Frequently Asked Questions
If you have a benefits-related question, check out these frequently asked questions and answers. If you do not find what you are looking for, please use our comments form to submit your question. After clicking the comments form link, select Benefits from the Subject pull-down list, enter your question, and press the Submit button.
Answers to some of the questions below take you to the CIGNA website. Those are noted.
Click on a question to either reveal the answer or be taken to the CIGNA website. Click again to close.
- Go to the CIGNA website at http://www.cigna.com/
- Under Find a Doctor, enter the city and state or the zip code.
- Click the Next button.
- Under What type of plan do you have, select “TN-Seamless (HMO, POS, Open Access)” from the Select Healthplan Network pull-down list.
- Under What you're looking for, select either Primary Care Physician or Specialist and the desired type from your selection's pull-down list.
- Click the Search button.
- Choose a health plan network from the Select Healthplan Network pull-down list. For most people, this choice will be “TN-Knoxville.”
- Click the Continue button.
When do I need to file a CIGNA claim form? [Link to CIGNA website.]
What prescriptions require a prior authorization?
Certain drugs may require a prior authorization in order to receive the prescription (or the full quantity) your doctor prescribes.
If you or your doctor feels there are circumstances that require greater quantities of medication than the Plan allows, your doctor may request a coverage review. For some drugs, more information than what is provided on a prescription form (or from the pharmacy) is needed to determine if coverage for additional medication can be provided. The prescribing doctor can provide additional information for the coverage review by calling toll-free 1.800.753.2851, Monday through Friday, 8 a.m. to 9 p.m., Eastern Time.
The following list identifies the brand names of the drugs that may require prior authorization and is subject to change.
- Anti-emetics
- Cox-2 inhibitors (Celebrex)
- Erythroid cell boosters
- H2-receptor antagonists (Axid, Pepcid, etc.)
- Herpes antivirals
- Hypnotics
- Irritable bowel syndrome agents (gastrointestinal medications)
- Leukotriene agents (allergy medications)
- Migrane drugs
- Multiple sclerosis drugs
- Narcolepsy agents
- Proton pump inhibitors (PPIs) (Nexium, Prilosec, etc.)
- Psoriasis
- Retin-A
- Rheumatoid arthritis
- Wellbutrin SR
- White cell boosters
- Xolair
If the prior authorization request is denied, or the quantity and/or dosage that the doctor presecribed is not approved, you should contact Medco at 1.800.753.2851 for instructions on how to appeal this decision.
What over-the-counter items can be reimbursed under the health care spending account?
View the list of over-the-counter items that can be reimbursed under the health care spending account. Hit the back button to return to this page.