A non-government entity
Cigna Preferred Medicare (HMO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Cigna Preferred 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 Medicare (HMO) in 2025, please refer to our full plan details page.
Cigna Preferred Medicare (HMO) is a HMO plan offered by The Cigna Group available for enrollment in 2025 to people living in Colorado Springs. This plan received an overall rating of 2.5 out of 5 stars in 2025.
It's important to know that Cigna Preferred 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 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 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 $4100.00 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 Medicare (HMO) plan has a $0 deductible for prescription drugs. In the initial coverage phase, you'll pay a copay for your prescriptions. For example, preferred generic drugs have a $4 copay at preferred pharmacies and a $15 copay at standard pharmacies. Once your total drug costs reach $2,000, you enter the catastrophic coverage phase, where you pay nothing for Part D covered drugs. However, you may still pay a share of the costs for excluded drugs covered under any enhanced benefit.
Additional Benefits
The Cigna Preferred Medicare (HMO) plan offers coverage for a variety of services with varying costs. Inpatient hospital stays have a $190 copay for days 1-5, and no copay for days 6-90. Outpatient services have copays ranging from $0 to $240, and emergency services have a $140 copay. This plan also covers primary care, preventive, hearing, vision, and dental services with copays ranging from $0-$30. Additionally, the plan provides coverage for ambulance, home infusion, dialysis, medical equipment, diagnostic and radiological services, and home health services. Other benefits include coverage for acupuncture and over-the-counter items.
Inpatient Hospital See details
Inpatient Hospital services, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric, are covered with a copay of $190 for days 1-5 and no copay for days 6-90. Additional days for Inpatient Hospital-Acute are covered, but Non-Medicare-covered Stay and Upgrades for Inpatient Hospital-Acute, as well as Additional Days and Non-Medicare-covered Stay for Inpatient Hospital Psychiatric, are not covered.
Outpatient Services See details
Outpatient Services include coverage for all outpatient hospital services, observation services, ambulatory surgical center (ASC) services, outpatient substance abuse services, and outpatient blood services. Outpatient Hospital Services have a copay between $0 and $240, Observation Services have a $240 copay, Ambulatory Surgical Center (ASC) Services have no copay, and Individual and Group Sessions for Outpatient Substance Abuse each have a copay of $30.
Partial Hospitalization See details
Partial Hospitalization is covered under the Cigna Preferred Medicare (HMO) plan, but requires prior authorization. You will have a $130 copay for this service.
Ambulance and Transportation Services See details
Ambulance and transportation services are covered by the Cigna Preferred Medicare (HMO) plan. Ground ambulance services have a $195 copay, while air ambulance services have a 20% coinsurance. Transportation services to plan-approved health-related locations are covered for up to 20 one-way trips per year.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered under the Cigna Preferred Medicare (HMO) plan. Emergency Services and Worldwide Emergency Coverage have a $140 copay, while Urgently Needed Services has a $30 copay; all services have no coinsurance.
Primary Care See details
The Cigna Preferred Medicare (HMO) plan covers primary care physician services, chiropractic services with a $20 copay, occupational therapy services with a $30 copay, physician specialist services with a $30 copay, other health care professional services with a $0-$30 copay, physical therapy and speech-language pathology services with a $30 copay, additional telehealth benefits with a $0-$30 copay, and opioid treatment program services with a $30 copay. Routine chiropractic care, individual and group sessions for mental health specialty services, individual and group sessions for psychiatric services, and podiatry services are not covered.
Preventive Services See details
The Cigna Preferred Medicare (HMO) plan covers preventive services, including annual physical exams, health education, support for caregivers, and fitness benefits. However, in-home safety assessments, personal emergency response systems, medical nutrition therapy, and several other services are not covered.
Hearing Services See details
Hearing services with Cigna Preferred Medicare (HMO) include hearing exams with a $25 copay, and prescription hearing aids with a copay between $399 and $1800 depending on the type of hearing aid. Routine hearing exams, and fitting/evaluation for hearing aids are covered, but inner ear, outer ear, and over the ear hearing aids are not covered.
Vision Services See details
Vision services include routine eye exams with a copay of $0-$30, and eyewear benefits with a maximum plan benefit coverage of $350 every year, including contact lenses, eyeglasses (lenses and frames), eyeglass lenses, and eyeglass frames.
Dental Services See details
Dental Services are covered, with a $30 copay for Medicare dental services. Other dental services include oral exams (4 visits per year), dental x-rays (limited to 1 complete series or panoramic x-rays every three years and 4 bitewing x-rays per year), other diagnostic dental services, prophylaxis (cleaning) (2 visits per year), fluoride treatment (2 visits per year), other preventive dental services, restorative services with a copay between $0 and $550, adjunctive general services with a copay between $0 and $285, endodontics with a copay between $0 and $675, periodontics with a copay between $0 and $595, prosthodontics (removable) with a copay between $25 and $615, prosthodontics (fixed) with a copay between $50 and $525, and oral and maxillofacial surgery. Maxillofacial prosthetics, implant services, and orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered by the Cigna Preferred Medicare (HMO) plan, and prior authorization is required. The plan has a $35 copay for Medicare Part B Insulin Drugs, and coinsurance between 0% and 20% for all other Medicare Part B drugs.
Dialysis Services See details
Dialysis Services are covered by Cigna Preferred Medicare (HMO), but require prior authorization. You will pay 20% coinsurance.
Medical Equipment See details
Medical equipment benefits are covered by the Cigna Preferred Medicare (HMO) plan, with no copay. Durable Medical Equipment (DME) has a 20% coinsurance, while Durable Medical Equipment for use outside the home is not covered. Prosthetics and Medical Supplies have a 20% coinsurance, and Diabetic Therapeutic Shoes/Inserts have a 20% coinsurance. Diabetic Supplies are not covered.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered, including diagnostic procedures and tests with a copay between $0 and $25, and lab services with no copay. Radiological Services are also covered, with copays up to $195 for diagnostic services, a 20% coinsurance for therapeutic services, and a $10 copay for outpatient X-ray services.
Home Health Services See details
Home Health Services are covered by the Cigna Preferred 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 not covered by the Cigna Preferred Medicare (HMO) plan. Prior authorization is required for these services.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by Cigna Preferred Medicare (HMO), but require prior authorization. For days 1-20, the copay is $20 per day, and for days 21-100, the copay is $214 per day.
Other Services See details
The Cigna Preferred Medicare (HMO) plan covers acupuncture with a maximum benefit coverage amount of $300 per year, and over-the-counter (OTC) items with a maximum benefit coverage amount of $105 every three months. The plan also offers a meal benefit for chronic illnesses or medical conditions that require the enrollee to remain at home for a period of time. However, Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services, Private Duty Nursing Services, Case Management (Long Term Care), and several other services are not covered.
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