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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 South Mississippi. This plan received an overall rating of 4 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 $17.90. 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 $6750.00 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 deductible of $590. After the deductible is met, you will pay the costs for your drugs based on the tier and pharmacy you use until your total drug costs reach $2000. Once your total drug costs reach $2000, you will enter the next coverage phase. If you qualify for the low-income subsidy, your monthly premium will be $17.90. After your yearly out-of-pocket drug costs reach $2000, you pay nothing for covered drugs.
Additional Benefits
The Cigna TotalCare (HMO D-SNP) plan offers comprehensive coverage, including inpatient and outpatient hospital services, with varying copays and coinsurance. You'll have no copay for primary care, preventive services, and home health services, while emergency services have a $125 copay. The plan also includes benefits for hearing, vision, and dental, with specific allowances for exams, eyewear, and dental services. Additionally, it covers ambulance, home infusion, dialysis, and medical equipment with copays or coinsurance, as well as skilled nursing facility services.
Inpatient Hospital See details
Inpatient Hospital services are covered, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric, both of which require prior authorization. For Inpatient Hospital-Acute, you'll pay a copay of $195 for days 1-6, and no copay for days 7-90; for Inpatient Hospital Psychiatric, the copay is $1850. Additional days, non-Medicare-covered stays, and upgrades are not covered for either service.
Outpatient Services See details
Outpatient Services are covered by the Cigna TotalCare (HMO D-SNP) plan, including outpatient hospital services, observation services, ambulatory surgical center (ASC) services, and outpatient blood services. Outpatient hospital services have a coinsurance of 0% - 20%, observation services have a 20% coinsurance, and ASC services have a coinsurance between 0% - 20%. Outpatient substance abuse services are not covered.
Partial Hospitalization See details
Cigna TotalCare (HMO D-SNP) covers partial hospitalization with a $105 copay. Prior authorization is required for this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered, including both ground and air ambulance services. Ground ambulance services have a copay of $245, while air ambulance services have a 20% coinsurance. Transportation Services to a plan-approved health-related location are covered.
Emergency Services See details
Emergency Services are covered by the Cigna TotalCare (HMO D-SNP) plan, with a $125 copay, and no coinsurance. Urgently Needed Services have a $55 copay and no coinsurance, and Worldwide Emergency Services, Worldwide Urgent Coverage, and Worldwide Emergency Transportation have a $125 copay and no coinsurance.
Primary Care See details
Primary care physician services, occupational therapy services, physical therapy and speech-language pathology services, and additional telehealth benefits are covered with no copay and no coinsurance. Chiropractic services, physician specialist services, mental health specialty services, other health care professional, psychiatric services, and opioid treatment program services are covered, but require prior authorization. Routine chiropractic care, individual sessions for mental health specialty services, individual sessions for psychiatric services and group sessions for both mental health and psychiatric services are not covered. Podiatry services are not covered.
Preventive Services See details
Preventive services are covered, including Medicare-covered preventive services, an annual physical exam, and additional preventive services like health education and fitness benefits, but not in-home safety assessments, personal emergency response systems, medical nutrition therapy, post-discharge in-home medication reconciliation, re-admission prevention, wigs for hair loss, weight management programs, alternative therapies, therapeutic massage, adult day health services, nutritional/dietary benefits, home-based palliative care, in-home support services, support for caregivers, smoking cessation counseling, enhanced disease management, telemonitoring services, remote access technologies, home and bathroom safety devices, and counseling services. Kidney disease education services, glaucoma screening, diabetes self-management training, barium enemas, digital rectal exams, and EKG following welcome visits are also covered.
Hearing Services See details
Hearing Services include routine hearing exams, fitting/evaluation for hearing aids, and prescription hearing aids. Routine hearing exams and fitting/evaluation for hearing aids are covered for 1 visit per year, and prescription hearing aids (all types) are covered for 2 visits per year 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
The Cigna TotalCare (HMO D-SNP) plan covers vision services, including routine eye exams with one visit per year, and eyewear, with a combined maximum benefit of $300 per year. Contact lenses are also covered, and upgrades are covered.
Dental Services See details
The Cigna TotalCare (HMO D-SNP) plan covers a range of dental services, including exams, x-rays, cleaning, and orthodontics, with a maximum benefit of $2,500 per year. Other services like restorative, endodontics, and oral surgery are also covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered by the Cigna TotalCare (HMO D-SNP) plan, with a $35 copay for Medicare Part B Insulin Drugs. The plan also covers Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs, and all three have a coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered by the Cigna TotalCare (HMO D-SNP) plan. You will pay 20% coinsurance for these services.
Medical Equipment See details
Medical Equipment benefits include Durable Medical Equipment (DME) with a 20% coinsurance and Prosthetic Devices, and Medical Supplies, with a 20% coinsurance. Diabetic Therapeutic Shoes/Inserts are covered with a 20% coinsurance, but Diabetic Supplies are not covered, and Durable Medical Equipment for use outside the home is not covered.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered. Diagnostic Procedures/Tests and Diagnostic Radiological Services have a coinsurance of at most 20%, while Lab Services have no copay, and Outpatient X-Ray Services have a coinsurance of at most 20%. Therapeutic Radiological Services have a coinsurance of at most 20%.
Home Health Services See details
Home Health Services are covered by the Cigna TotalCare (HMO D-SNP) plan, with no copay or coinsurance. Additional Hours of Care and Personal Care Services are not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are technically covered, but the plan does not cover Cardiac Rehabilitation Services, Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, or SET for PAD Services. Prior authorization is required for these 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, the copay is $10, and for days 21-100, the copay is $214.
Other Services See details
The Cigna TotalCare (HMO D-SNP) plan covers Over-the-Counter (OTC) Items with a maximum benefit of $115.00 every three months. However, 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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