Out-of-Network Reimbursement Methodology

2024 Plan Information

Reimbursement Methodology

Morgan Stanley’s medical plan administered by Cigna and UnitedHealthcare allows enrolled employees and covered dependents to use out-of-network providers for covered services under the plan. Effective January 1, 2024, the allowed amount for the reimbursement of non-network claims, also known as “eligible expenses” for out-of-network services, will be based on 300% of the Medicare rates published by the Centers for Medicare & Medicaid Services (CMS), instead of the current methodology of 90th percentile of “reasonable and customary” charges.  That means when you choose an out-of-network provider, you will be reimbursed at rates based on those that Medicare pays. Consider using an in-network provider to avoid higher out-of-pocket costs.

For additional information about this change, refer to the following questions and answers.


What types of services are affected by this change?

What does this change mean to me if I choose to see an out-of-network provider?

How can I make sure that a provider is in-network with Cigna or UnitedHealthcare?

What does this change mean to me if I always see providers who are in-network with Cigna or UnitedHealthcare?

What does it mean that a provider can balance bill me for services?

How will I know if the provider will balance bill me for a visit or service?

What is an example of costs when using an out-of-network provider instead of an in-network provider?

I need a specialist and there are not any network providers in my area. What should I do?

Can I appeal a bill from an out-of-network provider?

Does this change have any impact on when a bill from a non-network provider is considered a surprise bill?

Help Finding an In-Network Provider or Facility

As a reminder, for help finding an in-network provider or facility, log on to myCigna.com or myUHC.com, or call the number on the back of your medical plan ID card. Additionally, you may contact an Accolade Health Assistant  who can help you find in-network providers and facilities, answer your benefits questions, help you navigate the health care system and connect you with Morgan Stanley resources. Type accolade/ in a Firm browser, visit member.accolade.com when not on a Firm network or call 866-386-0076.