Bowdoin College Open Access Health Plan
The Bowdoin College Open Access Plus Health Plan is provided through Cigna using their “Open Access Plus, OA plus, Choice Fund OA Plus” network. The OAP health plan covers many medical expenses such as doctor visits, lab tests, medications, medical treatments and mental health benefits.
The plan has different co-pays for in-network primary care office visits (your personal or family doctor) or specialist office visits and for other doctors that are in-network. For in-network primary care office visits, the co-pay is only $20 and for in-network office visits to a specialist it is $50 per visit. You do not need to pay a deductible or coinsurance on regular In-Network office visits (such as going to your primary care doctor when you are sick).
Out-of-Network office visits and services are paid at 60% after the deductible and coverage is subject to the maximum allowances for the plan.
Preventive Care Services
Preventive care services are offered at no cost. Routine physicals, mammograms, Pap smears, and colonoscopies are covered at 100% when they are done as part of a recommended screening schedule. The recommended screenings and immunizations can change depending on your gender, age, and family health history.
Provisions of Health Care Reform provide enhancements to women’s preventive services covered at 100% including: Well Women exams, prescription contraceptives (generics and brand name drugs with no generic equivalent), sterilization procedures and patient education/counseling for women, breastfeeding support, supplies and counseling, etc. Services must be obtained from an in-network provider for 100% coverage.
Be sure to ask your doctor if any preventive screenings are recommended for you.
Laboratory Tests and X-rays
Lab tests and x-rays are subject to your deductible and coinsurance.
Bowdoin College has a tiered drug plan, which means your co-pay will depend on the type of drug your doctor prescribes.
The Bowdoin College Open Access Plus Health Plan includes coverage for:
- Primary Care Physician Office Visits
- Specialty Physician Office Visits
- Preventive Care (such as routine physicals, health screenings and well child visits)
- Hospital Visits
- Mental Health
- Routine Eye Exams (limited – see the EyeMed Vision Plan for more robust coverage)
- Medical Tests (such as X-ray and lab services)
- Prescription Medications
- Tier 1 - $10 copay for a 30-day supply (includes generic drugs and some brand name medications used to manage chronic health conditions)
- Tier 2 - $40 copay for a 30-day supply (includes brand name drugs without a generic equivalent)
- Tier 3 - $70 copay for a 30-day supply (may include more costly medications or medications very recently approved by the Food and Drug Administration)
You do not need to meet your deductible for prescriptions – only the co-pay applies. Some prescription medicines may require step therapy or prior authorization to make sure they are appropriate, safe, and affordable for you and are covered by our plan. Your doctor will work with Cigna to obtain these authorizations.
TIP: If you are taking a drug that you can buy through Cigna’s Mail Order Pharmacy Program, you can save money and Bowdoin saves money. Select retail pharmacies also honor the mail order 90-day supply discount as well. A 90-day supply of a Tier 1 drug is $20, Tier 2 is $100 and Tier 3 is $175. Specialty medications must be filled through Accredo, Cigna’s specialty home delivery pharmacy.