Be a Smart Consumer

They bill your insurance company directly at negotiated rates, saving you time and money. Make sure a service is covered by your insurance company before you receive care. Find your in-network provider.

It’s fully covered by all of our medical plans and can help detect and prevent potentially costly health issues. You pay nothing for annual physicals, recommended immunizations, routine cancer screenings, and more when you see in-network providers.

With eligible Cigna medical plans, you will receive a Health Reimbursement Account (HRA) administered by Cigna to help cover the cost of your health care. It’s free money! You don’t contribute to the account, and you don’t pay income tax on the money that’s put in the account for you to use.

Contributing to a Flexible Spending Account (FSA) is easy and saves you money. You can set aside before-tax dollars from your paycheck to use for your out-of-pocket costs. With an FSA, unused money does not carry over at the end of each year — use it or lose it! Be sure to use it up.

Using generic alternatives will almost always save you money — and they’re just as effective as brand-name prescriptions. You pay less when using the Novant Health NHRMC Employee Pharmacy or Walgreen’s Retail Pharmacies. You can also save on the cost of maintenance medications for a 90-day supply when you use the Novant Health NHRMC Employee Pharmacy mail-order delivery option.

Log in to your medical plan’s website to see how much of your deductible you’ve met, review claims, find in-network providers, use helpful cost-estimating tools, and more.

Coinsurance is how you and your medical plan share the cost of medical services after you meet the plan’s annual deductible. For example, if your deductible is $3,000 and your coinsurance is 20%, once your out-of-pocket expenses reach $3,000, your plan would start to pay 80% of your covered costs, leaving you responsible for the other 20%. Your provider will usually send you a bill for the 20% you owe after your claim has been processed by your health plan. With the Surest plan, there is no coinsurance to calculate.

A copay is a fixed amount you pay for a covered health care service. For example, you might have a $25 copay when you go to the doctor’s office. Your copay is usually due at the time you receive the service and can vary based on the type of service you receive.

Surest plans are copay-only plans. This means you receive full coverage on day one, with no deductible to satisfy before your plan starts working for you. See the Plan Comparison for the copays for services.

A deductible is the amount of eligible expenses you must pay each year before your plan begins paying for covered services. For example, if your annual deductible is $3,000, you must pay for your no preventive expenses until your costs reach $3,000, after which the plan will start to pay a percentage of costs.

Plans typically have different deductibles for individual coverage and family coverage. Depending on your plan, you might need to meet a separate deductible for each covered family member or one larger family deductible before coinsurance begins for anyone.

Your deductible does not apply to in-network preventive care, which is covered at no cost to you. Depending on your medical plan, the deductible may not apply to other services, too, such as doctor’s office visits and prescriptions.

With the Surest plans, there is no deductible to meet.

A Dependent Care FSA allows you to pay for eligible dependent care expenses with tax-free dollars. Since you don’t pay income tax on money you put in an FSA, it’s like getting a discount on your childcare or elder care costs! Eligible expenses for a Dependent Care FSA include day care and summer camps for children under age 13, and day care for dependent elders.

You contribute to your FSA through before-tax payroll deductions by selecting how much you want to contribute over the course of the plan year, with a proportionate amount of that annual contribution coming out of each paycheck. You can only use money actually deposited into your account.

Dependent Care FSAs have a “use it or lose it” rule, so typically, any unused money left in your account at year-end is forfeited.

A Health Care FSA is an account you can use to pay for eligible health care expenses with tax-free dollars. Since you don’t pay income tax on the money you put in an FSA, it’s like getting a discount on your medical, dental, vision, and medication costs! Eligible expenses for a Health Care FSA include deductibles, coinsurance, and copays for medical, dental, and vision care, as well as many over-the-counter items like bandages, sunscreen, and feminine care products.

You contribute to your FSA through before-tax payroll deductions by selecting how much you want to contribute over the course of the plan year, with a proportionate amount of that annual contribution coming out of each paycheck. Your entire annual contribution to a Health Care FSA is available to you from the beginning of the plan year.

FSAs have a “use it or lose it” rule, so you may forfeit any unused money at the end of the year. Depending on your account rules, you may be able to carry over your balance up to a certain amount, or you may be offered an extension to the year-end deadline.

Team members enrolled in a Cigna medical plan can earn money into their HRA through participation in the Novant Health well-being program. It’s free money! You don’t contribute to the account, and you don’t pay income tax on the money that’s put in the account for you to use.

However, unlike a Health Savings Account, you don't own the HRA. Please note that your HRA cannot be used toward dental and vision expenses.

An out-of-pocket maximum is the most money you would have to pay in a plan year for covered health care expenses. If your out-of-pocket expenses (such as your deductible, coinsurance, and copays) reach your plan’s out-of-pocket maximum, you won’t pay anything further for covered services for the rest of the year.

Premiums are the money you contribute from your paycheck to pay your share of the cost of being enrolled in a health plan.

Your premium depends on the plan you choose and who you enroll. For example, a medical plan with a low deductible will have a higher premium than a plan with a higher deductible. And you’ll pay a lower premium to enroll yourself, while a higher premium would apply when enrolling your spouse and kids.

Preventive care services include routine physicals, health screenings, routine blood work, and recommended immunizations. In-network preventive care is covered free of charge with all plans.

A qualified life event is a change in your life that qualifies you to update your benefits enrollment before the next Open Enrollment. For example, if you get married in April and your Open Enrollment is typically in the fall, you wouldn’t need to wait until then to change your benefits. You could add your spouse to your coverage or drop your coverage and join your spouse’s plan within 31 days of your wedding. Only changes related to your life event are allowed.