The care you deserve, without the hassle.

CGS Health partners with best-in-class medical and pharmacy networks to help employers tailor plans to the unique needs of their employees, ensuring you get the specific coverage you need from a broad range of participating providers without the need to obtain a referral. CGS Health handles enrollment and claims processing, helping you keep your mind off paperwork and on staying healthy.

Best in class network benefits including:

Medical

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.

Prescriptions

Rx

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.

Telemedicine

Telemedicine

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!

All the benefit information you need at your fingertips.

As a feature of your healthcare benefits, CGS Health provides secure internet access to give you the information you need, anytime you need it. Get instant access to:

Insurance Card

ID Cards

Real-time access to print a temporary ID card or request new ID cards for yourself, spouse and dependents.

Transparent billing icon

Coverage & Utilization

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.

Claims

Medical Claims

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.

Provider

Provider Lookup

Search for healthcare providers in your network by specialty, name or location.

Member Portal

Frequently Asked Questions

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:

  • Cold and flu
  • Sports injuries
  • Addictions
  • Skin issues and rashes
  • Travel illness
  • Depression
  • Sore throats
  • And much more!

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.)

  • Loss of health coverage
    • Losing existing health coverage, including job-based, individual, and student plans
    • Losing eligibility for Medicare, Medicaid, or CHIP
    • Turning 26 and losing coverage through a parent’s plan
  • Changes in household
    • Getting married or divorced
    • Having a baby or adopting a child
    • Death in the family
  • Changes in residence
    • Moving to a different ZIP code or county
    • A student moving to or from the place they attend school
    • A seasonal worker moving to or from the place they both live and work
    • Moving to or from a shelter or other transitional housing
  • Other qualifying events
    • Changes in your income that affect the coverage you qualify for
    • Gaining membership in a federally recognized tribe or status as an Alaska Native Claims Settlement Act (ANCSA) Corporation shareholder
    • Becoming a U.S. citizen
    • Leaving incarceration (jail or prison)
    • AmeriCorps members starting or ending their service

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 your HR Representative as eligibility varies from group to group and plan to plan.

Need more assistance?

Our thoughtful, informed customer service verifies eligibility, resolves issues and gets you the care you need, when you need it.

Portal

Eligibility and Benefits:

Verify eligibility and benefits through our 24/7 portal.

precert

Pre-Certification:

Obtain prior authorization for services and prescriptions according to your plan.