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 Fort Collins. 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 $3550.00 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 will pay a copay for your prescriptions depending on the drug tier and the pharmacy you use. For preferred generic drugs, the copay is $4.00. For standard generic drugs, the copay is $45.00. For preferred brand drugs, the copay is $100.00, and for non-preferred drugs, you pay 33% coinsurance. Once your total drug costs reach $2000.00, you enter the catastrophic coverage phase, where you pay nothing for covered drugs.
Additional Benefits
The Cigna Premier Medicare (HMO-POS) plan offers a wide range of benefits, including inpatient hospital stays with a $250 copay for the first six days, and no copay for days 7-90. Outpatient services have varying copays, and the plan covers primary care, hearing, vision, and dental services. This plan includes coverage for emergency services, ambulance services, and home health services with no copays. Additional benefits include coverage for prescription hearing aids, eyewear, and a quarterly allowance for over-the-counter items.
Inpatient Hospital See details
Inpatient Hospital benefits are covered under the Cigna Premier Medicare (HMO-POS) plan, with a copay of $250 for days 1-6, and no copay for days 7-90. Additional days, non-Medicare covered stays, and upgrades for inpatient hospital are not covered.
Outpatient Services See details
Outpatient Services are covered under the Cigna Premier Medicare (HMO-POS) plan, including outpatient hospital services with a copay between $0 and $250, observation services with a $250 copay, ambulatory surgical center services with no copay, and outpatient substance abuse services with a $25 copay for individual and group sessions. Outpatient blood services are also covered with a waived three-pint deductible.
Partial Hospitalization See details
Partial Hospitalization is covered under the Cigna Premier Medicare (HMO-POS) plan, but requires prior authorization. The copay for this service is $130.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by the Cigna Premier Medicare (HMO-POS) plan. Ground ambulance services have a $255 copay, and 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, Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation are covered by the Cigna Premier Medicare (HMO-POS) plan. Emergency Services and Worldwide Emergency Coverage have a $140 copay, while Urgently Needed Services has a $25 copay; all have no coinsurance.
Primary Care See details
The Cigna Premier Medicare (HMO-POS) plan covers primary care physician services, chiropractic services with a $20 copay, occupational therapy services with a $25 copay, physician specialist services with a $25 copay, physical therapy and speech-language pathology services with a $25 copay, and opioid treatment program services with a $25 copay. The plan does not cover routine chiropractic care, individual or group sessions for mental health specialty services, individual or group sessions for psychiatric services, or podiatry services. Additional telehealth benefits are covered with a copay between $0 and $25.
Preventive Services See details
The Cigna Premier Medicare (HMO-POS) plan covers a variety of preventive services, including Medicare-covered services and annual physical exams. Additional preventive services include Health Education, Support for Caregivers of Enrollees, and Fitness Benefit, while other services like In-Home Safety Assessment and Counseling Services are not covered.
Hearing Services See details
Hearing services are covered by the Cigna Premier Medicare (HMO-POS) plan, including routine hearing exams with a $25 copay. The plan covers fitting/evaluation for hearing aids once per year, and covers prescription hearing aids with a copay between $399 and $1800, depending on the type of hearing aid. Prescription hearing aids for the inner ear, outer ear, and over the ear are not covered, and OTC hearing aids are not covered.
Vision Services See details
Vision services are covered, including eye exams with a copay between $0 and $25, and routine eye exams once per year. Eyewear is also covered with a combined maximum of $250 per year, and contact lenses are covered, as are eyeglasses (lenses and frames), eyeglass lenses, and eyeglass frames, each once per year. Upgrades are also covered.
Dental Services See details
Dental services are covered under the Cigna Premier Medicare (HMO-POS) plan, with a $25 copay for Medicare Dental Services, and a yearly maximum of $1,700 for Other Dental Services. 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 covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered by the Cigna Premier Medicare (HMO-POS) plan. For Medicare Part B Insulin Drugs, you will pay a $35 copay, and coinsurance between 0% and 20%. For Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs, you will pay coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered by the Cigna Premier Medicare (HMO-POS) plan, but require prior authorization. The coinsurance is 20%.
Medical Equipment See details
Medical Equipment benefits are covered, including Durable Medical Equipment with 20% coinsurance and no copay, and Prosthetics/Medical Supplies with 20% coinsurance and no copay, as well as Diabetic Therapeutic Shoes/Inserts with 20% coinsurance. 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, including diagnostic procedures and tests with a copay between $0 and $50, lab services with no copay, and diagnostic radiological services with a copay up to $250. Therapeutic radiological services have a 20% coinsurance, 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 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 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 the Cigna Premier Medicare (HMO-POS) plan, with a prior authorization requirement. You will pay a copay of $20 for days 1-20, and a copay of $214 for days 21-100.
Other Services See details
Other Services include Over-the-Counter (OTC) Items and 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. Over-the-Counter (OTC) Items have a maximum benefit of $75 every three months.
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