NFP
Plan Overview – OAP Buy Up Plan
The Cigna Open Access Plus (OAP) Buy Up Plan offers broad coverage from August 1, 2025 through July 31, 2026. It’s designed for individuals and families seeking flexibility to visit in-network providers without referrals. Below is a summary of core cost-sharing and key features drawn directly from the official Summary of Benefits and Coverage.
01 At a glance
$2,000
$5,000
$30 copay
$300 copay
02 What you’ll pay
| Service | In-Network | Out-of-Network |
|---|---|---|
| Specialist Visit | $60 copay (per visit) | 20% coinsurance |
| Urgent Care | $100 copay (per visit) | 20% coinsurance |
| Diagnostic Test (X-ray, blood work) | No charge | 20% coinsurance |
| Imaging (CT, MRI, PET) | $250 copay per day (outpatient) | 20% coinsurance |
| Generic Drugs (Tier 1) | $15 copay (30 days) | 20% coinsurance |
| Preferred Brand (Tier 2) | $45 copay (30 days) | 20% coinsurance |
| Non-Preferred Brand (Tier 3) | $85 copay (30 days) | 20% coinsurance |
| Specialty Drugs (Tier 4) | $150 copay (30 days) | 20% coinsurance |
| Outpatient Surgery Facility | No charge | 20% coinsurance |
| Inpatient Hospital Stay | No charge | 20% coinsurance |
| Home Health Care | No charge (60 visits max/yr) | 20% coinsurance |
| Rehab & Chiropractic Care | $60 copay/visit (40 visits max/yr) | 20% coinsurance |
| Mental Health Office Visit | $60 copay/visit | 20% coinsurance |
03 Key observations
Preventive care at no cost. In-network routine checkups, screenings, and immunizations are covered 100% before the deductible.
Predictable office costs. Flat copays ($30 primary, $60 specialist) help you anticipate routine visit expenses.
Consistent pharmacy tiers. Four-tier drug structure ranging from $15 generic to $150 specialty encourages use of cost-effective options.
Limited pediatric vision/dental. Children’s eye and dental exams are not covered, and adult dental or routine vision care are excluded from benefits.