NFP
Plan comparison – OAP Buy Up vs. HDHPQ OAP Mid (2025–2026)
This comparison reviews two Cigna Open Access Plus plans for the 2025–2026 coverage period. Both plans share the same provider network but differ in deductible, out‑of‑pocket limits, and cost‑sharing details. The table below shows the side‑by‑side benefits so you can see how the Buy Up and HDHPQ Mid designs diverge across key services.
Key change: The HDHPQ OAP Mid plan shifts to higher deductibles ($3,000 single / $6,000 family versus $2,000 / $4,000) and reduces emergency‑room copay to $200 (was $300), reflecting its high‑deductible structure.
Changed this year
| Benefit | OAP Buy Up Plan | HDHPQ OAP Mid Plan |
|---|---|---|
| Overall deductible (in‑network) | $2,000 individual / $4,000 family | $3,000 individual / $6,000 family |
| Out‑of‑pocket max (in‑network) | $5,000 individual / $10,000 family | $6,000 individual / $12,000 family |
| Primary care visit | $30 copay | $15 copay |
| Specialist visit | $60 copay | $30 copay |
| Imaging (CT/MRI) | $250 per day copay (deductible not applied) |
Same $250 per day copay |
| Generic drugs (Tier 1) | $15 / $45 (30/90‑day) | Same $15 / $45 |
| Preferred brand drugs (Tier 2) | $45 / $135 | Same $45 / $135 |
| Emergency room care | $300 copay per visit | $200 copay per visit |
| Urgent care | $100 copay | $75 copay |
| Hospital stay (inpatient facility) | No charge (after precert) | Same – no charge |
| Mental health outpatient | $60 copay per visit | $30 copay per visit |
| Rehabilitation therapy | $60 copay per visit | $30 copay per visit |
| Children’s dental / vision | Not covered | Not covered |
| Excluded services (select) | Both plans exclude acupuncture, bariatric surgery, long‑term care, routine eye or dental, and weight‑loss programs. | |
| Sample cost – Having a baby | $2,060 out‑of‑pocket | $3,340 out‑of‑pocket |
| Sample cost – Simple fracture | $1,690 out‑of‑pocket | $3,030 out‑of‑pocket |