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Cigna Preferred GA Medicare (HMO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Cigna Preferred GA Medicare (HMO). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Cigna Preferred GA Medicare (HMO) in 2025, please refer to our full plan details page.
Cigna Preferred GA Medicare (HMO) is a HMO plan offered by The Cigna Group available for enrollment in 2025 to people living in Georgia. This plan received an overall rating of 4 out of 5 stars in 2025.
It's important to know that Cigna Preferred GA 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 Preferred GA 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 Preferred GA 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.
This plan does not come with a Part B Premium reduction. You must continue to pay your 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 $5500.00 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 Preferred GA Medicare (HMO) plan has a $0 deductible for prescription drugs. During the initial coverage phase, you'll pay a copay for each prescription, which varies depending on the drug tier and pharmacy. For example, preferred generic drugs have a $10 copay at preferred pharmacies. Once your total drug costs reach $2,000, you enter the catastrophic coverage phase, where you pay nothing for Part D covered drugs. If you qualify for the low-income subsidy, you may have your premium reduced.
Additional Benefits
The Cigna Preferred GA Medicare (HMO) plan offers a wide range of benefits with varying cost-sharing. You can expect a $265 copay for inpatient hospital stays for days 1-5, with no copay for days 6-90. Outpatient services have copays ranging from $0 to $375, and primary care visits have a $5 copay. This plan also includes coverage for preventive services with no copay for Medicare-covered services, as well as hearing, vision, and dental services, with specific copays and maximum benefits. Ambulance services have a $260 copay for ground transport and a 20% coinsurance for air transport. The plan also covers home health services with no copay, and skilled nursing facility stays, with a $214 copay for days 21-100.
Inpatient Hospital See details
The Cigna Preferred GA Medicare (HMO) plan covers inpatient hospital stays, with a copay of $265 for days 1-5 and no copay for days 6-90 for acute care, and a copay of $595 for days 1-3 and no copay for days 4-90 for psychiatric care. Additional days for inpatient hospital-acute are covered, while non-Medicare-covered stays and upgrades for inpatient hospital-acute, and additional days and non-Medicare-covered stays for inpatient hospital psychiatric are not covered.
Outpatient Services See details
Outpatient Services, including outpatient hospital services, observation services, and outpatient substance abuse services, are covered. Outpatient Hospital Services have a copay between $0 and $375, Observation Services have a $305 copay, and Individual and Group Sessions for Outpatient Substance Abuse have a copay of $40.
Partial Hospitalization See details
Partial Hospitalization is covered by the Cigna Preferred GA Medicare (HMO) plan with a $105 copay, and requires prior authorization.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by the Cigna Preferred GA Medicare (HMO) plan. Ground Ambulance Services have a $260 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 under the Cigna Preferred GA Medicare (HMO) plan. Emergency Services and Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation each have a $125 copay, while Urgently Needed Services have a $55 copay; all have no coinsurance.
Primary Care See details
The Cigna Preferred GA Medicare (HMO) plan covers primary care physician services with a $5 copay, chiropractic services with a $15 copay, occupational therapy services with a $40 copay, physician specialist services with a $40 copay, physical therapy and speech-language pathology services with a $40 copay, and additional telehealth benefits with a copay between $0 and $40. Mental health and psychiatric services, and routine chiropractic care are not covered.
Preventive Services See details
The Cigna Preferred GA Medicare (HMO) plan covers preventive services, including Medicare-covered services with no copay, and an annual physical exam with a $5 copay. The plan also covers Health Education and Fitness benefits, while In-Home Safety Assessment, Personal Emergency Response System (PERS), Medical Nutrition Therapy (MNT), and several other services are not covered.
Hearing Services See details
Hearing exams are covered with a $25 copay, including routine hearing exams and fitting/evaluation for hearing aids. Prescription hearing aids are partially covered, with a copay between $399 and $1800 for all types of prescription hearing aids, but not for inner ear, outer ear, or over the ear hearing aids. OTC hearing aids are not covered.
Vision Services See details
The Cigna Preferred GA Medicare (HMO) plan covers vision services, including routine eye exams with a copay between $0 and $50. Eyewear is covered with a combined maximum benefit of $250 every year, and contact lenses are covered. Additionally, the plan covers one pair of eyeglasses lenses and frames, and eyeglass frames every year.
Dental Services See details
Dental Services are covered, with a maximum plan benefit of $850 per year. Medicare Dental Services have a $40 copay, while Oral Exams, Dental X-Rays, Other Diagnostic Dental Services, Prophylaxis (Cleaning), Fluoride Treatment, Other Preventive Dental Services, Restorative Services, Adjunctive General Services, Endodontics, Periodontics, Prosthodontics (removable), Maxillofacial Prosthetics, Implant Services, Prosthodontics (fixed), Oral and Maxillofacial Surgery, and Orthodontics are all covered with no copay or coinsurance.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered and require prior authorization. For Medicare Part B Insulin Drugs, there is a $35 copay and a coinsurance between 0% and 20%. For Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs, the coinsurance is between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered by the Cigna Preferred GA Medicare (HMO) plan and require prior authorization. You will pay 20% coinsurance.
Medical Equipment See details
Medical Equipment benefits are covered, including Durable Medical Equipment (DME), Prosthetics/Medical Supplies, and Diabetic Equipment. Durable Medical Equipment (DME) has a 20% coinsurance, while Prosthetics/Medical Supplies and Diabetic Therapeutic Shoes/Inserts have a 20% coinsurance, and Diabetic Supplies are not covered.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered, including all diagnostic services, diagnostic procedures/tests, lab services, all radiological services, diagnostic radiological services, therapeutic radiological services, and outpatient X-ray services. Diagnostic procedures/tests have a copay between $0 and $225, lab services have no copay, diagnostic radiological services have a copay up to $275, therapeutic radiological services have a coinsurance of at least 20%, and outpatient X-ray services have no copay.
Home Health Services See details
Home Health Services are covered by the Cigna Preferred GA Medicare (HMO) plan with no copay and no coinsurance, but additional hours of care and personal care services are not covered. Authorization is required for this benefit.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered, but the plan does not specify the cost sharing details. However, Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, and SET for PAD Services are not covered by the plan.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by Cigna Preferred GA Medicare (HMO), but require prior authorization. For days 1-20, there is no copay, and for days 21-100, there is a $214 copay.
Other Services See details
Other Services include an Over-the-Counter (OTC) Items benefit with a $30 maximum benefit every three months, and a Meal Benefit for chronic illnesses or conditions requiring the enrollee to stay home. 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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