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Cigna Preferred Savings Medicare (HMO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Cigna Preferred Savings 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 Savings Medicare (HMO) in 2025, please refer to our full plan details page.
Cigna Preferred Savings Medicare (HMO) is a HMO plan offered by The Cigna Group available for enrollment in 2025 to people living in Southwest Ohio/North Kentucky. This plan received an overall rating of 2.5 out of 5 stars in 2025.
It's important to know that Cigna Preferred Savings 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 Savings 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 Savings 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. Additionally, this plan comes with a Part B Premium reduction of $95.00. You must continue to pay paying your reduced 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 $5825.00 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 Savings Medicare (HMO) plan has a $0 deductible for prescription drugs. During the initial coverage phase, you'll pay a copay for your prescriptions, which varies based 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 your 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 Savings Medicare (HMO) plan offers a range of benefits with varying costs. Inpatient hospital stays have a copay, but no copay for days 6-90. Outpatient services have copays, while emergency services have a $125 copay, and urgent care has a $55 copay. Preventive services are covered with no copay, and primary care services have copays for specialist visits. The plan also includes coverage for hearing, vision, and dental services, with specific copays and maximum benefits. Home health services have no copay, but some services such as cardiac rehabilitation are not covered.
Inpatient Hospital See details
Inpatient Hospital services, including acute and psychiatric care, are covered, but require prior authorization. For days 1-5, there is a $360 copay, and for days 6-90, there is no copay.
Outpatient Services See details
Outpatient services, including all outpatient hospital services, are covered by Cigna Preferred Savings Medicare (HMO). Outpatient Hospital Services have a copay between $0 and $360, while Observation Services have a $360 copay. Ambulatory Surgical Center (ASC) Services have no copay, and Outpatient Substance Abuse Services have a $40 copay for both individual and group sessions.
Partial Hospitalization See details
Partial Hospitalization is covered by the Cigna Preferred Savings Medicare (HMO) plan, with a copay of $85.00. Prior authorization is required for this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by the Cigna Preferred Savings Medicare (HMO) plan. Ground ambulance services have a copay of $245, 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, with rideshare services, bus/subway, medical transport, and other modes of transportation covered. Transportation services to any health-related location are not covered.
Emergency Services See details
Emergency Services are covered by the Cigna Preferred Savings Medicare (HMO) plan with a $125 copay and no coinsurance, while Urgently Needed Services have a $55 copay and no coinsurance. Worldwide Emergency Services are also covered, with a $125 copay for Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation, and a maximum plan benefit of $50,000.
Primary Care See details
The Cigna Preferred Savings Medicare (HMO) plan covers primary care physician services, occupational therapy, physician specialist services, other health care professionals, physical therapy and speech-language pathology services, additional telehealth benefits, and opioid treatment program services. Chiropractic services are covered with a $15 copay, and routine chiropractic care is not covered. Occupational therapy services have a $40 copay. Specialist services and physical therapy have a $40 copay. Additional telehealth benefits have a copay between $0 and $40, and opioid treatment program services have a $40 copay. Mental health specialty services and psychiatric services do not cover individual or group sessions, and podiatry services are not covered.
Preventive Services See details
The Cigna Preferred Savings Medicare (HMO) plan covers preventive services, including Medicare-covered services with no copay, annual physical exams, health education, kidney disease education services, glaucoma screenings, diabetes self-management training, barium enemas, digital rectal exams, EKG following a Welcome Visit, and fitness benefits. However, 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, in-home support services, support for caregivers of enrollees, 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 exams are covered with a $30 copay, including routine hearing exams and fitting/evaluation for hearing aids. Prescription hearing aids (all types) are covered with a copay between $399 and $1800, but prescription hearing aids for the inner, outer, or over the ear are not covered, nor are OTC hearing aids.
Vision Services See details
Vision services include eye exams with a copay of $0-$40, and eyewear with a combined maximum benefit of $150 per year. Contact lenses are covered, and eyeglasses (lenses and frames), eyeglass lenses, and eyeglass frames are each limited to one per year.
Dental Services See details
Dental services include coverage for Medicare dental services with a $40 copay, as well as coverage for 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. There is a $1250 maximum plan benefit per year for other dental services.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, and prior authorization is required. For Medicare Part B Insulin Drugs, there is a $35 copay and a coinsurance between 0% and 20%. For Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs, there is a coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered under the Cigna Preferred Savings Medicare (HMO) plan, but require prior authorization. You will pay 20% coinsurance for these services.
Medical Equipment See details
Medical Equipment benefits are covered by the Cigna Preferred Savings Medicare (HMO) plan, including Durable Medical Equipment (DME) with a 20% coinsurance and Prosthetic Devices and Medical Supplies with a 20% coinsurance. Durable Medical Equipment for use outside the home and Diabetic Supplies are not covered, while Diabetic Therapeutic Shoes/Inserts have a 20% coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered by the Cigna Preferred Savings Medicare (HMO) plan. Diagnostic Procedures/Tests have a copay between $0 and $100, while Lab Services have no copay. Diagnostic Radiological Services have a copay up to $235, Therapeutic Radiological Services have a $60 copay, and Outpatient X-Ray Services have a $60 copay.
Home Health Services See details
Home Health Services are covered by the Cigna Preferred Savings 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 Savings Medicare (HMO) plan. Prior authorization is required for these services, but the plan does not cover any of the listed sub-services.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the Cigna Preferred Savings Medicare (HMO) plan, but require prior authorization. For days 1-20, there is no copay, and for days 21-100, the copay is $214.
Other Services See details
Under the Cigna Preferred Savings Medicare (HMO) plan, 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. Over-the-Counter (OTC) Items are covered with a maximum benefit of $50 every three months, and the plan also offers a meal benefit for a chronic illness or medical condition.
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