Outpatient Services
Covered outpatient services include, but are not limited to the following services and is subject to change at any time, also subject to any limitations or requirements and based on medical necessity:
- Acupuncture when used as a form of pain control and performed by a licensed provider (check with Cigna Global Health Benefits);
- Allergy testing and treatment;
- Chemotherapy and radiation treatments;
- Chiropractic care when medically necessary as determined by Cigna Global Health Benefits to diagnose or treat illness, injury, or disease. Coverage is limited to 20 visits per year and ends once maximum medical recovery has been achieved and treatment is primarily for maintenance or managing pain;
- Diagnostic services, including:
- EEG, EKG, and other medical electronic procedures;
- Laboratory and pathology tests; and
- Radiology services.
- Education therapy, but only for participants with a diagnosis of diabetes mellitus;
- Eye exams for patients with diabetes (covered as a specialist office visit);
- Hemodialysis provided at a free-standing facility such as a dialysis center, or your home, when ordered by a licensed provider;
- Licensed, general hospital emergency room use for treatment of an injury or sudden illness, including:
- Emergency treatment rooms;
- Laboratory and pathology tests;
- Licensed providers' services;
- Supplies and medicines administered during the visit; and
- Radiology services.
- Licensed provider-prescribed respiratory therapy approved by Cigna Global Health Benefits;
- Mental health care/substance abuse care;
- Occupational therapy rendered by a licensed therapist, up to a combined total of 60 visits per calendar year for care received in-/out-of-network and outside the U.S.;
- Outpatient surgery and related follow-up care;
- Physical therapy rendered by a licensed therapist, up to a combined total of 60 visits per calendar year for care received in-/out-of-network and outside the U.S.;
- Podiatric care when medically necessary as determined by Cigna Global Health Benefits to diagnose or treat illness, injury, or disease. Coverage ends once maximum medical recovery has been achieved and treatment is primarily for maintenance or managing pain;
- Prenatal care;
- Speech therapy rendered by a licensed therapist, up to a combined total of 60 visits per calendar year for care received in-/out-of-network and outside the U.S.; and
- Temporomandibular joint syndrome (TMJ) medical treatment only, including exams, X-rays, injections, anesthetics, physical therapy, and oral surgery up to $1,000 combined for in-/out-of-network care and care received outside the United States (appliances are not covered).
This list is subject to change at any time.