A non-government entity
Cigna Alliance Medicare (HMO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Cigna Alliance Medicare (HMO). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Cigna Alliance Medicare (HMO) in 2025, please refer to our full plan details page.
Cigna Alliance Medicare (HMO) is a HMO plan offered by The Cigna Group available for enrollment in 2025 to people living in Central Arizona. This plan received an overall rating of 4 out of 5 stars in 2025.
It's important to know that Cigna Alliance Medicare (HMO) is a Medicare Advantage (MA) Plan with drug coverage. That means that this plan covers both medical services and prescription drugs.
Key Plan Facts
Below are a few key facts and commonly-asked questions about Cigna Alliance Medicare (HMO).
Plan Costs:
The cost of a Medicare Advantage Plan is made up of four main parts.
- First, the monthly premium — the amount you pay every month.
- Second, the deductible — the amount you pay out of pocket for covered services before the plan starts paying.
- Third, the copayments and coinsurance — the amounts you pay out of pocket for covered services, usually after meeting the deductible (if applicable). Copays are fixed dollar amounts; coinsurance is a percentage of the cost.
- Fourth, the Out-of-Pocket Maximum — the maximum amount you could have to pay out of pocket in a year. This may be different for in-network and out-of-network services.
For Cigna Alliance Medicare (HMO), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $0.00. This is the amount you must pay every month. Additionally, this plan comes with a Part B Premium reduction of $5.00. You must continue to pay paying your reduced Part B Premium.
Deductibles
This plan does not have a health deductible. Your insurance coverage on covered health services will start immediately.
This plan has no drug deductible. Your prescription medication coverage will start immediately.
Out-of-Pocket Maximums
This plan has a Maximum Out-Of-Pocket cost of $2300.00 for out-of-network services. You will pay copays, coinsurance, and deductibles toward this amount. Once your total out-of-pocket costs reach $0.00 for in-network covered services, the plan will pay 100% of in-network covered costs for the rest of the year.
You can see below for the coinsurance and specific copayments for in the Additional Benefits section below, or refer to our Plan Details page for more details.
Common Services:
Doctor Visits:
Specialist Visits:
Emergency Room:
Urgent Care:
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Drug Coverage
The Cigna Alliance Medicare (HMO) plan has a $0 deductible for prescription drugs. In the initial coverage phase, you'll pay a copay for your prescriptions depending on the drug tier and pharmacy used. For example, preferred generic drugs have a $5 copay at preferred pharmacies, and $20 at standard pharmacies. Once your total drug costs reach $2,000, you enter the catastrophic coverage phase where you pay nothing for covered drugs.
Additional Benefits
The Cigna Alliance Medicare (HMO) plan offers a range of benefits, including coverage for inpatient hospital stays with a copay, and outpatient services. It also covers emergency services, primary care, preventive services, and vision services. The plan also provides coverage for hearing exams and hearing aids, dental services, and home health services with no copay. Additionally, the plan includes coverage for ambulance services, diagnostic and radiological services, and skilled nursing facility services.
Inpatient Hospital See details
Inpatient Hospital services are covered. For Inpatient Hospital-Acute, you will pay a $150 copay for days 1-7, and no copay for days 8-90; additional days are covered with no copay. Inpatient Hospital Psychiatric has a $150 copay for days 1-7, and no copay for days 8-90, but additional days are not covered.
Outpatient Services See details
Outpatient services include outpatient hospital services with a copay between $0 and $150, observation services with a $100 copay, ambulatory surgical center services with no copay, outpatient substance abuse services with $5 copays for both individual and group sessions, and outpatient blood services.
Partial Hospitalization See details
Partial Hospitalization is covered by Cigna Alliance Medicare (HMO) with a $130 copay, and requires prior authorization.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered, including ground and air ambulance services, as well as transportation services to plan-approved health-related locations. Ground ambulance services have a $200 copay, while air ambulance services have a 20% coinsurance. Transportation services to any health-related location are not covered.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered. For Emergency Services and Worldwide Emergency Coverage, the copay is $140, and for Urgently Needed Services, the copay is $10; there is no coinsurance for any of these services.
Primary Care See details
The Cigna Alliance Medicare (HMO) plan covers primary care physician services, chiropractic services with a $20 copay, occupational therapy services with a $5 copay, physician specialist services with a $5 copay, podiatry services with a $5 copay, physical therapy and speech-language pathology services with a $5 copay, and opioid treatment program services with a $5 copay. Mental health and psychiatric services are not covered, and individual and group sessions are not covered. Additional telehealth benefits are covered with a copay between $0 and $5.
Preventive Services See details
Preventive services include coverage for Medicare-covered services with no copay, annual physical exams, health education, kidney disease education services, and other preventive services. Additional services like In-Home Support Services, Support for Caregivers of Enrollees, and Fitness Benefits are also covered. However, services such as In-Home Safety Assessment, Personal Emergency Response System, Medical Nutrition Therapy, and several others are not covered.
Hearing Services See details
Hearing exams and prescription hearing aids are covered benefits under the Cigna Alliance Medicare (HMO) plan. Routine hearing exams have a $5 copay, and prescription hearing aids have a copay between $399 and $1800; however, prescription hearing aids for the inner, outer, and over the ear are not covered.
Vision Services See details
Vision services include eye exams with a copay of $0-$5, and eyewear with a combined maximum benefit of $500 per year. Contact lenses, eyeglasses (lenses and frames), eyeglass lenses, eyeglass frames, and upgrades are also covered.
Dental Services See details
Dental Services are covered, with a maximum plan benefit of $3,000 every year. Medicare Dental Services have a $5 copay, and other services include oral exams, dental x-rays, and more.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered and require prior authorization. Medicare Part B Insulin Drugs have a $35 copay and a coinsurance between 0% and 20%, while Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs have a coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered by the Cigna Alliance Medicare (HMO) plan, but require prior authorization. You will pay 20% coinsurance for these services.
Medical Equipment See details
Medical Equipment is covered by Cigna Alliance Medicare (HMO), including Durable Medical Equipment (DME) with a 20% coinsurance and Prosthetic Devices and Medical Supplies with a 20% coinsurance. Durable Medical Equipment for use outside the home, Diabetic Supplies, and Diabetic Therapeutic Shoes/Inserts are not covered.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered by the Cigna Alliance Medicare (HMO) plan. Lab services have no copay, while Diagnostic Radiological Services have a copay of up to $150, and Outpatient X-Ray Services have a $10 copay. Therapeutic Radiological Services have a coinsurance of at least 20%.
Home Health Services See details
Home Health Services are covered by the Cigna Alliance Medicare (HMO) plan with no copay and no coinsurance, but additional hours of care and personal care services are not covered. This benefit requires authorization.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered by the Cigna Alliance Medicare (HMO) plan. This includes Medicare-covered Intensive Cardiac Rehabilitation Services, Medicare-covered Pulmonary Rehabilitation Services, Medicare-covered Supervised Exercise Therapy (SET) for Symptomatic Peripheral Artery Disease (PAD) Services, and Additional Cardiac Rehabilitation Services.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the Cigna Alliance Medicare (HMO) plan, but require prior authorization. For days 1-20, there is no copay, while days 21-100 have a $214 copay. Additional days beyond Medicare-covered for SNF and non-Medicare-covered stays for SNF are not covered.
Other Services See details
Other Services include Over-the-Counter (OTC) Items, with a maximum benefit of $125 every three months, and Meal Benefit. Acupuncture, Dual Eligible SNPs with Highly Integrated Services, Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services, Private Duty Nursing Services, Case Management (Long Term Care), Institution for Mental Disease Services for Individuals 65 or Older, Services in an Intermediate Care Facility for Individuals with Intellectual Disabilities, Case Management, Tobacco Cessation Counseling for Pregnant Women, Freestanding Birth Center Services, Respiratory Care Services, Family Planning Services, Nursing Home Services, Home and Community Based Services, Personal Care Services, and Self-Directed Personal Assistance Services are not covered.
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