A non-government entity
Cigna Alliance Medicare (HMO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Cigna Alliance Medicare (HMO). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Cigna Alliance Medicare (HMO) in 2025, please refer to our full plan details page.
Cigna Alliance Medicare (HMO) is a HMO plan offered by The Cigna Group available for enrollment in 2025 to people living in Baltimore. This plan received an overall rating of 3 out of 5 stars in 2025.
It's important to know that Cigna Alliance 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 Alliance 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 Alliance Medicare (HMO), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $32.00. 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 $9200.00 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 Alliance Medicare (HMO) plan has a $0 deductible for prescription drugs. In the initial coverage phase, you'll pay a copay depending on the drug tier and pharmacy you use. For example, preferred generic drugs have a $4 copay at preferred pharmacies. Once your total drug costs reach $2000, you enter the catastrophic coverage phase, where you will pay nothing for Part D covered drugs. If you qualify for the low-income subsidy, you will pay $4 for Part D drugs.
Additional Benefits
The Cigna Alliance Medicare (HMO) plan offers comprehensive coverage with a variety of benefits. This plan includes coverage for inpatient and outpatient hospital services, with varying copays, as well as emergency services. You'll also find coverage for primary care, preventive services, hearing, vision, and dental services, each with specific copays or coinsurance. This plan includes coverage for ambulance and transportation services, home health services, medical equipment, and diagnostic and radiological services. Additional benefits include partial hospitalization, home infusion services, and skilled nursing facility care. However, some services, such as cardiac rehabilitation, are not covered.
Inpatient Hospital See details
Inpatient Hospital coverage includes both Inpatient Hospital-Acute and Inpatient Hospital Psychiatric, both of which require prior authorization. For Inpatient Hospital-Acute, you will pay a $350 copay for days 1-7, and no copay for days 8-90. For Inpatient Hospital Psychiatric, you will pay a $350 copay for days 1-5, and no copay for days 6-90. Additional days and non-Medicare-covered stays are not covered.
Outpatient Services See details
Outpatient services, including outpatient hospital services, observation services, ambulatory surgical center services, outpatient substance abuse services, and outpatient blood services, are covered. Outpatient hospital services have a copay between $0 and $450, observation services have a $450 copay, individual and group sessions for outpatient substance abuse have a $55 copay, and ambulatory surgical center services have no copay.
Partial Hospitalization See details
Partial Hospitalization is covered under the Cigna Alliance Medicare (HMO) plan, but requires prior authorization. You will have a copay of $80 for this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by Cigna Alliance Medicare (HMO). Ground Ambulance Services have a copay of $220, while Air Ambulance Services have a 20% coinsurance; however, Transportation Services to any health-related location are not covered.
Emergency Services See details
Emergency Services, including Worldwide Emergency Services, are covered by the Cigna Alliance Medicare (HMO) plan. Emergency Services and Worldwide Emergency Coverage have a $110 copay, while Urgently Needed Services have a $45 copay; all have no coinsurance. Worldwide Emergency Services have a maximum plan benefit coverage of $50,000.
Primary Care See details
The Cigna Alliance Medicare (HMO) plan covers primary care physician services, chiropractic services (with a $15 copay), occupational therapy (with a $35 copay), physician specialist services (with a $55 copay), other health care professionals (with a copay between $0 and $55), physical therapy and speech-language pathology services (with a $35 copay), additional telehealth benefits (with a copay between $0 and $55), and opioid treatment program services (with a $55 copay). However, routine chiropractic care, individual and group mental health specialty sessions, individual and group psychiatric sessions, and podiatry services are not covered.
Preventive Services See details
The Cigna Alliance Medicare (HMO) plan covers preventive services, including annual physical exams, health education, fitness benefits, and kidney disease education services. Additional services such as in-home safety assessments, personal emergency response systems (PERS), medical nutrition therapy (MNT), and others are not covered. Other preventive services like glaucoma screening, diabetes self-management training, barium enemas, digital rectal exams, and EKG following a Welcome Visit are covered.
Hearing Services See details
Hearing exams are covered with a $15 copay, and routine hearing exams and fitting/evaluation for hearing aids are covered annually. Prescription hearing aids are partially covered, with a copay between $399 and $1800 for all types of hearing aids, but inner ear, outer ear, and over-the-ear hearing aids are not covered. OTC hearing aids are not covered.
Vision Services See details
Vision services are covered, including routine eye exams with a copay between $0 and $55. Eyewear is covered with a combined maximum plan benefit of $200 every year, and includes contact lenses, eyeglasses (lenses and frames), eyeglass lenses, and eyeglass frames. Upgrades are also covered.
Dental Services See details
Cigna Alliance Medicare (HMO) covers dental services, with a $55 copay for Medicare Dental Services, and a $5,000 annual maximum. Oral exams are covered up to 4 times per year, and Dental X-Rays are covered with limitations. Other covered services include Other Diagnostic Dental Services, Prophylaxis (Cleaning) up to 2 times per year, Fluoride Treatment up to 2 times per year, Other Preventive Dental Services, Adjunctive General Services, and Periodontics. However, Restorative Services, Endodontics, Prosthodontics, removable, Maxillofacial Prosthetics, Implant Services, Prosthodontics, fixed, Oral and Maxillofacial Surgery, and Orthodontics are not covered.
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, with a coinsurance between 0-20%. Other Medicare Part B drugs have a coinsurance between 0-20%.
Dialysis Services See details
Dialysis services are covered by Cigna Alliance Medicare (HMO). The plan requires prior authorization, and the coinsurance is 20%.
Medical Equipment See details
Medical Equipment is covered by Cigna Alliance Medicare (HMO), including Durable Medical Equipment with 20% coinsurance, Prosthetic Devices with 20% coinsurance, and Medical Supplies with 20% coinsurance, while Durable Medical Equipment for use outside the home, and Diabetic Supplies are not covered. Diabetic Therapeutic Shoes/Inserts have 20% coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered, with all diagnostic services and radiological services requiring prior authorization. Diagnostic Procedures/Tests have a copay between $0 and $50, Lab Services have no copay, Diagnostic Radiological Services have a copay up to $200, Therapeutic Radiological Services have a copay of $60, and Outpatient X-Ray Services have a $40 copay.
Home Health Services See details
Home Health Services are covered by the Cigna Alliance Medicare (HMO) plan with no copay and no coinsurance, but 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 Alliance Medicare (HMO) plan. This includes 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.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the Cigna Alliance Medicare (HMO) plan, but require prior authorization. For days 1-20, there is no copay, and for days 21-100, the copay is $214. Additional days beyond Medicare-covered SNF and non-Medicare-covered stays are not covered.
Other Services See details
Other Services for Cigna Alliance Medicare (HMO) are not covered, including acupuncture, over-the-counter items, 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. However, the plan does offer a meal benefit for chronic illnesses or medical conditions that require the enrollee to remain at home for a period of time.
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