Out-of-Area Plans
Most MILA Members live in areas where the Trustees have
decided that the network is adequately staffed to their
needs. Members will always be in an adequately staffed
area when seeking a behavioral health provider or when
seeking a Caremark® retail pharmacy. However, the
Trustees have decided that certain geographical areas have
insufficient CIGNA network providers and, because of
this, these Members are eligible for Out-of-Area benefits.
You will be notified if you live in such an area and you
will receive a special ID card. In these areas, the Out-of-Network Member charges have been modified as follows:
- Your deductible is $150 per individual and $300 per family.
- Your coinsurance is 20% rather than 40%.
- Your out-of-pocket maximum expense for the deductible and coinsurance during the calendar year is $2,500 per individual and $5,000 per family.
In addition, preventive care and family planning
are covered services Out-of-Network in the
Out-of-Area Plan.
If you live in an area which has been designated Out-of-Area, you may use network providers and receive all the
benefits which they provide. However, if you must use
non-network providers, these Plan adjustments will
reduce your cost to do so.
The Trustees continually review the
network and encourage CIGNA to
recruit providers in areas in which
Members live. As a result, the
Trustees will reclassify areas as the
network becomes sufficiently
staffed and Members who live
within areas which have been
reclassified will be notified.
