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 Colorado Springs. 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 $3400.00 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 an enhanced alternative drug benefit. There is no deductible for prescription drugs. In the initial coverage phase, you will pay a copay for your prescriptions. For preferred generic drugs, you will pay a $4 copay at a preferred pharmacy or preferred mail order, and a $15 copay at a standard pharmacy or standard mail order. For preferred brand drugs, the copay is $100. Non-preferred drugs have a 33% coinsurance. After your total drug costs reach $2000, you enter the catastrophic coverage phase, where you pay nothing for your covered drugs.
Additional Benefits
The Cigna Premier Medicare (HMO-POS) plan offers a range of benefits with varying costs. Inpatient hospital stays have a $250 copay for the first six days, with no copay for the remainder of a 90-day stay. Outpatient services can have copays ranging from $0 to $250, while primary care visits, specialist services, and chiropractic services have a $20-$25 copay. This plan includes coverage for ambulance services, with a $255 copay for ground transport and 20% coinsurance for air ambulance. Vision services include routine eye exams with a $0-$25 copay and eyewear benefits up to $250 annually. Dental services are covered with a $25 copay for Medicare dental services, up to a $1,700 annual maximum. Other benefits include hearing services, home health, and home infusion.
Inpatient Hospital See details
Inpatient Hospital benefits, including acute and psychiatric care, are covered with a $250 copay for days 1-6 and no copay for days 7-90. Additional days and non-Medicare-covered stays for both acute and psychiatric care are not covered.
Outpatient Services See details
Outpatient Services include coverage for Outpatient Hospital Services with a copay between $0 and $250, Observation Services with a $250 copay, Ambulatory Surgical Center (ASC) Services with no copay, Outpatient Substance Abuse Services with a $25 copay for both individual and group sessions, and Outpatient Blood Services with an enhanced benefit. Prior authorization is required for some services.
Partial Hospitalization See details
Partial Hospitalization is covered under the Cigna Premier Medicare (HMO-POS) plan with a $130 copay and requires prior authorization.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered, with prior authorization required. Ground ambulance services have a $255 copay, while air ambulance services have a 20% coinsurance. Transportation Services to a plan-approved health-related location are covered for up to 20 one-way trips per year, while transportation services to any health-related location are not covered.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered. Emergency Services and Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation 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 (with a $25 copay), 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). Mental health specialty services (individual and group sessions), podiatry services, and psychiatric services (individual and group sessions) are not covered. Additional telehealth benefits are covered with a copay between $0 and $25.
Preventive Services See details
The Cigna Premier Medicare (HMO-POS) plan covers preventive services, including Medicare-covered services with no copay, an annual physical exam, and additional preventive services. Some services, such as in-home safety assessments, personal emergency response systems, and several others are not covered.
Hearing Services See details
Hearing Services are covered, including hearing exams with a $25 copay. Routine hearing exams and fitting/evaluation for hearing aids are covered once per year, while prescription hearing aids (all types) are covered with a copay between $399 and $1800 for 2 visits per year; however, 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
The Cigna Premier Medicare (HMO-POS) plan covers vision services including routine eye exams with a copay between $0 and $25, and eyewear with a combined maximum benefit of $250 every year. Contact lenses, eyeglass lenses, eyeglass frames, and upgrades are also covered.
Dental Services See details
Dental services are covered, with a $25 copay for Medicare dental services, which require prior authorization. This plan also covers 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 $1,700 maximum plan benefit coverage per year.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, but require prior authorization. For Medicare Part B Insulin Drugs, there is a $35 copay and coinsurance between 0% and 20%; for Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs, there is 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. You will pay 20% coinsurance for these services.
Medical Equipment See details
Medical Equipment benefits with the Cigna Premier Medicare (HMO-POS) plan include Durable Medical Equipment (DME), Prosthetics/Medical Supplies, and Diabetic Equipment. DME has a 20% coinsurance and requires authorization, while Prosthetics/Medical Supplies and Diabetic Equipment have a 20% coinsurance. Diabetic Supplies and DME for use outside the home are not covered.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered by the Cigna Premier Medicare (HMO-POS) plan. Diagnostic Procedures/Tests have a copay between $0 and $50, and Lab Services have no copay. Diagnostic Radiological Services have a copay up to $250, Therapeutic Radiological Services have a coinsurance of at least 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 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 Premier Medicare (HMO-POS) plan. Some services that fall under this benefit include Medicare-covered Intensive Cardiac Rehabilitation Services, Medicare-covered Pulmonary Rehabilitation Services, Medicare-covered Supervised Exercise Therapy (SET) for Symptomatic Peripheral Artery Disease (PAD) Services, and Additional Cardiac Rehabilitation Services, but these are not covered.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered, but require prior authorization. For days 1-20, the copay is $20, and for days 21-100, the copay is $214; additional days beyond Medicare-covered and non-Medicare-covered stays are not covered.
Other Services See details
Other Services include Over-the-Counter (OTC) Items and a Meal Benefit. Acupuncture and Dual Eligible SNPs with Highly Integrated Services are not covered. The plan offers up to $75 every three months for OTC items, including nicotine replacement therapy and Naloxone.
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