When it comes to health insurance, Cigna and CareFirst are two big names that often come up. Both companies offer a range of health insurance plans and services to individuals, families, and employers across the United States.
However, there are some key differences between Cigna and CareFirst worth considering when choosing a health insurance provider.
This article will compare and contrast Cigna and CareFirst on a variety of factors to help you determine which may be a better fit for your needs and budget.
A Brief Comparison Table
| Category | Cigna | CareFirst |
| Coverage Area | National | Mid-Atlantic region |
| Plan Types Offered | PPO, HMO, POS, EPO, Medicare Advantage | HMO, PPO, POS, Medicare Advantage |
| Provider Network Size | Over 1.5 million providers | Nearly 44,000 providers |
| Average Claims Processing Time | 30 days | 15-20 days |
| Customer Service Reputation | Positive overall but long hold times | Shorter hold times, highly rated portal |
| Wellness Programs | Cigna Plus with MotivateCare® incentives | Preventative care incentives |
| Prescription Coverage | Home delivery pharmacy service | Drug price comparison tool |
| Financial Strength Ratings | A Excellent from A.M. Best, AA- Very Strong from S&P | A- Excellent from Weiss, A Excellent from A.M. Best |
Overview of Cigna
Cigna is a large national health insurance company offering employer-sponsored and individual health plans in all 50 states. Some key facts about Cigna:
- Offers HMO, PPO, POS, and EPO plans as well as Medicare Advantage plans
- Covers over 16 million medical customers and has over 1.5 million dental customers
- Has an expansive nationwide network with over 1.5 million healthcare providers and facilities
- Offers telehealth services through MDLive
- Has strong financial ratings from independent agencies
Cigna’s plans are known for their low out-of-pocket costs, affordable premiums, and extensive provider networks. A unique offering is Cigna Plus with MotivateCare® which provides adult customers with incentives for healthy behaviors.
Overview of CareFirst
CareFirst is a not-for-profit health insurance company that offers plans in Maryland, Washington D.C., Northern Virginia, and parts of North Carolina. Some background on CareFirst:
- Offers HMO, PPO, and POS plans for individuals and employers
- Covers over 3.4 million members in its service areas
- Has a robust regional network with nearly 44,000 providers and five hospital systems
- Owns CareFirst Video Visit for telehealth services
- Has excellent financial strength ratings
CareFirst is known for its focus on patient-centric care and investments in the local community. They offer HMO plans through Kaiser Permanente in Maryland and Washington D.C. for access to that network. Their plans emphasize preventative care and wellness programs.
Also Read: Is Horizon Better Than UnitedHealthcare?
Key Differences Between Cigna And CareFirst
Now that we have cover the basics about them. Let’s compare them across key categories:
1. Plan Networks
One of the biggest factors in choosing a health insurance provider is their network of healthcare providers.
Cigna offers an expansive nationwide network. This gives you in-network access to care when travelling across the country. Cigna has a network of over 1.5 million providers and 6,000 hospitals. With their broad PPO networks, referrals are not required to see specialists.
CareFirst’s provider network is focused in the Mid-Atlantic region covering Maryland, Washington D.C., Virginia, and North Carolina. They have nearly 44,000 local providers and five major hospital systems in their network. This regional concentration can be beneficial if you don’t need regular nationwide coverage.
For convenience, both Cigna and CareFirst offer virtual telehealth services so you can access care 24/7 without leaving home. Cigna uses MDLive while CareFirst has its own CareFirst Video Visit platform.
2. Plan Options
Both Cigna and CareFirst offer a range of health insurance plans and types to choose from.
Cigna offers PPO, HMO, POS, and EPO plans. They also offer Medicare Advantage plans. Plan options include:
- Cigna Connect – Off-exchange individual and family plans
- Cigna Connect + Medicare – Individual Medigap plans
- Cigna LocalPlus – Small business health plans
- Cigna Health and Life – Large employer group health plans
- Cigna Medicare Advantage – Medicare plans with extra benefits
CareFirst offers HMO, PPO, and POS plans. They also partner with Kaiser Permanente for HMO options. Some of their plan choices include:
- CareFirst BlueChoice – PPO plans with in- and out-of-network coverage
- CareFirst BlueCross BlueShield – Comprehensive major medical coverage
- CareFirst BluePreferred – PPO plans with cost savings for in-network care
- CareFirst Direct – Basic, no-frills health plans
- Kaiser Permanente – HMO plans through CareFirst
So in terms of plan variety, Cigna offers more national insurance options while CareFirst focuses on regional choices.
3. Costs and Benefits
When comparing the costs and coverage of Cigna and CareFirst, some important factors stand out.
Cigna is recognized for its low out-of-pocket costs on medical services. Their plans have modest deductibles and competitive premiums. With their high number of in-network providers, you’re more likely to minimize your out-of-network costs as well.
CareFirst also offers plans with copays for doctor visits instead of coinsurance rates that apply after you meet your deductible. This can keep your costs more manageable. Monthly premiums are competitively priced.
Both insurers cover all of the essential health benefits required under the Affordable Care Act. This includes emergency services, hospitalization, preventive care, prescription drugs, pediatric services, and more. CareFirst emphasizes member wellness programs and preventative care incentives.
For drug coverage, Cigna and CareFirst both use a formulary system. Cigna offers a home delivery pharmacy service for convenience and savings. CareFirst members can compare prescription prices at different pharmacies through their website.
Overall the costs and benefits offered by each company are comparable. Focus on choosing a plan tier that fits your expected medical usage and budget. Compare out-of-pocket estimates for your care needs.
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4. Customer Satisfaction
In terms of customer service and satisfaction, both Cigna and CareFirst receive positive reviews with a few differences.
Cigna gets high marks for customer service, claims processing, and their online resources. Their website and apps make it easy to find providers, manage your benefits, and view claims. However wait times to speak to a representative can be longer than ideal.
CareFirst also gets praise for helpful customer service and online self-service options. Their website has been recognized for its transparency in cost estimates and care quality information. Policyholders report shorter call center hold times compared to some national insurers.
For claims processing, Cigna takes an average of 30 days while CareFirst claims are generally processed within 15-20 days. Both companies offer online claims submission for convenience.
5. Financial Strength
With any health insurance provider, you want to ensure they have strong financial footing to pay out current and future claims.
Cigna has an “A” Excellent rating from A.M. Best and AA- Very Strong rating from S&P Global. CareFirst holds an A- Excellent rating from Weiss Ratings and A Excellent rating from A.M. Best.
Both companies have maintained steady financial strength over decades in business, with ample reserves and assets to cover policy costs. This gives added peace of mind that your benefits will be covered.
Also Read: Comparison Between Quotacy And Policygenius
Frequently Asked Questions (FAQs)
Below are answers to some common questions about Cigna and CareFirst to help give further insight.
Cigna processes claims within approximately 30 days on average. Claims can be submitted online or through the mobile app for faster processing. Cigna will send you an Explanation of Benefits detailing if the claim was approved and when payment was sent.
Cigna’s strategy focuses on whole person health. They aim to go beyond traditional insurance to fully understand the unique needs of each customer. Key strategic priorities include expanding into new geographic markets, enhancing their wellness and digital capabilities, growing their Medicare Advantage business, and improving affordability.
No, CareFirst operates in Maryland, Washington D.C., Northern Virginia, and parts of North Carolina. However, their provider networks are strongest within the Maryland and D.C. regions. They are the largest health insurer serving the Baltimore and D.C. Metro areas.
No, CareFirst does not offer Medicaid plans. They offer private individual and employer-sponsored health insurance. Some of their plans can supplement government-sponsored coverage like Medicare Advantage options. But CareFirst itself is not a Medicaid insurer.
Also Read: Differences Between Amerigroup And UnitedHealthcare.
Final Takeaway
When choosing between Cigna and CareFirst, first consider if you need broader nationwide coverage or concentrated regional networks.
Those who frequently travel long distances across the country may prefer Cigna’s expansive national networks. If you mainly stick to the Mid-Atlantic region, CareFirst can provide robust coverage options at competitive rates.
Compare specific plan benefits like deductibles, copays, coinsurance, prescription coverage, total out-of-pocket maximums, and premiums. Look at how costs for your expected healthcare services may differ between insurers.
Factor in also extras like wellness programs, chronic disease management, telehealth services, and healthcare advocacy assistance. Weigh the strengths and weaknesses of each company in terms of customer service, claims handling, and online experience based on reviews and personal priorities.
Consider if you need access to top national providers like Mayo Clinic or prefer local community hospitals and health systems. You can look at quality ratings for network providers through independent organizations like J.D. Power and NCQA.
Make sure to evaluate the financial standing and long-term stability of the insurer to minimize risk. Both Cigna and CareFirst score well in this area.
There’s no one-size-fits all answer to Cigna or CareFirst. Taking a close look at your specific location, healthcare needs, budget, and preferences makes choosing much easier. Consider getting quotes from both, and leverage any offered plan preview periods to experience each one first-hand.