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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 $19.00. 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 $7900.00 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 your medications, 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 your Part D covered drugs. If you qualify for the low-income subsidy (LIS), your Part D premium will be $19.00.
Additional Benefits
The Cigna Preferred GA Medicare (HMO) plan offers a variety of benefits, including inpatient and outpatient hospital services, with copays ranging from $0 to $375. The plan also covers emergency services, primary care, preventive, hearing, vision, and dental services, each with its own copay structure. Additionally, the plan provides coverage for home infusion, dialysis, medical equipment, diagnostic and radiological services, home health services, and skilled nursing facility stays. This plan has specific copays for various services, such as a $5 copay for primary care visits and a $20 copay for routine hearing exams. The plan offers a $20 benefit every three months for over-the-counter items. Some services, such as cardiac rehabilitation and additional hours of home health care, are not covered.
Inpatient Hospital See details
Inpatient Hospital benefits are covered, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric. For Inpatient Hospital-Acute, you'll pay a $275 copay for days 1-5, and no copay for days 6-90. For Inpatient Hospital Psychiatric, there is a $595 copay for days 1-3, and no copay for days 4-90. Additional Days for Inpatient Hospital-Acute are covered, but Non-Medicare-covered Stay and Upgrades for Inpatient Hospital-Acute are not covered. Additional Days and Non-Medicare-covered Stay for Inpatient Hospital Psychiatric are not covered.
Outpatient Services See details
Outpatient Services are covered, including all outpatient hospital services, with copays ranging from $0 to $375. Observation Services have a $325 copay, while Ambulatory Surgical Center (ASC) Services have no copay. Outpatient Substance Abuse Services, including individual and group sessions, have a $50 copay. Outpatient Blood Services are also covered, with a waived three-pint deductible.
Partial Hospitalization See details
Partial Hospitalization is covered by the Cigna Preferred GA Medicare (HMO) plan, but requires prior authorization. The copay for this benefit is $80.
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 $235 copay, while air ambulance services have 20% coinsurance; transportation services to plan-approved or any health-related locations are not covered.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered by the Cigna Preferred GA Medicare (HMO) plan. Emergency Services and Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation have a $110 copay, while Urgently Needed Services have a $45 copay. Worldwide Emergency Services have a maximum plan benefit coverage of $50,000.
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 $35 copay, physician specialist services with a $50 copay, physical therapy and speech-language pathology services with a $35 copay, additional telehealth services with a $0-$50 copay, and opioid treatment program services with a $50 copay. This plan does not cover routine chiropractic care, individual or group sessions for mental health specialty services, individual or group sessions for psychiatric services, or podiatry services.
Preventive Services See details
Preventive Services include coverage for annual physical exams with a $5 copay, Health Education, and Fitness Benefits. Some services are not covered, including In-Home Safety Assessment, Personal Emergency Response System (PERS), Medical Nutrition Therapy (MNT), and several others.
Hearing Services See details
Hearing Services are covered by the Cigna Preferred GA Medicare (HMO) plan, including routine hearing exams with a $20 copay, and fitting/evaluation for hearing aids. Prescription Hearing Aids (all types) are covered with a copay between $399 and $1800, while prescription hearing aids for the inner ear, outer ear, and over the ear are not covered, and 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 of $0-$50. Eyewear is covered, with a combined maximum benefit of $225 per year, and contact lenses, eyeglass lenses, and eyeglass frames are covered. Upgrades are also covered.
Dental Services See details
Dental Services are covered, including 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 and fixed), maxillofacial prosthetics, implant services, oral and maxillofacial surgery, and orthodontics. Medicare Dental Services require a $50 copay, and other dental services have a $700 maximum benefit per year.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, including Medicare Part B Insulin Drugs with a $35 copay and 0-20% coinsurance, Medicare Part B Chemotherapy/Radiation Drugs with 0-20% coinsurance, and Other Medicare Part B Drugs with 0-20% coinsurance. Prior authorization is required for this benefit.
Dialysis Services See details
Dialysis Services are covered by the Cigna Preferred GA Medicare (HMO) plan, but require prior authorization. The coinsurance for this service is 20%.
Medical Equipment See details
Medical Equipment is covered, including Durable Medical Equipment (DME) with a 20% coinsurance and Prosthetics/Medical Supplies with a 20% coinsurance, though Durable Medical Equipment for use outside the home is not covered. Diabetic Therapeutic Shoes/Inserts are covered with a 20% coinsurance, while Diabetic Supplies are not covered.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered, including Diagnostic Procedures/Tests, Lab Services, Diagnostic Radiological Services, Therapeutic Radiological Services, and Outpatient X-Ray Services. Diagnostic Procedures/Tests have a copay between $0 and $225, and Lab Services have no copay. Diagnostic Radiological Services have a copay up to $275, and Therapeutic Radiological Services have a 20% coinsurance. 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. Prior authorization is required for this benefit.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered by the Cigna Preferred GA Medicare (HMO) plan. Specifically, 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 are not covered.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the Cigna Preferred GA Medicare (HMO) plan, but require prior authorization. There is no copay for days 1-20, and a $214 copay for days 21-100. Additional days beyond Medicare-covered and non-Medicare-covered stays for SNF are not covered.
Other Services See details
The Cigna Preferred GA Medicare (HMO) plan's "Other Services" benefit covers over-the-counter items, including nicotine replacement therapy and naloxone, with a maximum benefit coverage amount of $20.00 every three months. However, 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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