No. Your plan does not require you to have a referral to see specialists; however, you should always confirm that the specialist is a participating provider in order to avoid unnecessary out of pocket expense.
Does surgery require pre-certification?
Yes. You must get approval in advance for surgeries, hospital stays and certain procedures. To pre-certify, please call 800-551-3225.
Am I covered for a hearing aid?
If you are covered by an Cigna plan, you are entitled to a hearing aid benefit up to $550 payable once per ear, per lifetime.
What are my co-pays for office/ER visits?
It depends on your plan (check your SPD). Typically there’s a relatively small co-payment for a doctor’s visit and a much higher one for the Emergency Room. The ER is not meant for routine care.
How can I find a participating provider in my area?
1. If you participate in an Cigna plan:
• Use this website to Find-A-Doctor
• Call 212-388-3500 in NYC or 800-551-3225 from outside NYC
• Come to the Walk In Center at 25 West 18th Street in Manhattan Monday – Friday, 8:00 a.m. – 6:00 p.m.
• Visit www.cigna.com
2. If you participate in Independence Blue Cross (IBC) Plan visit www.ibxpress.com.
3. If you participate in a Kaiser Plan visit kp.org .
Can I see an out of network doctor?
If you are covered by an Cigna plan, you can choose to see a non-participating provider for most procedures, but going out-of-network is costly. You have to pay an annual deductible before you receive any benefits. Once you have met your deductible and file a claim, Cigna will cover a percentage of the Cigna fee schedule. You will end up paying a lot because most out-of-network doctors charge much more than Cigna’s negotiated rates.
What if I go to a network hospital, but get an out of network doctor bill?
If you schedule an appointment for a procedure in a hospital, you should verify that the hospital and the provider are both in your network.
If you go to a network hospital and receive a bill for the services that were rendered, please contact our Member Services department at 212-388-3500.
We will review the claim to determine if the claim was processed correctly.
What does the health plan cover?
Full-time workers usually have hospital, medical, prescription drug, behavioral health and substance abuse,
dental, vision and life insurance benefits for themselves and their eligible dependents, including spouse and children.
Check your SPD on this website for details.
What do I do if I get a bill that I don’t understand?
Call Member Services at 212-388-2500 immediately if you receive a bill that includes services you did not receive or charges you don’t understand.
Building Service 32BJ Benefit Funds
25 West 18th Street, New York, NY 10011
Tel: 212.388.3500 or 800.551.3225
