September 2019

Dedicated to making insulin more affordable and accessible – Cigna’s Patient Assurance ProgramSM

For those who live with diabetes, the costs of essential medications, like insulin, shouldn’t add to their burden. That’s why Cigna will offer the Patient Assurance Program beginning in 2020. By working with pharmaceutical manufacturers for this program, we will assist customers with diabetes in participating plans to manage their costs for eligible insulin products.

The Patient Assurance Program will:

  • Help make insulin costs affordable and predictable.
  • Cap the customer’s out-of-pocket costs at no more than $25 for a 30-day supply; and no more than $75 for a 90-day supply (per prescription) any time the customer fills certain participating preferred brand insulin products through the benefit plan.1
  • Help ease the burden of individuals paying high out-of-pocket costs for insulin, particularly those with coinsurance or those who must satisfy a high deductible before their insulin is covered.

A full list of drugs eligible under the program will be announced later in 2019. It will include some insulin products on the market such as Humulin, Humalog, Novolin, Novolog, and Lantus.

Beginning in early 2020, Cigna Pharmacy clients may elect to enroll in the Patient Assurance Program upon renewal or plan start. Clients must also be upgraded to our new claims engine. Note: This program is not available to Medicare or Medicaid plans. Insured plan availability is also dependent upon state filing approvals.

The Patient Assurance Program is a blueprint for other therapeutic areas where customers may be exposed to higher out-of-pocket medication costs - which may affect adherence for some customers.2

Learn more

  1. The drug manufacturer value of this program is applied at the point of sale. Actual customer cost may be less depending upon plan design. Plans with higher copays may have to absorb additional cost to get the customer to $25, after discounts from the drug makers. Clients must have benefit designs that align to the program requirements. Health benefit plans vary, but in general to be eligible for coverage a drug must be approved by the Food and Drug Administration (FDA), prescribed by a health care professional, purchased from a licensed pharmacy and medically necessary. Out-of-network coverage may be excluded or limited by plan terms.
  2. Health IT Analytics, Cost is a Primary Driver of Medication Non-Adherence Rates, Jennifer Bresnick, 9/2017.

Patient Assurance Program is a trademark of Express Scripts Strategic Development, Inc.

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Health benefit plans vary, but in general to be eligible for coverage a drug must be approved by the Food and Drug Administration (FDA), prescribed by a health care professional, purchased from a licensed pharmacy and medically necessary. Some plans require you to use an in-network pharmacy for prescriptions to be covered. Coverage is subject to any plan deductible, copayment and/or coinsurance requirements. Product availability may vary by location and plan type and is subject to change. All group health insurance policies and health benefit plans contain exclusions and limitations. For costs and details of coverage, contact a Cigna representative. Group medical and pharmacy plans are insured and/or administered by Cigna Health and Life Insurance Company or its affiliates. Policy forms: OK - HP-APP-1 et al., OR - HP-POL38 02-13, TN - HP-POL43/HC-CER1V1 et al. All pictures are used for illustrative purposes only. This website is not intended for residents of New Mexico.

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