Your new membership card
The Cigna membership card at a glance
away from home care
Client logo
1
2
SARAH JOHNSON
4
Pers. ref. n°
5
Cigna ID n°
8
Account name
xxx/xxxxx
Account n°
xxxxxxxxx
11
xxxxxxxxx
9
xxxxxxxxxxxxxxx
12
13
+ 32 3 217 xx xx
15
6
+ 32 3 217 xx xx
[email protected]
US Health care providers
17
Electronic: Cigna PAYOR 62308
Paper: Cigna International • P.O. Box 15050
Wilmington DE 19850-5050 • USA
www.cignahealthbenefits.com
3
7
Preferred care network in the USA: Cigna HealthCare PPO
Start date
21
22
xx-xx-xxxxx (d-m-y)
SOS contract n°
xxxxxxxxx
Toll-free (US)
+ 32 3 217 xx xx
10
SOS
xxxxxxxxxxxx
14
Member coverage
RxBIN 017010 RxPCN 02160000
Issuer (80840)
20
For questions concerning cover and hospital invoices, please contact Cigna.
Card possession does not certify coverage. For inpatient services pre-authorisation is required. www.cignaenvoy.com
Toll-free (other)
Front: Contact details
for plan members
1.
Cigna logo
2.
Website address
3.Name
4.
Personal reference number
5. Cigna ID number
6.
Start date
7.
Account number
8.
Account name
9.
Contract number International SOS (optional) 10.
Telephone number International SOS (optional)
11.
Telephone number
12.
Fax number
13. US toll-free number (optional)
14.
Toll-free number (optional)
15.
Email address
16.
P.O. Box address
Europe, Africa &
+ 32 3 293 18 11
Middle East
North & South + 1 305 908 92 11
America
Asia & Pacific + 603 217 814 11
19
+ 32 3 217 xx xx
16 P.O. Box xxxxx • 2140 Antwerpen • Belgium
Toll-free 1 866 428 3935
18
non-US Health care providers
[email protected]
[email protected]
Back: Contact details for health
care providers
17.
18.
19.
20.
21.
22. Address for health care providers in the USA
US toll-free number
Details for pharmacy coverage
Legal notice and website address
Website address for health care providers
outside of the USA
Regional telephone numbers
Did you know?
Your membership card is also available online on
your personal webpages and on the mobile app.
The app is free to download
from the App StoreSM or Google PlayTM.
Search for ‘Cigna Health Benefits’.
www.cignahealthbenefits.com
Cigna International Health Services BVBA • Plantin en Moretuslei 299 •2140 Antwerpen • Belgium • RPR Antwerpen • VAT BE 0414 783 183 • FSMA 13799 A-R
Copyright 2015 Cigna Corporation • 5.90.591_EN (0715)