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Cigna TotalCare (HMO D-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Cigna TotalCare (HMO D-SNP). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Cigna TotalCare (HMO D-SNP) in 2025, please refer to our full plan details page.
Cigna TotalCare (HMO D-SNP) is a HMO D-SNP plan offered by The Cigna Group available for enrollment in 2025 to people living in Colorado. This plan received an overall rating of 2.5 out of 5 stars in 2025.
It's important to know that Cigna TotalCare (HMO D-SNP) is a Medicare Advantage (MA) Plan with drug coverage. That means that this plan covers both medical services and prescription drugs.
Important:
Cigna TotalCare (HMO D-SNP)is a Special Needs Type (SNP) plan. This means you can only enroll in this plan if you meet specific criteria. See our full plan details page for more information.
Key Plan Facts
Below are a few key facts and commonly-asked questions about Cigna TotalCare (HMO D-SNP).
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 TotalCare (HMO D-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $27.80. 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 a $590.00 drug deductible. You will need to pay this amount towards covered prescriptions before your insurance coverage for prescription medications kicks in.
Out-of-Pocket Maximums
This plan has a Maximum Out-Of-Pocket cost of $3800.00 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 TotalCare (HMO D-SNP) plan has a $590 deductible for prescription drugs. After the deductible, you will pay the costs for drugs in each tier until your total drug costs reach $2000, at which point you enter the next coverage phase. If you qualify for the low-income subsidy (LIS), you will pay $27.80. Once your yearly out-of-pocket drug costs reach $2000, you pay nothing for Medicare Part D covered drugs.
Additional Benefits
The Cigna TotalCare (HMO D-SNP) plan offers a range of benefits with varying costs. Inpatient hospital stays have a copay, while outpatient services have copays that vary depending on the service. Emergency and urgent care services have copays, and ambulance services have copays or coinsurance. The plan also covers primary care, preventive, hearing, vision, dental, and home infusion services. Hearing aids and vision eyewear are covered, and there is a maximum yearly benefit for dental services. Other services include home health, medical equipment, and diagnostic services with copays or coinsurance, and over-the-counter items with a quarterly benefit.
Inpatient Hospital See details
Inpatient Hospital services, including acute and psychiatric care, are covered, but require prior authorization. For days 1-5 of inpatient hospital stays, there is a $180 copay, and for days 6-90, there is no copay. Additional days for inpatient hospital acute are covered, while non-Medicare-covered stays and upgrades for inpatient hospital acute are not covered. Non-Medicare-covered stays and additional days for inpatient hospital psychiatric are not covered.
Outpatient Services See details
Outpatient Services are covered by the Cigna TotalCare (HMO D-SNP) plan, including outpatient hospital services, observation services, ambulatory surgical center (ASC) services, and outpatient blood services. Outpatient hospital services have a copay between $0 and $190, observation services have a $190 copay, and ASC services have no copay; outpatient substance abuse services are not covered.
Partial Hospitalization See details
Partial Hospitalization is covered by the Cigna TotalCare (HMO D-SNP) plan, but requires prior authorization. The copay for this benefit is $130.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by the Cigna TotalCare (HMO D-SNP) plan. Ground ambulance services have a $205 copay, while air ambulance services have a 20% coinsurance. Transportation Services to a plan-approved health-related location are covered for up to 50 one-way trips per year, while other transportation services are not covered.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered by the Cigna TotalCare (HMO D-SNP) plan. Emergency Services and Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation each have a $140 copay, while Urgently Needed Services has a $15 copay; all have no coinsurance.
Primary Care See details
The Cigna TotalCare (HMO D-SNP) plan covers Primary Care Physician Services, Occupational Therapy Services, Physician Specialist Services, Podiatry Services, Other Health Care Professional, Physical Therapy and Speech-Language Pathology Services, Additional Telehealth Benefits, and Opioid Treatment Program Services. Chiropractic Services, Mental Health Specialty Services (Individual and Group Sessions), and Psychiatric Services (Individual and Group Sessions) require prior authorization, and Routine Chiropractic Care, Individual Sessions for Mental Health Specialty Services, and Group Sessions for Mental Health Specialty Services are not covered.
Preventive Services See details
Preventive Services are covered by the Cigna TotalCare (HMO D-SNP) plan, including Medicare-covered preventive services, annual physical exams, health education, In-Home Support Services, Support for Caregivers of Enrollees, and fitness benefits. However, In-Home Safety Assessment, Personal Emergency Response System (PERS), Medical Nutrition Therapy (MNT), Post discharge In-Home Medication Reconciliation, Re-admission Prevention, Wigs for Hair Loss Related to Chemotherapy, Weight Management Programs, Alternative Therapies, Therapeutic Massage, Adult Day Health Services, Nutritional/Dietary Benefit, Home-Based Palliative Care, Additional Sessions of Smoking and Tobacco Cessation Counseling, Enhanced Disease Management, Telemonitoring Services, Remote Access Technologies, Home and Bathroom Safety Devices and Modifications, and Counseling Services are not covered.
Hearing Services See details
Hearing services include coverage for routine hearing exams, fitting/evaluation for hearing aids, and prescription hearing aids. Routine hearing exams and fitting/evaluation for hearing aids are covered once per year. Prescription hearing aids (all types) have a copay between $399 and $1800, with a limit of 2 per year; however, prescription hearing aids for the inner ear, outer ear, and over the ear are not covered.
Vision Services See details
The Cigna TotalCare (HMO D-SNP) plan covers vision services, including routine eye exams with one visit every year, and eyewear with a combined maximum of $300 every 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 $1,500 per year. 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 are all covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered by the Cigna TotalCare (HMO D-SNP) plan. 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 TotalCare (HMO D-SNP) plan, but prior authorization is required. There is a 20% coinsurance for these services.
Medical Equipment See details
Medical equipment is covered, but Durable Medical Equipment for use outside the home and Diabetic Supplies are not covered. For Durable Medical Equipment (DME), you pay 20% coinsurance, and for Medical Supplies you pay 20% coinsurance. For Diabetic Therapeutic Shoes/Inserts you pay 20% coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered by the Cigna TotalCare (HMO D-SNP) plan. Diagnostic Procedures/Tests have a coinsurance of at most 20%, and Lab Services have no copay. Diagnostic Radiological Services have a coinsurance of at most 20%, while Therapeutic Radiological Services and Outpatient X-Ray Services are not covered.
Home Health Services See details
Home Health Services are covered by the Cigna TotalCare (HMO D-SNP) plan. There is no copay or coinsurance for this benefit, but authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered by the Cigna TotalCare (HMO D-SNP) plan. Specifically, Cardiac Rehabilitation Services, Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, and SET for PAD Services are not covered.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered under the Cigna TotalCare (HMO D-SNP) plan, with a copay of $20 for days 1-20 and $214 for days 21-100; additional days beyond Medicare-covered for SNF and non-Medicare-covered stays for SNF are not covered. Prior authorization is required.
Other Services See details
The Cigna TotalCare (HMO D-SNP) plan covers over-the-counter items with a maximum benefit of $100.00 every three months, and also includes meal benefits for chronic illnesses or medical conditions requiring the member to stay at home; however, acupuncture, Dual Eligible SNPs with Highly Integrated Services, Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services, and other services are not covered.
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