The difference between Cigna Open Access Plus and Cigna Open Access Plus In-Network comes down to out-of-network care. A standard Open Access Plus (OAP) plan covers out-of-network doctors at a higher cost. A Cigna Open Access Plus In-Network (OAPIN) plan covers out-of-network care only in emergencies and urgent situations. Both use the same large national network, and neither requires referrals. Because OAPIN limits your choices, it often costs less each month.
- OAP covers out-of-network care at a reduced benefit level. OAPIN covers it only for emergencies and urgent care.
- Both plans use Cigna's national Open Access Plus network.
- Neither plan requires referrals, and choosing a primary care provider is optional.
- In Texas, OAP plans count as PPO plans and OAPIN plans count as EPO plans.
Cigna OAP vs. OAP In-Network: Side by Side
| Feature | Open Access Plus | Open Access Plus In-Network |
|---|---|---|
| Network | Large national OAP network | Same national OAP network |
| Out-of-network care | Covered at a higher cost | Emergencies and urgent care only |
| Referrals to specialists | Not required | Not required in network |
| Primary care provider | Recommended, not required | Recommended, not required |
| Prior authorization | May apply to some care | May apply to some care |
| Typical premium | Higher | Often lower |
The Big Difference: Out-of-Network Care
With standard OAP, you can see a doctor outside the network and still get some coverage. However, you'll usually pay a separate or higher deductible and more coinsurance. For example, one Cigna OAP plan pays 80% in network but 60% out of network. You may also have to file the claim yourself.
With OAPIN, there's no out-of-network benefit except for emergencies and urgent care. So if you see an out-of-network specialist for routine care, you'll likely pay the whole bill. Learn more in our guide to Cigna Open Access Plus out-of-network coverage.
Choosing between the two at work? List every doctor you see now, then check each one in Cigna's directory. If they're all in network, OAPIN's lower premium may be the better deal.
Is Cigna OAPIN an EPO?
In practice, yes. Cigna says that in Texas, Open Access Plus In-Network plans are considered Exclusive Provider plans, while standard OAP plans are considered Preferred Provider plans. Elsewhere, the labels can differ, but the features match.
That makes OAP work like a PPO and OAPIN work like an EPO. Compare those plan types in our guides to EPO vs. POS plans and Cigna plan options.
A licensed Vivna agent can walk you through your options, including individual, dental and vision plans, at no cost.
How to Tell Which Plan You Have
- Check your ID card. It names the network and lists out-of-network costs for OAPIN plans.
- Log in to myCigna. Your plan name and coverage details are listed there.
- Read your Summary of Benefits and Coverage. Look at the out-of-network column. If it says "not covered," you likely have OAPIN.
- Ask HR. Your benefits team can confirm the exact plan.
Not sure how to read the card? See how to read your health insurance card, or call 888-730-6001.
Which One Should You Pick?
| If this sounds like you | Better fit |
|---|---|
| All your doctors are in the Cigna network | OAP In-Network |
| You see a specialist outside the network | Open Access Plus |
| You travel or have family in other states | Open Access Plus |
| You want the lowest premium | OAP In-Network |
| You have a planned surgery with a specific surgeon | Whichever plan covers that surgeon in network |
Cigna OAP vs. OAP In-Network: FAQs
Is Cigna Open Access Plus In-Network a PPO or HMO?
Neither, exactly. It works like an EPO: no referrals, but no out-of-network coverage except emergencies.
Does OAPIN cover emergencies out of network?
Yes. Emergency and urgent care are covered even when the provider is out of network.
Do both plans use the same doctors?
Yes. Both use Cigna's national Open Access Plus network.
Which plan costs less?
OAPIN usually has a lower premium, since it limits out-of-network care. Compare both in your employer's enrollment materials.
Can I switch from OAPIN to OAP?
Usually only during your employer's open enrollment or after a qualifying life event.
We'll compare COBRA, Marketplace and short-term options for you. Call Monday through Friday, 9am to 6pm.
Sources
- Cigna: Open Access Plus plans
- Cigna for Health Care Professionals: OAP and OAP In-Network
- Cigna: Open Access Plus for employers
- Sample Cigna OAP benefits summary (Otero County, CO)
Plan features vary by employer and state. Your Summary of Benefits and Coverage has the final word. Vivna Insurance is a licensed, independent agency (NPN 19168641) and an appointed broker with Cigna for select products. We are not Cigna and don't administer employer plans.
Related guides
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