General questions
Who are the dependants I can enroll?
You can enroll your spouse (even those above 65 years old) and adopted and biological children below 21 years old. You can also enroll your domestic partner upon submission of required documents.
How much is my coverage?
US$25000 (approximately PHP1.1M) for the principal member. US$25000 (approximately PHP1.1M) for the spouse or domestic partner. US$25000 (approximately PHP1.1M) for each biological or adopted child.
What is a care provider?
A care provider is a doctor, clinic, or hospital.
What happens if I exhaust my maximum benefit limit (USD25,000) before the contract year ends?
The member will have to shoulder the expenses that will be incurred beyond the MBL. A new MBL will only take effect at the start of each contract year (1st of January).
What type of room can I avail of if I get hospitalized?
Room and board for all members is semi-private room.
My doctor is affiliated with a hospital that is not in Cigna's network. Can I still arrange for a cashless transaction for a planned inpatient treatment (e.g. childbirth)?
No, this will be on a pay and reimburse basis. However, if the doctor and hospital are willing to have an arrangement with Cigna, this can be cashless on the part of the member.
What if I get hospitalized during the transition dates (e.g. admitted on 30 June 2015)?
Call HRS to inform Cigna that they will take over the payment starting from 1 July 2015. However, because the plan with Cigna covers only a semi-private room, the member shall pay for the difference in rate.
What if I get sick/have an accident abroad?
We suggest travelers to please know accredited care providers within the area of the country you are travelling to. This is so you may go to one of these care providers for medical treatment if needed, without paying cash.
Will I shoulder the difference in room cost if no semi-private room is available in an accredited hospital and a more expensive room is assigned to me?
If there is no semi-private room available, Cigna will cover the cost of the room assigned to you.
What if the Guarantee of Payment (GOP) has not yet been received by the hospital and I am about to be discharged?
Inform HRS that the GOP has not yet been received so that Cigna can be notified at once. Upon admission, it is important to remind the hospital to accomplish the cost estimate form and send it immediately to Cigna.
What if the treatment I need is not available in the Philippines but available in another country?
If you need to undergo a treatment that is not available in the Philippines, you may go to another country where this treatment is available subject to the approval of a Cigna medical consultant. The medical expenses that will be incurred will be covered based on the Reasonable and Customary (R&C) charges applicable to the country where the treatment is available. Reasonable and Customary charges refer to the prevailing pattern of charges for professional and other health services at the country where the staff is stationed. Costs/expenses above the R&C will not be reimbursed.
Will Cigna cover my travel expenses if I go to another country for treatment?
No, Cigna will only cover the treatment but not the transportation expenses of the member.
Are maintenance medications covered?
They are covered, but the members are required to submit a medical prescription from their treating doctor clearly indicating the diagnosis.
How do I log-in to the Cigna web site?
A password to access the web site will be provided by Cigna to each principal member. Please refer to these steps on how to login, or you may download the NRS Medical Plan Brochure for detailed instructions.
Does Cigna have a toll free number that members can directly contact?
As of the moment, there is none yet. But Cigna has committed to provide a toll free number for the Philippines. This will be announced once operational. In the meantime, you may contact Cigna at +60 3 2053 9922.
What happens to IRRI Clinic?
This is under negotiation with the assistance from Safety and Security Services.
Who are the care providers in Cigna's network in the Philippines?
You may find the list of care providers in Cigna's network in the Philippines in the Resources page or in the NRS Medical Plan brochure.
Is there a forum I can go to to get more information?
You may visit http://myhr.irri.org/forum to leave questions and get more information. IRRI.ORG account is required for access.
Alternative medicine
Is acupuncture covered?
Acupuncture is covered only if it was rendered to treat a medical condition. Hence, plan members have to submit a prescription from the treating doctor clearly indicating the diagnosis.
Dermatological
Is wart removal/cauterization covered?
Wart removal/cauterization is subject to the medical necessity. Hence, plan members need to submit a medical prescription indicating the diagnosis and type of treatment for review.
Is treatment for hair loss covered?
Hair loss treatments are not covered.
Dental
Are teeth braces covered?
Teeth braces are covered if they are deemed necessary by the dentist. Only 80% of the cost shall be reimbursed, and only up to the maximum ceiling of US$500 per member per calendar year.
Optical
Is Lasik treatment covered?
Lasik treatment is not covered under the plan.
Psychiatric
Will Cigna cover the cost of psychiatric counseling?
Yes, treatment of psychological problems are covered at 50% with a ceiling amount of USD600 per member per year. A prescription from psychiatrist stating the diagnosis is required.
Reimbursement
If Cigna requires additional medical report form me, but the doctor says I have to pay for it, will Cigna reimburse the cost of the medical report?
Yes, Cigna will reimburse it as long as you have a receipt from your doctor as proof of payment and send it to Cigna for reimbursement.
Can I reimburse the cost of nebulizer?
Nebulizer is not covered under the plan.
How long does it take before Cigna reimburses my claim?
It usually takes Cigna five to ten working days upon receipt of documents to process the reimbursement claim which shall be included in the payroll following receipt of the money by Finance. Processing may take more than ten days if additional documents are required.
How do I reimburse my medical expenses if no receipt was issued to me?
You will not be reimbursed without an official receipt so make sure you get receipt for your medical treatment.
Vaccinations
Are anti-rabies and anti-tetanus shots covered?
Both vaccinations are considered medically necessary and are covered under the plan.
Can I reimburse flu vaccinations?
Flu vaccination is not covered in the plan.