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Cigna TotalCare Plus (HMO D-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Cigna TotalCare Plus (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 Plus (HMO D-SNP) in 2025, please refer to our full plan details page.
Cigna TotalCare Plus (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 Plus (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 Plus (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 Plus (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 Plus (HMO D-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $9.30. 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 $9350.00 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 Plus (HMO D-SNP) plan has a $590 deductible for prescription drugs. After the deductible is met, you will pay the specified costs for each drug tier until your total drug costs reach $2000. If you qualify for the low-income subsidy (LIS), your Part D premium will be $9.30. Once your yearly out-of-pocket drug costs reach $2000, you will enter the catastrophic coverage phase and pay nothing for covered drugs.
Additional Benefits
The Cigna TotalCare Plus (HMO D-SNP) plan offers a wide range of benefits, including coverage for inpatient and outpatient services, with varying coinsurance rates. You'll find coverage for emergency services, primary care, preventive services, and home health services, often with no copay. This plan also includes coverage for hearing, vision, and dental services, with specific copays or coinsurance amounts. Additional benefits include coverage for ambulance services, partial hospitalization, and medical equipment, along with coverage for dialysis services, and diagnostic and radiological services.
Inpatient Hospital See details
Inpatient Hospital services, including acute and psychiatric care, are covered under the Cigna TotalCare Plus (HMO D-SNP) plan, but the specific copay is not detailed in this summary. Additional days, non-Medicare covered stays, and upgrades for both acute and psychiatric inpatient hospital care are not covered.
Outpatient Services See details
Outpatient services are covered by the Cigna TotalCare Plus (HMO D-SNP) plan, including all outpatient hospital services, with a coinsurance between 0% and 20%, and observation services with a 20% coinsurance. Ambulatory Surgical Center (ASC) Services are covered with a coinsurance between 0% and 20%. Outpatient substance abuse services are also covered, with individual and group sessions each having a 20% coinsurance. Outpatient blood services are covered as well.
Partial Hospitalization See details
Partial Hospitalization is covered under the Cigna TotalCare Plus (HMO D-SNP) plan, but requires prior authorization. You will have an $80 copay for this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by the Cigna TotalCare Plus (HMO D-SNP) plan, with no copay. Ground and Air Ambulance Services have a 20% coinsurance, and Transportation Services to a plan-approved health-related location are covered for up to 50 one-way trips per year. Transportation Services to any health-related location is not covered.
Emergency Services See details
Emergency Services, Urgently Needed Services, Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation are covered. Emergency Services, Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation have a $110 copay, while Urgently Needed Services have a $45 copay. All services have no coinsurance.
Primary Care See details
The Cigna TotalCare Plus (HMO D-SNP) plan covers Primary Care Physician Services, Chiropractic Services, Occupational Therapy Services, Physician Specialist Services, Podiatry Services, Other Health Care Professional, Psychiatric Services, Physical Therapy and Speech-Language Pathology Services, Additional Telehealth Benefits, and Opioid Treatment Program Services. Primary Care Physician Services, Chiropractic Services, Physician Specialist Services, Psychiatric Services, and Opioid Treatment Program Services have a 20% coinsurance, while Occupational Therapy Services, Physical Therapy and Speech-Language Pathology Services, and Other Health Care Professional also have a 20% coinsurance. Additional Telehealth Benefits have a coinsurance between 0% and 20%. 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
The Cigna TotalCare Plus (HMO D-SNP) plan covers a variety of preventive services, including annual physical exams with a 20% coinsurance, health education, In-Home Support Services, Support for Caregivers of Enrollees, and fitness benefits. However, the plan does not cover in-home safety assessments, personal emergency response systems, medical nutrition therapy, 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 benefits, 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, or counseling services.
Hearing Services See details
Hearing Services include coverage for hearing exams with a coinsurance of at most 20%, fitting/evaluation for hearing aids, and prescription hearing aids. Prescription hearing aids have a copay between $399 and $1800.
Vision Services See details
Vision services are covered, including eye exams with a coinsurance of 0% - 20%, and eyewear with a combined maximum benefit of $400 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 20% coinsurance for Medicare Dental Services, which require prior authorization. Other dental services have a maximum plan benefit of $3,000 every 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), maxillofacial prosthetics, implant services, prosthodontics (fixed), oral and maxillofacial surgery, and orthodontics are all unlimited benefits. Orthodontic services are covered under Diagnostic and Preventive Dental (16b).
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, with prior authorization required. For Medicare Part B Insulin Drugs, there is a $35 copay and a coinsurance between 0% and 20%. The plan also covers Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs, with a coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered, but require prior authorization. You will pay 20% coinsurance.
Medical Equipment See details
Medical Equipment coverage includes Durable Medical Equipment (DME) with a 20% coinsurance and Prosthetics/Medical Supplies with a 20% coinsurance, but 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 and tests with a coinsurance of up to 20%, and lab services with no copay. Diagnostic radiological services and outpatient X-ray services have a coinsurance of up to 20% and therapeutic radiological services have a coinsurance of 20%.
Home Health Services See details
Home Health Services are covered by the Cigna TotalCare Plus (HMO D-SNP) plan with no copay and no coinsurance, but additional hours of care and personal care services are not covered. Prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered, but not in practice, as Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, and SET for PAD Services are not covered. Prior authorization is required.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered, but additional days beyond Medicare-covered stays and non-Medicare-covered stays are not covered. The plan requires prior authorization, and the cost sharing is the Medicare-defined cost share for tier 1, charged per admission or per stay, including the day of discharge.
Other Services See details
Other Services includes coverage for Over-the-Counter (OTC) Items, with a maximum benefit of $300 every three months; the plan also covers meal benefits for chronic illnesses or medical conditions that require the enrollee to remain at 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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