Cigna Healthcare Medicare Advantage Transaction Frequently Asked Questions

Health Care Service Corporation (HCSC) and The Cigna Group entered into a definitive agreement whereby HCSC will acquire Cigna Healthcare’s Medicare Advantage, Supplemental Benefits, Medicare Part D, and CareAllies businesses. We expect the transaction to be completed in the first quarter of 2025, subject to customary closing conditions and required regulatory approvals.

General questions and answers

1. Are Cigna Healthcare Medicare Advantage customers’ or HCSC Medicare members’ plan benefits changing in 2025?
   • No. Members’ and customers’ plan benefits selected during the annual enrollment period for 2025 will not change in 2025.
2. Since the annual enrollment period for 2025 will occur before the transaction is finalized, what happens to customers or members who purchase Cigna Healthcare or HCSC Medicare Advantage plans during 2025 annual enrollment?
   • Cigna Healthcare’s Medicare Advantage businesses and HCSC remain separate companies until the transaction is finalized. Since the transaction is expected to close in 2025, each company will operate independently and sell their respective products through the annual enrollment period from Oct. 15 through Dec. 7, 2024. People who purchase Cigna Healthcare or HCSC plans during open enrollment will remain enrolled in and covered by the Cigna Healthcare Medicare Advantage or HCSC plan they selected for the duration of the 2025 plan year.
3. Although plan benefits remain the same, will anything else change for 2025?
   • Both companies regularly update their business processes and technology throughout the year. If these types of regular operational updates take place, we will keep you informed of any changes impacting you or your business. For Cigna Healthcare Medicare Advantage updates, see the provider newsroom.  
4. What will happen in 2026?
   • We will keep you posted on any changes impacting the 2026 plan year. For Cigna Healthcare Medicare Advantage updates, see the Cigna Healthcare Medicare Advantage provider newsroom.

Information Sources

1. Where do I go for information about caring for these customers and members?
   • For Cigna Healthcare Medicare Advantage customers, go to the Cigna Healthcare Medicare Advantage provider website. For Cigna Healthcare Medicare Advantage updates, see the provider newsroom.
2. What if I have questions about a member’s or customer’s care?
   • If you have questions, please call the number on the member’s or customer’s ID card.
3. Whom do I call for help?
   • Provider network contacts for Cigna Healthcare Medicare Advantage and HCSC will remain the same for 2025. For Cigna Healthcare Medicare Advantage, contact your aligned provider relations representative or Cigna Healthcare Medicare Advantage Provider Customer Service at 800.230.6138. We will provide information about 2026 at the appropriate time.

Behavioral Health

1. I’m a behavioral health provider contracted with Evernorth Behavioral Health and provide care to Cigna Healthcare Medicare Advantage customers. Will my network or processes change as a result of this transaction?
   • No. You will remain in the Evernorth network. Follow your normal processes for caring for Cigna Healthcare Medicare Advantage customers.

Processes

1. How do I know which processes to follow for Cigna Healthcare Medicare Advantage customers and HCSC members?
   • When providing services to Cigna Healthcare Medicare Advantage customers and HCSC members:
     • Ask to see the customer or member ID card before all appointments
     • Check eligibility and benefits before all appointments
     • Follow utilization management review requirements and guidelines
     • Follow the billing instructions on the customer or member ID card
2. Since HCSC Medicare business and Cigna Healthcare’s Medicare Advantage businesses will be joining together in early 2025, which medical policies, prior authorization and billing processes do I follow?
   • Following finalization of this transaction, you should not expect any changes to processes related to medical policies, prior authorization or billing as a result of the transaction. For Cigna Healthcare Medicare Advantage customers, follow Cigna Healthcare Medicare Advantage processes for providing and billing for care. For HCSC members, follow HCSC processes for providing and billing for care.
3. Which provider manuals should I follow?
   • Follow Cigna Healthcare Medicare Advantage provider manuals for Cigna Healthcare Medicare Advantage customers, and follow HCSC provider manuals for HCSC members throughout 2025.
4. Where do I submit claims?
   • Follow Cigna Healthcare Medicare Advantage claims submission processes for Cigna Healthcare Medicare Advantage customers, and HCSC claims submission processes for HCSC members throughout 2025. We will provide you with information for 2026 at the appropriate time.
5. Cigna Healthcare Medicare Advantage has a provider portal and HCSC uses Availity® Essentials. Will I need to get an Availity account?
   • Use the current Cigna Healthcare Medicare Advantage provider portal when caring for Cigna Healthcare Medicare Advantage customers, and use Availity Essentials when caring for HCSC members. We will provide you with information for 2026 at the appropriate time. 

Payments

1. Where will my payments come from, HCSC or Cigna Healthcare Medicare Advantage?
   • You will continue to bill and receive payments from each respective company as you do today.
2. In 2025, will I be paid HCSC rates or Cigna Healthcare Medicare Advantage rates?
   • When caring for Cigna Healthcare Medicare Advantage customers, you will receive Cigna Healthcare Medicare Advantage contracted rates if you are in that network. When caring for an HCSC member, you will receive HCSC contracted rates if you are in the member’s network.

Contracting

1. I’m contracted with both Cigna Healthcare Medicare Advantage and HCSC. What do I do?
   • When caring for Cigna Healthcare Medicare Advantage customers, follow Cigna Healthcare Medicare Advantage processes. When caring for HCSC members, follow HCSC processes.
2. I’m contracted with Cigna Healthcare Medicare Advantage but not HCSC. What do I do?
   • For 2025, follow your normal processes for caring for Cigna Healthcare Medicare Advantage customers. We will provide information about 2026 at the appropriate time.
3. I’m contracted with HCSC but not Cigna Healthcare Medicare Advantage. What do I do?
   • For 2025, follow your normal processes for caring for HCSC members. We will provide information about 2026 at the appropriate time.

Credentialing

1. My credentialing is due for renewal in 2025. How do I get recredentialed?
   • For 2025, follow the Cigna Healthcare Medicare Advantage or HCSC credentialing process as applicable. We will provide information about 2026 at the appropriate time.