Augusta Health Assistance Center for Cigna Patients

Augusta Health is in active contract negotiations with Cigna. Negotiations are a standard part of business operations between health systems and health plans and most of time, agreements are reached without disruption to network status.

We have been negotiating with Cigna for almost a year in the hopes of coming to an agreement regarding reimbursement rates but unfortunately Cigna’s proposals are falling short of market and inflationary trends.  It’s vitally important to Augusta Health’s mission and our ability to care for our community that we receive fair reimbursement. As a result of this shortfall, Augusta Health has submitted a Notice of Termination to Cigna.

If we do not reach an agreement before December 31, 2025, Augusta Health will be considered an out-of-network provider for Cigna on January 1, 2026 which could make getting your care at Augusta Health more expensive.

By not compromising on a reasonable contract, Cigna is putting your in-network access to Augusta Health providers and facilities at risk. We are working diligently to preserve your in-network benefits for the quality care you’ve come to rely on from your Augusta Health provider.

• Please note that the Emergency Room at Augusta Health is always accessible to Cigna patients, even if our contract expires. Patients who seek care in the emergency room will only pay in-network expenses at all times.
  
  
• For non-emergent services, if your plan includes out-of-network benefits, you can continue to see your Augusta Health providers, but may have to pay more out of pocket. You can contact Cigna to verify your out-of-network coverage.
  
  
• For non-emergent services, if your plan does not include out-of-network benefits and you have any ongoing treatment or procedures scheduled after December 31, 2025, call Cigna immediately to request that Cigna approve your treatment under “Continuity of Care.” Without a Continuity of Care authorization from Cigna, you may be responsible for payment of services beginning January 1, 2026.
  
  

Yes. As of right now, nothing changes for our Cigna patients—and this notice does not impact our ability to accept Cigna patients at Augusta Health. If we do not reach an agreement, our contract will expire at midnight on December 31, 2025 and Augusta Health will be out-of-network with Cigna. After January 1, 2026, if Augusta Health remains out-of-network, claims for non-emergent services will be processed as out-of-network.

Please note: Emergency services will always be covered as in-network even if our contract expires.

As of now, nothing changes for Cigna members and their access to Augusta Health primary care providers.

However, if we are unable to reach resolution and our contract with Cigna expires at midnight on December 31, 2025, all Augusta Health employed providers, including primary care physicians, will be considered out-of-network with Cigna beginning January 1, 2026. This means you would likely face higher out-of-pocket costs when visiting your Augusta Health PCP, even if you previously had in-network coverage for that physician.

As of now, nothing changes for Cigna members and their access to Augusta Health physicians, but if we are unable to find a resolution with Cigna by midnight on December 31, 2025, then there will be changes for patients dependent on their individual situation and health plan beginning January 1, 2026.

Certain patients, including those who are hospitalized, in their second or third trimester of pregnancy, or currently undergoing a course of treatment with providers from Augusta Health, may be eligible to continue their service course of treatment with their Augusta Health providers and have their covered as in-network as part of the “Continuity of Care” transitional period. The length of the transitional period depends on the specific health plan.

Continuity of Care Process:

1. Contact Cigna at the number on your insurance card to request a Continuity of Care application.
2. Download the form directly: Click here.
3. Your provider will need to complete portions of this form.
4. Submit the completed form to Cigna as soon as possible.
5. Cigna will review your request within 10 days of receipt.
6. Continuity of Care requests must be submitted by November 30, 2025 (within 30 days of contact termination). Should you have any questions regarding the Continuity of Care provisions, you can call Cigna at the number on the back of your card or the Augusta Health Assistance Center for Cigna patients at 540-213-2670.
   
   

Pregnant patients in their second or third trimester on January 1, 2026 may be eligible for Continuity of Care benefits, which means the care for the delivery and nursery would be covered in-network. If you are pregnant, please contact Cigna as soon as possible to begin the Continuity of Care application process.

Yes. Even without a new contract, Virginia state law protects patient access to Augusta Health when they need emergency care. Our emergency room is always open to all patients, and the cost for emergency services is not impacted based on a patient’s network status.

All emergency care for patients with Cigna insurance will be covered at in-network benefits levels, regardless of our contract status. Any patient experiencing a medical emergency should always visit the nearest emergency room.

As of now, nothing changes for Cigna members and their access to Augusta Health.

Patients are entitled to emergency care at any hospital until they are stabilized. Once stabilized, authorization will be required from Cigna for Augusta Health to continue providing a patient with care in-network. However, if we are unable to find a resolution with Cigna and they do go out-of-network on December 31, 2025 instead of providing authorization, Cigna may request that the patient be transferred to an in-network facility, at which time the patient can choose to be transferred or incur additional out-of-pocket costs to continue receiving care at Augusta Health as an out-of-network patient.

We are continuing to work with Cigna during this notice period to find a resolution. If we do not reach an agreement with Cigna, our current contract will expire on December 31, 2025.

To remain updated with the most recent information, please visit our website at augustahealth.com/Cigna or contact our Assistance Center for Cigna patients at 540-213-2670.

While all insurance plans are different, receiving care at an out-of-network facility will likely cost more for the patient than at an in-network facility. We encourage all Cigna patients to call the customer service number on the back of their insurance card for more details and to understand your specific benefits.

We have relationships with several of the other major health insurance networks. We will be in-network with the following health plans in 2026:

Accepted Insurances (other than Cigna):

• Aetna | Commercial, Medicare, and Medicaid
• Anthem (Blue Cross/Blue Shield) | Commercial, Medicare, and Medicaid
• Humana | Commercial and Medicare
• Meritain Molina Healthcare | Medicare and Medicaid
• Multiplan / Private Healthcare Systems (PHCS) | Commercial
• Sentara Health | Commercial, Medicare, and Medicaid
• Tricare
• United Healthcare (UHC) | Commercial, Medicare, and Medicaid
• Veterans Optum CCN (administered by UHC)
  
  

No. Cigna Medicare Supplemental plans (also known as MediGap health plans) are not impacted. You will continue to have in-network access to all Augusta providers.

Yes. We are currently negotiating with Cigna to renew all insurance products.

As of now, nothing changes for Cigna members and their access to Augusta Health. However, if we are unable to find a resolution with Cigna and they go out-of-network on December 31, 2025, your care will be considered out-of-network and will result in higher out of pocket costs for you.

We are continuing to work with Cigna during this notice period to find a resolution, but we need your help: Call Cigna at the number on the back of your insurance card and request that Augusta Health be fairly reimbursed at a rate that covers inflationary costs, telling Cigna you want a solution so that you can continue to access community-based, independent care in your insurance network.