Pre-65 Retiree Health Benefits 2022
Dartmouth offers a choice of three different medical plans. All three plans include prescription drug coverage and preventive vision care. The medical plans are self-insured and administered by Cigna Health and Life Insurance Company (Cigna). Pharmacy benefits are administered by Express Scripts
Choosing a Health Plan
Dartmouth offers a choice of three different medical plans:
Other Considerations
- Undersrtanding Your Plan
- Durable Medical Equipment
- Wellness Reimbursement
- Telehealth
- Cancer Support
- OMADA Program
All Three Plans Offer
- Coverage by Cigna Health
- Coverage for medical care, including visits to your doctor's office, hospital stays, mental health and substance abuse services, chiropractic treatment, physical therapy and other services.
- An option to choose a primary care doctor to help guide your care. It's recommended, but not required.
- A national network of providers (Open Access Plus/Carelink), as well as emergency coverage when traveling abroad for personal travel. For more information on coverage while travleing abroad.
- No referral is needed to see a specialist, although pre-certification may be required.
- In-network preventive care* services covered at no additional cost to you. Refer to the Summary of Benefits under each plan for a list of covered preventive care services.
- 24-hour emergency care, in- or out-of-network.
- Limits on what you'll pay out-of-pocket. Once you spend the annual out-of-pocket maximum amount, the medical plan pays your covered health care costs at 100%.
- No copay or coinsurance (depending on the plan) for care received through Cigna Telehealth Connection.
- No-claim paperwork is necessary when you receive care in-network.
- Access to Dartmouth Health Connect (now One Medical at Dartmouth)
- Each family member pays toward their own individual deductible and out-of-pocket maximum. Family limits are in place to help minimize the total amount of deductibles and out-of-pocket maximums that your family would have to pay in a given year.
- The ability to manage and track claims, order ID cards, find doctors, and track account balances through the myCigna.com website.
- *Some preventive services may not be covered. For example, immunizations for travel are generally not covered. Other non-covered services/supplies may include any service or device that is not medically necessary or services/supplies that are unproven (experimental or investigational).
Open Access Plus Plan (OAP)
The OAP Summary of Benefits provides a detailed list of covered services.
Key Benefits
- The deductible and medical copays are the lowest of the three plans.
- Dartmouth Health Connect (now One Medical at Dartmouth) is available.
Other Considerations
- The OAP has the highest rates of all three plans.
- Medical and prescription copays DO NOT count toward annual deductibles, but DO count toward annual out-of-pocket maximums.
- This plan has additional hearing aid coverage.
Plan overview
See page 9 of the 2022 Pre-65 Retiree Open Enrollment Guide for a larger view of these charts.
Cigna Choice Fund Plan (CCF)
The CCF Summary of Benefits provides a detailed list of covered services.
Key Benefits
- The deductible and copays are mid-level.
- Dartmouth contributes to an HRA.
- Dartmouth Health Connect (now One Medical at Dartmouth) is available.
Other Considerations
- Medical and prescription copays DO NOT count toward annual deductibles, but DO count toward annual out-of-pocket maximums.
Plan Overview
See page 10 of the 2022 Pre-65 Retiree Open Enrollment Guide for a larger view of these charts.
High Deductible Health Plan (HDHP)
The HDHP Summary of Benefits provides a detailed list of covered services (Note: This plan does not come with employer HRA or HSA contribution).
Key Benefits
- The plan has the lowest rates of all three plans.
- Dartmouth Health Connect (now One Medical at Dartmouth) is available for enrolled members over age 18 not contributing to a Health Savings Account.
Other Considerations
- This plan has the highest deductible of the three plans.
- You pay 100% of all medical and prescription costs until your annual deductible has been met.
- This plan is not eligible for the HSA or HRA
Plan Overview
See page 11 of the 2022 Pre-65 Retiree Open Enrollment Guide for a larger view of these charts.
Vision Coverage
Retirees and/or their dependents who are enrolled in one of the above health plans are also eligible for vision coverage. For coverage details, please review the Summary of Benefits below that matches the health plan that you are enrolled in.
- OAP/CCF - Review the OAP and CCF Vision Summary of Benefits
- HDHP - Review the HDHP Vision Summary of Benefits
Durable Medical Equipment
Cigna uses a National network of contracted vendors as a convenient and cost efficient way of getting you the necessary medical equipment supplies that you need. Your Doctor provides the appropriate vendor with a prescription and the vendor will make all of the arrangements to deliver the supplies right to your front door. If supplies are needed immediately, your doctor can indicate overnight delivery on the provided prescription. Click here for a full list of DME providers and contact numbers.
Wellness Reimbursement
Dartmouth offers a $225 fitness reimbursement benefit per family, per calendar year, for expenses limited to fitness facilities and exercise classes, including online/DVD exercise classes. Reimbursements are subject to applicable tax withholdings. Please visit the Wellness at Dartmouth website for more details.
Telehealth
Cigna Telehealth is a resource where you are able to connect with a board-certified doctor for help with minor, non-life threatening conditions through secure video, chat or phone 24/7/365, including holidays! If you are enrolled in the Cigna Open Access Plus Plan or the Cigna Choice Fund there is no copay. If you are enrolled in the Cigna High Deductible Health Plan there is a $55 copay (Rates for the HDHP are subject to change). Get the care you need, including most prescriptions (use of this service does not guarantee that a prescription will be written.)
You can visit your www.mycigna.com to register at TeleHealth in anticipation of future use. By registering ahead of time, the process will not be delayed when you need to utilize this benefit.
Cancer Support Program
Whether you have cancer - or are a cancer survivor, you can get one-on-one support with the Cigna Cancer Support Program. From understanding your diagnosis to discussing your health care provider's treatment to celebrator your surviorship, Cigna is here to support you and your family throughout your journey, and help you get the care you need. The Cigna Cancer Support program is part of your health plan and is offered at no extra cost to you. The specialists who help customers in this program have experience as oncology nurses. More information on Cigna's Cancer Support program.
OMADA for Pre-Diabetes
OMADA is free digital behavioral change program focused on pre-diabets and metabolic syndrome and is offered to members enrolled in a Dartmouth Cigna health plan. The program is designed to help members lose weight and avoid chronic illnesses. Participants receive personalized virtual support along with a digital scale, professional health coaching, social support groups and online training lessons.
View more information on the OMADA Program.
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