Medical Plan Frequently Asked Questions
- Which services are subject to the annual deductible?
The Wesleyan Open Access Plus and Open Access Plus In-Network plans have an annual deductible of $500 for individuals and $1,000 for families.
The following services fall under this deductible:
Lab work
Imaging (X-ray, MRI, PET, CT, and ultrasound)
Durable medical equipment
Inpatient procedures and services
Outpatient procedures and services
Home health care
Prosthetic devices
Hearing aids
Once the deductible is met, these services are covered at 100% for the rest of the plan year.
The deductible also counts toward your annual out-of-pocket maximum.
- I went for a preventive procedure and expected to pay nothing. Why am I being billed?
All preventive services that are coded as preventive are covered at 100%. A diagnostic procedure is subject to the applicable deductible and copay. Make sure you talk with your provider about the procedure so you know how it is being billed.
- How do I get an ID Card for my Medical/Dental/Vision Coverage?
Cigna (Health and Vision coverage) – Go to myCigna.com. Log in and scroll to the bottom of the page where you will see a link to ‘Get an ID Card’.
Delta Dental – Go to DeltaDentalCT.com. Log in to MySmile and download your ID card from your dashboard.
EyeMed (lenses and frames) – Go to Member Web. Log in and follow the instructions to print an ID card. You can also load the EyeMed Members App through App Store or Google Play instead.
- I am turning 65 but am not planning to retire soon. Do I have to terminate Wesleyan's benefits and apply for Medicare Parts B and D? What about my spouse/partner?
As long as you are an active, benefits-eligible employee, you and your spouse/partner may remain on the Wesleyan benefit plan, regardless of age.
- I have questions about my medical bill. Whom should I contact?
Call Cigna at 1-800-244-6224 and log into your mycigna.com portal to look up the date of service correlating to the bill. Bills are often sent by the provider before Cigna has fully processed the claim. Always check your Explanation of Benefits (EOB) to see how the claim is being processed. A representative at Cigna is available to help you resolve any eligibility or claim issues you have.
- Cigna denied a prescription my doctor wants me to have. I have tried other therapeutic equivalent drugs but have medical challenges and can only take this one drug. What should I do?
Your doctor should assist you with an appeal to Cigna by documenting your medical need for the prescription. Have your provider’s office contact Cigna to initiate the appeal process for you.
- I am getting married. How can I add my spouse to my plan?
Visit our page on qualifying life events, which details how to make changes to your benefits.
- My doctor wants me to get an MRI, yet Cigna sent me a letter of denial. What should I do?
Call Cigna at 1-800-244-6224 to have someone explain the reason for the denial. It is important to receive clarification.
In many cases of denied authorizations, the treating provider did not submit all of the necessary medical documents needed for an approval. By calling Cigna and engaging with your provider, you should be able to resolve the issue quickly.