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Cigna TotalCare (HMO D-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Cigna TotalCare (HMO D-SNP). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Cigna TotalCare (HMO D-SNP) in 2025, please refer to our full plan details page.
Cigna TotalCare (HMO D-SNP) is a HMO D-SNP plan offered by The Cigna Group available for enrollment in 2025 to people living in Baltimore/Delaware. This plan received an overall rating of 3 out of 5 stars in 2025.
It's important to know that Cigna TotalCare (HMO D-SNP) is a Medicare Advantage (MA) Plan with drug coverage. That means that this plan covers both medical services and prescription drugs.
Important:
Cigna TotalCare (HMO D-SNP)is a Special Needs Type (SNP) plan. This means you can only enroll in this plan if you meet specific criteria. See our full plan details page for more information.
Key Plan Facts
Below are a few key facts and commonly-asked questions about Cigna TotalCare (HMO D-SNP).
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 TotalCare (HMO D-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $23.20. 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 a $590.00 drug deductible. You will need to pay this amount towards covered prescriptions before your insurance coverage for prescription medications kicks in.
Out-of-Pocket Maximums
This plan has a Maximum Out-Of-Pocket cost of $7550.00 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 TotalCare (HMO D-SNP) plan has a $590 deductible for prescription drugs. After the deductible, you will pay the costs for your drugs in each tier until your total drug costs reach $2,000. Once your yearly out-of-pocket drug costs reach $2,000, you will pay nothing for Medicare Part D covered drugs. If you qualify for the low-income subsidy, your monthly premium for Part D will be $23.20.
Additional Benefits
The Cigna TotalCare (HMO D-SNP) plan offers a range of benefits with varying costs. Inpatient hospital stays have a copay, while outpatient services and emergency services have coinsurance or copays. Preventive services, like annual physical exams, have no copay, and many other services like hearing and vision, are covered with copays or coinsurance. This plan also includes coverage for dental services, home infusion, and medical equipment with coinsurance. Additionally, there are benefits for skilled nursing facilities, outpatient services, and transportation. The plan offers extra benefits like over-the-counter items and meal benefits.
Inpatient Hospital See details
Inpatient Hospital benefits are covered by the Cigna TotalCare (HMO D-SNP) plan, with a $1,500 copay per admission for Inpatient Hospital-Acute and a $350 copay for days 1-5, and no copay for days 6-90 for Inpatient Hospital Psychiatric. Additional days, non-Medicare-covered stays, and upgrades for both Inpatient Hospital-Acute and Inpatient Hospital Psychiatric are not covered.
Outpatient Services See details
Outpatient Services, including outpatient hospital services, observation services, ambulatory surgical center (ASC) services, outpatient substance abuse services, and outpatient blood services, are covered. Outpatient Hospital Services have a coinsurance of 0% to 20%, Observation Services have a 20% coinsurance, and Individual and Group Sessions for Outpatient Substance Abuse have a 20% coinsurance.
Partial Hospitalization See details
Partial Hospitalization is covered with a $70 copay, and prior authorization is required.
Ambulance and Transportation Services See details
Ambulance and Transportation Services, including ground and air ambulance, are covered by the Cigna TotalCare (HMO D-SNP) plan. All ambulance services have a 20% coinsurance, while transportation services to any health-related location are not covered, and transportation services to plan-approved health-related locations are covered for up to 30 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 TotalCare (HMO D-SNP) plan. Emergency Services and Worldwide Emergency Coverage have a $110 copay, while Urgently Needed Services have a $45 copay. Worldwide Emergency Services have a maximum benefit of $50,000.
Primary Care See details
The Cigna TotalCare (HMO D-SNP) plan covers Primary Care Physician Services, Occupational Therapy Services, Physician Specialist Services, Podiatry Services, Other Health Care Professional, Physical Therapy and Speech-Language Pathology Services, Additional Telehealth Benefits, and Opioid Treatment Program Services, with coinsurance of 20% for Chiropractic Services, Physician Specialist Services, and Physical Therapy and Speech-Language Pathology Services. Routine Chiropractic Care, Individual and Group Sessions for Mental Health Specialty Services, and Individual and Group Sessions for Psychiatric Services are not covered.
Preventive Services See details
The Cigna TotalCare (HMO D-SNP) plan covers preventive services including Medicare-covered services, annual physical exams, health education, kidney disease education services, and other preventive services, with no copay or coinsurance. However, this plan does not cover In-Home Safety Assessment, Personal Emergency Response System (PERS), Medical Nutrition Therapy (MNT), 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 Benefit, 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.
Hearing Services See details
Hearing services include routine hearing exams with a coinsurance of 20%, and fitting/evaluation for hearing aids with no copay. Prescription hearing aids are covered with a copay between $399 and $1800, but inner ear, outer ear, and over the ear hearing aids are not covered, and OTC hearing aids are not covered.
Vision Services See details
The Cigna TotalCare (HMO D-SNP) plan covers vision services, including routine eye exams with a coinsurance of 0% to 20%, and eyewear with a combined maximum benefit of $225 every year. Contact lenses, eyeglasses (lenses and frames), eyeglass lenses, eyeglass frames, and upgrades are also covered.
Dental Services See details
Dental services are covered under the Cigna TotalCare (HMO D-SNP) plan. Medicare Dental Services have a 20% coinsurance and require prior authorization, while other dental services have a maximum benefit of $4,000 per year.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, and require prior authorization. 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 by the Cigna TotalCare (HMO D-SNP) plan, but require prior authorization. There is a 20% coinsurance for these services.
Medical Equipment See details
Medical Equipment benefits include Durable Medical Equipment (DME) with 20% coinsurance and Prosthetics/Medical Supplies with 20% coinsurance. This plan does not cover Durable Medical Equipment for use outside the home or Diabetic Supplies, but does cover Diabetic Therapeutic Shoes/Inserts with 20% coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered, including Diagnostic Procedures/Tests, Lab Services, Diagnostic Radiological Services, Therapeutic Radiological Services, and Outpatient X-Ray Services. Diagnostic Procedures/Tests and Diagnostic Radiological Services have a coinsurance of at most 20%, and Lab Services have no copay. Therapeutic Radiological Services and Outpatient X-Ray Services have a coinsurance of at most 20%.
Home Health Services See details
Home Health Services are covered 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 TotalCare (HMO D-SNP) 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 TotalCare (HMO D-SNP) 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 stays and non-Medicare-covered SNF stays are not covered.
Other Services See details
The Cigna TotalCare (HMO D-SNP) plan covers Over-the-Counter (OTC) items with a maximum benefit of $130.00 every three months. The plan also covers meal benefits for a chronic illness or a medical condition. 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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