Medical
Shorter wait times to see your preferred doctors and providers, saving you time and money. CGS Health provides access to the Cigna national PPO network for major medical plans, and the MultiPlan/ PHCS network for MEC and MEC-Enhanced plans.
Shorter wait times to see your preferred doctors and providers, saving you time and money. CGS Health provides access to the Cigna national PPO network for major medical plans, and the MultiPlan/ PHCS network for MEC and MEC-Enhanced plans.
Access to nationally recognized pharmacy benefit managers (PBMs) providing prescription coverage and access to 65,000 pharmacies nationwide to ensure you get the medicine you need quickly without breaking the bank.
All CGS Health plans come with FREE 24/7 telemedicine access by Teladoc, immediately connecting you with board-certified clinicians at your convenience. Treat cold & flu, skin issues & rashes, sore throats, travel illness, and much more!
Real-time access to print a temporary ID card or request new ID cards for yourself, spouse and dependents.
Information regarding your coverage and benefits is easily available. View up-to-date information including deductibles, copays, co-insurance, out-of-pocket limits, and preventative health benefits usage.
CGS Health provides quick access to your claim status and explanation of benefits (EOBs). You can track your medical claims as they move through the CGS Health claims processing system.
Search for healthcare providers in your network by specialty, name or location.
Portal: mycgshealth.com
If you are part of a Cigna plan: please go to https://cgshealth.com/cigna and follow the prompts.
If you are part of a Multiplan plan: https://cgshealth.com/multiplan and follow the prompts.
Your health plan leases the Cigna network through Cigna Payer Solutions. As such, Cigna direct will not recognize your name in their retail healthcare system. Always call CGS Health Member Services to verify eligibility.
Your health plan leases the Cigna network through Cigna Payer Solutions. Often, providers use an exchange or clearing house to verify eligibility and benefits. Members accessing the Cigna network through Cigna Payer Solutions may not be part of the Cigna direct clearing house network. Providers should always call CGS Health Member Services to verify eligibility.
Please go to your member portal, download a temporary ID Card, and request a new one.
Only the subscriber and the spouse receive an ID card. By default, dependents do not receive ID cards. If you would like to order additional ID cards for dependents, please contact CGS Health Member Services, and they will fulfill the ID card request.
Please contact CGS Health Member Services if you need assistance to understand your EOB.
If you are part of a Cigna plan: please go to https://cgshealth.com/cigna and follow the prompts
If you are part of a Multiplan plan: https://cgshealth.com/multiplan and follow the prompts
Claims should be submitted by the provider. If a claim was not submitted by a provider, please contact CGS Health Member Services for assistance.
Teladoc telemedicine service is included as part of all CGS Health benefit plans. Before using the Teladoc service, you must first complete a profile for each member and eligible dependent at teladoc.com or by calling 800.Teladoc.
Teladoc is your doctor on demand that gives you instant and free 24/7 access to a board-certified physician without having to leave your house.
Teladoc can treat:
One Call is our network of discounted advance imaging (MRI, PET/CT Scan). Please go to http://providerlookup.onecallcm.com/ or call 888.458.8746 to find a facility.
Please go to the Member Portal to find information about your healthplan accumulators (e.g. deductible, copays, co-insurance and max-out-of-pocket costs).
Please contact your HR Representative as eligibility varies from group to group and plan to plan.
There are 4 basic types of qualifying life events. (The following are examples, not a full list.)
If you are terminated or leave your company this will prompt a COBRA event and a letter will be sent to your address on file providing the opportunity to elect COBRA.
They can receive coverage until their 26th birthday, which will then trigger a COBRA event.
Unless you have a qualifying life event, you will need to wait for your company’s open enrollment to change plans.
Please contact CGS Health Member Services.
Please contact your HR Representative as eligibility varies from group to group and plan to plan.
Please visit this link to access the MRFs here.
Verify eligibility and benefits through our 24/7 portal.
Obtain prior authorization for services and prescriptions according to your plan.