> The costs after you susbcribe are also insane: $420 for a 15min online chat. > > I got the same type of appointment for something around $20 directly from Cig

> The costs after you susbcribe are also insane: $420 for a 15min online chat. > > I got the same type of appointment for something around $20 directly from Cigna. And that's with a high deductible account. Cigna (and any insurer) is always going to charge you way more for services that they don't provide themselves, because their direct incentive is to encourage (or force) you to use the services that they provide directly instead of using independent in-network providers. Their profit margins are way higher on those (compared to in-network providers), and furthermore they have way more control to use those as a mechanism to gatekeep further specialized care. You can sort of think of it like a loss leader, but in reverse: providing those services "at-cost"[0] allows the insurer to save way more by using that virtual visit to deny you a referral to a specialist, or denying you a particular procedure, based on some clinical guideline that the insurer has decreed, when an in-network independent provider would have come to a different judgement. Remember that, for in-network coverage, the amount that you have to pay is a somewhat arbitrary number that is entirely decided by your insurer, and has very little (if anything) to do with how much the providers on the other end are actually making. Cigna makes you pay more for independent providers because it benefits them to charge you more for those. I'm using Cigna here because you mentioned Cigna, but to be honest, all the insurers operate like this. [0] "cost" is a fuzzy term here; I'm being figurative