mental Health and Substance Abuse Services provided by CIGNA Behavioral Health, Inc., one of the CIGNA Companies. Then, to access to care, call 24 hours a day, 7 days a week at the toll-free number listed on your ID card.
Case Management For Insurance
Coordinated by CIGNA HealthCare. Then, this is a services designed to provide assistance to patients who are at risk of developing medical complexity or for whom the health incident has triggered the need for rehabilitation or additional health care support. Then, program strives to strike a balance between quality and cost-effective maintenance while maximizing patient’s quality of life.
Exception in PPA Insurance
Your package provides protection for medical required service. Your plan is not provide protection for the following except as: required by law:
- Services that are not medically necessary, unless specifically stated prevention care.
- Cosmetic surgery, unless a) someone received an injury that resulted in damage requiring surgery; a little qualify as reconstructive surgery done on someone after surgery and both surgery and medical reconstructive surgery required; c) qualify as reconstructive surgery after mastectomy, including surgery and reconstruction the other breast to achieve symmetry; or d) performed to correct congenital abnormalities abnormalities in each dependent who has has not yet reached bone maturity.
- Unlawful claims against the person required to pay.
- Costs incurred by hospitals owned or operated by the US government if costs are directly related to the disease or injuries related to military service.
- Experimental or investigative procedures and treatments are not approved by the American Medical Association.
- Any injury resulting from, or in of course, any work for wages or profit.
- All illnesses are borne by the Worker Compensation or similar laws.
- Custodial services are not for primarily to treat certain injuries or illnesses, or any education or training.
- Reports, evaluations, inspections or hospitalization is not necessary for health reason.
- Then, reversal of voluntary sterilization Procedure.
- Costs for or in connection with in vitro fertilization, artificial insemination, or other similar procedures.
- Then, transsexual operations and related services.
- Surgical treatment for correction refractive errors, including radial keratotomy.
- Routine foot care
- Non-surgical TMJ
- Amniocentesis, ultrasound or other procedures requested solely for sex determination of the fetus, except medically needed to determine the existence sex-related genetic disorders.
- Over the counter disposable or consumables, including orthotics device.
- The following drugs or medications: diet pills, minoxidil or Retin-A after age 35, unless medically necessary, and not prescription drugs.
- Exceeding Reasonable Costs and Customary allowance.
- Then, speech therapy if a) for improve incomplete speaking skills; b) as custodian or education; or c) to maintain speech communication
- Routine eye and eye exams or lenses with the exception of the first pair lenses or glasses after cataract operation.
- Then, routine hearing checks or hearing aids.
- Dental/periodontal care except the costs are incurred for:
- expenses for sustainable dental care treatment start within six months after injury to healthy natural teeth;
- cost by the hospital to sleep and eat or necessary services and supplies;
- costs by outpatients in hospital department with surgery.
Vital Records in PPA Insurance
This summary contains highlights only and is may change at any time. Special terms from scopes, exceptions and limitations, including benefits regulated by law, contained in
Description of the insurance plan or certificate of PPA Insurance. So, This program is insured and/or managed by Connecticut General Life Insurance Company, a CIGNA Company
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