A non-government entity
Cigna Preferred Plus Medicare (HMO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Cigna Preferred Plus 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 Plus Medicare (HMO) in 2025, please refer to our full plan details page.
Cigna Preferred Plus 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 Plus 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 Plus 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 Plus Medicare (HMO), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $18.00. 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 $6800.00 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:
Sign up for Cigna Preferred Plus Medicare (HMO)
Need help deciding? Talk with one of our licensed insurance specialists 1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
Drug Coverage
The Cigna Preferred Plus Medicare (HMO) plan has a $0 deductible for prescription drugs. In the initial coverage phase, you'll pay a copay for each prescription, which varies depending on the drug tier and pharmacy type. For example, preferred generic drugs have a $4 copay at preferred pharmacies. Once your total drug costs reach $2,000, you enter the catastrophic coverage phase and pay nothing for Part D covered drugs. If you qualify for the low-income subsidy, you'll pay $18.00.
Additional Benefits
The Cigna Preferred Plus Medicare (HMO) plan offers a range of benefits, including inpatient hospital stays with a copay, outpatient services with varying copays, and coverage for emergency services. Preventive services, such as annual physical exams, come with no copay, and there is also coverage for hearing, vision, and dental services. This plan provides coverage for ambulance and transportation services, with copays and coinsurance depending on the service. You'll also find coverage for home health, skilled nursing facilities, and medical equipment, often with no copay, but prior authorization may be required. Additionally, this plan provides an over-the-counter (OTC) benefit and a meal benefit for those with specific health needs.
Inpatient Hospital See details
Inpatient Hospital coverage includes Inpatient Hospital-Acute with a $290 copay for days 1-6, and no copay for days 7-90, as well as Inpatient Hospital Psychiatric with a $595 copay for days 1-3, and no copay for days 4-90. Additional days for Inpatient Hospital-Acute are covered, while Non-Medicare-covered Stay and Upgrades for Inpatient Hospital-Acute are not covered, and Additional Days and Non-Medicare-covered Stay for Inpatient Hospital Psychiatric are not covered.
Outpatient Services See details
Outpatient Services, including all outpatient hospital services, are covered by the Cigna Preferred Plus Medicare (HMO) plan. Outpatient Hospital Services have a copay between $0 and $325, and Observation Services have a copay of $325. Ambulatory Surgical Center (ASC) Services have no copay, and Outpatient Substance Abuse Services have a $25 copay for both individual and group sessions. Outpatient Blood Services are also covered.
Partial Hospitalization See details
Partial Hospitalization is covered under the Cigna Preferred Plus 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 Cigna Preferred Plus Medicare (HMO), with prior authorization required. Ground ambulance services have a $260 copay, and air ambulance services have a 20% coinsurance. Transportation services to a plan-approved health-related location are covered for up to 20 one-way trips per year, while 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 by the Cigna Preferred Plus Medicare (HMO) plan. Emergency services have a $110 copay, urgently needed services have a $45 copay, and worldwide emergency coverage, urgent coverage, and emergency transportation all have a $110 copay. Worldwide emergency services have a maximum plan benefit of $50,000.
Primary Care See details
The Cigna Preferred Plus Medicare (HMO) plan covers Primary Care Physician Services, Chiropractic Services with a $15 copay, Occupational Therapy Services with a $25 copay, Physician Specialist Services with a $25 copay, Physical Therapy and Speech-Language Pathology Services with a $25 copay, and Opioid Treatment Program Services with a $25 copay. The plan does not cover Routine Chiropractic Care, Individual Sessions for Mental Health Specialty Services, Group Sessions for Mental Health Specialty Services, Podiatry Services, Individual Sessions for Psychiatric Services, or Group Sessions for Psychiatric Services.
Preventive Services See details
Preventive Services include coverage for Medicare-covered services, Annual Physical Exams, Additional Preventive Services, Kidney Disease Education Services, and Other Preventive Services, with no copay. Additional services covered include Health Education and Fitness Benefits. However, the plan does not cover In-Home Safety Assessments, Personal Emergency Response Systems, Medical Nutrition Therapy, and several other services.
Hearing Services See details
Hearing services are covered by Cigna Preferred Plus Medicare (HMO), including hearing exams with a $25 copay. Prescription hearing aids are covered with a copay between $399 and $1800, but inner ear, outer ear, and over the ear hearing aids are not covered, and OTC hearing aids are not covered.
Vision Services See details
Vision services are covered, including eye exams with a copay of $0-$25, and eyewear. Contact lenses are covered, eyeglasses (lenses and frames), and eyeglass lenses and frames are each covered once per year. The plan covers up to $250 per year for all eyewear.
Dental Services See details
Dental Services are covered, with a $1,300 annual maximum. Medicare Dental Services have a $25 copay, while other dental services include 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.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, but require prior authorization. For Medicare Part B insulin drugs, there is a $35 copay with a coinsurance between 0% and 20%. Other Medicare Part B drugs have a coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis services are covered by the Cigna Preferred Plus Medicare (HMO) plan, but require prior authorization. You will pay 20% coinsurance for dialysis services.
Medical Equipment See details
Medical equipment is covered by the Cigna Preferred Plus Medicare (HMO) plan, but durable medical equipment for use outside the home and diabetic supplies are not covered. Prosthetic devices, medical supplies, and diabetic therapeutic shoes/inserts have a 20% coinsurance, and durable medical equipment has a 20% coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services include coverage for all diagnostic services, diagnostic procedures and tests with a copay between $0 and $95, lab services with no copay, diagnostic radiological services with a copay up to $250, therapeutic radiological services with a 20% coinsurance, and outpatient X-ray services with no copay. All services require prior authorization.
Home Health Services See details
Home Health Services are covered by the Cigna Preferred Plus 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 Plus Medicare (HMO) plan. Prior authorization is required for this benefit.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered under the Cigna Preferred Plus 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 for SNF and non-Medicare-covered stays for SNF are not covered.
Other Services See details
Other Services include coverage for Over-the-Counter (OTC) items, with a maximum benefit of $30 every three months, and a Meal Benefit for chronic illnesses or conditions requiring the member to stay at home. Acupuncture and several other services are not covered.
Get Personalized Help from a licensed insurance agent
1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
*/SMID: MULTIPLAN_HCIHNMEDADVRX25_HCI_M
MedicareAdvantageRX.com is owned and operated by Dog Media Solutions LLC.
This is a promotional communication.
Every year, Medicare evaluates plans based on a 5-star rating system.
Part B premium reduction is not available with all plans. Availability varies by carrier and location. Actual Part B premium reduction could be lower. Deductibles, copays and coinsurance may apply.
* Benefit(s) mentioned may be part of a special supplemental program for chronically ill members with one of the following conditions: Diabetes mellitus, Cardiovascular disorders, Chronic and disabling mental health conditions, Chronic lung disorders, Chronic heart failure. This is not a complete list of qualifying conditions. Having a qualifying condition alone does not mean you will receive the benefit(s). Other requirements may apply.
Enrollment in Medicare/Medicare Advantage may be limited to certain times of the year unless you qualify for a Special Enrollment Period
We do not offer every plan available in your area. Currently, we represent 18 organizations, which offer 52,101 products in your area. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all of your options.
We represent Medicare Advantage HMO, PPO and PFFS organizations and stand-alone PDP prescription drug plans that are contracted with Medicare. Enrollment depends on the plan's contract renewal.
Not all plans offer all of these benefits. Benefits may vary by carrier and location. Limitations and exclusions may apply.
Please contact Medicare.gov ,1-800-MEDICARE , or your local State Health Insurance Program (SHIP) to get information on all of your options.
Medicare has neither approved nor endorsed any information on this site.
Speak with a licensed insurance agent: 1-877-649-2073 / TTY 711 | 8am - 11pm ET | 7 days a week
© 2023 Dog Media Solutions LLC. All rights reserved