A non-government entity
Cigna Premier Medicare (HMO-POS)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Cigna Premier Medicare (HMO-POS). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Cigna Premier Medicare (HMO-POS) in 2025, please refer to our full plan details page.
Cigna Premier Medicare (HMO-POS) is a HMO-POS plan offered by The Cigna Group available for enrollment in 2025 to people living in Denver. This plan received an overall rating of 2.5 out of 5 stars in 2025.
It's important to know that Cigna Premier Medicare (HMO-POS) 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 Premier Medicare (HMO-POS).
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 Premier Medicare (HMO-POS), 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 $3600.00 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 Premier Medicare (HMO-POS) plan has a $0 deductible for prescription drugs. In the initial coverage phase, you'll pay a copay for your prescriptions, which varies based on the drug tier and whether you use a preferred or standard pharmacy. For example, preferred generic drugs have a $4 copay, while standard generic drugs have a $45 copay. After your total drug costs reach $2000, you enter the catastrophic coverage phase where you pay nothing for your Part D covered drugs.
Additional Benefits
The Cigna Premier Medicare (HMO-POS) plan offers a wide range of benefits, including inpatient and outpatient services, with varying copays. This plan covers emergency services, primary care, preventive services, hearing, vision, and dental services. You will also find that the plan provides additional benefits such as home health services, medical equipment, and diagnostic services. This plan has a $250 copay for inpatient hospital stays (days 1-6), and no copay for days 7-90. Outpatient services have copays between $0 and $250, and ambulance services have a copay of $255 (ground) or 20% coinsurance (air). This plan also covers hearing aids and eyewear with a combined maximum benefit of $250 per year.
Inpatient Hospital See details
Inpatient Hospital benefits are covered, with a copay of $250 for days 1-6 and no copay for days 7-90. Additional days for inpatient hospital-acute, non-Medicare-covered stays for inpatient hospital-acute, upgrades for inpatient hospital-acute, and additional days for inpatient hospital psychiatric and non-Medicare-covered stays for inpatient hospital psychiatric are not covered.
Outpatient Services See details
The Cigna Premier Medicare (HMO-POS) plan covers outpatient services, including outpatient hospital services with a copay between $0 and $250, observation services with a $250 copay, and ambulatory surgical center services with no copay. Outpatient substance abuse services are covered with a $25 copay for both individual and group sessions. Outpatient blood services are covered with a waived three-pint deductible.
Partial Hospitalization See details
Partial Hospitalization is covered by Cigna Premier Medicare (HMO-POS) with a $130 copay, and prior authorization is required.
Ambulance and Transportation Services See details
Ambulance and transportation services are covered by Cigna Premier Medicare (HMO-POS), including all ambulance services and transportation services to plan-approved health-related locations. Ground ambulance services have a copay of $255, while air ambulance services have a 20% coinsurance. Transportation services to any health-related location are not covered.
Emergency Services See details
Emergency services are covered by the Cigna Premier Medicare (HMO-POS) plan. Emergency services have a $140 copay, while urgently needed services have a $25 copay, and both have no coinsurance. Worldwide emergency services are covered, including Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation, each with a $140 copay and no coinsurance, up to a maximum of $50,000.
Primary Care See details
The Cigna Premier Medicare (HMO-POS) plan covers Primary Care Physician Services, Chiropractic Services (with a $20 copay), Occupational Therapy (with a $25 copay), Physician Specialist Services (with a $25 copay), Physical Therapy and Speech-Language Pathology Services (with a $25 copay), and Additional Telehealth Benefits (with a $0-$25 copay). However, 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, and Group Sessions for Psychiatric Services.
Preventive Services See details
Preventive Services are covered, including Medicare-covered services with no copay, annual physical exams, and additional preventive services. Health education, support for caregivers of enrollees, and fitness benefits are also covered, while in-home safety assessments, personal emergency response systems, medical nutrition therapy, and several other services are not covered.
Hearing Services See details
Hearing services are covered, including routine hearing exams with a $25 copay. This plan also covers fitting and evaluation for hearing aids, and prescription hearing aids (all types) with a copay between $399 and $1800. Prescription hearing aids - inner ear, outer ear, and over the ear, as well as OTC hearing aids, are not covered.
Vision Services See details
Vision services are covered, including routine eye exams with a copay of $0-$25, and eyewear, including contact lenses, eyeglasses, eyeglass lenses and frames, and upgrades. Eyewear has a combined maximum benefit of $250 every year.
Dental Services See details
The Cigna Premier Medicare (HMO-POS) plan covers dental services, including oral exams, dental x-rays, and more, with a maximum plan benefit of $1800 per year. Medicare Dental Services have a $25 copay, and all other dental services are covered with no copay or coinsurance.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered by the Cigna Premier Medicare (HMO-POS) plan and require prior authorization. Medicare Part B Insulin Drugs have a $35 copay, with 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 Premier Medicare (HMO-POS) plan. The coinsurance for dialysis services is 20%.
Medical Equipment See details
Medical Equipment is covered, including Durable Medical Equipment with 20% coinsurance, and Prosthetic Devices and Medical Supplies with 20% coinsurance. Diabetic Therapeutic Shoes/Inserts are covered with 20% coinsurance, but Durable Medical Equipment for use outside the home and Diabetic Supplies are not covered.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered. Diagnostic Procedures/Tests have a copay between $0 and $50, while Lab Services have no copay. Diagnostic Radiological Services have a copay up to $250, Therapeutic Radiological Services have a coinsurance of at most 20%, and Outpatient X-Ray Services have a $10 copay.
Home Health Services See details
Home Health Services are covered by the Cigna Premier Medicare (HMO-POS) plan with no copay and no coinsurance, but prior authorization is required. Additional Hours of Care and Personal Care Services are not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered by the Cigna Premier Medicare (HMO-POS) plan. Prior authorization is required for these services.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by Cigna Premier Medicare (HMO-POS), but require prior authorization. You will pay a copay of $20 for days 1-20, and a copay of $214 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 includes coverage for Over-the-Counter (OTC) items with a maximum benefit of $75 every three months, as well as a meal benefit. 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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