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Cigna TotalCare Plus (HMO D-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Cigna TotalCare Plus (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 Plus (HMO D-SNP) in 2025, please refer to our full plan details page.
Cigna TotalCare Plus (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 Plus (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 Plus (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 Plus (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 Plus (HMO D-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $10.50. 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 $9350.00 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 Plus (HMO D-SNP) plan has a $590 deductible for prescription drugs. After you meet your deductible, you will pay the costs for your drugs based on the tier and pharmacy you use. Once your total drug costs reach $2000, you enter the catastrophic coverage phase where you will pay nothing for your Part D covered drugs. If you qualify for the low-income subsidy, your monthly premium will be $10.50.
Additional Benefits
The Cigna TotalCare Plus (HMO D-SNP) plan offers a variety of benefits with varying costs. Inpatient hospital services require a copay, while outpatient services have a coinsurance of 0-20%. The plan also covers emergency services with a copay, primary care with a 20% coinsurance, and preventive services. Additional benefits include hearing and vision services, with coinsurance or copays for exams and eyewear. Dental services are covered with 20% coinsurance for Medicare services and a $3,000 annual maximum for other services. The plan also provides coverage for home infusion, dialysis, medical equipment, diagnostic services, and home health services, with costs ranging from no copay to a 20% coinsurance.
Inpatient Hospital See details
Inpatient Hospital services, including acute and psychiatric, are covered, but additional days and non-Medicare-covered stays are not covered. For covered services, you will have a copay, and prior authorization may be required.
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 by the Cigna TotalCare Plus (HMO D-SNP) plan. Outpatient hospital services have a coinsurance of 0% to 20%, while observation services have a 20% coinsurance. Outpatient substance abuse individual and group sessions both have a 20% coinsurance. Outpatient blood services include an enhanced benefit with a three-pint deductible waived.
Partial Hospitalization See details
Partial hospitalization is covered under the Cigna TotalCare Plus (HMO D-SNP) plan, with a copay of $80.00. Prior authorization is required for this benefit.
Ambulance and Transportation Services See details
The Cigna TotalCare Plus (HMO D-SNP) plan covers ambulance and transportation services, including ground and air ambulance services with a 20% coinsurance. Transportation services to a plan-approved health-related location are covered for up to 50 one-way trips per year, but transportation services to any other health-related location are not covered.
Emergency Services See details
Emergency Services, including Urgently Needed Services and Worldwide Emergency Services, are covered. Emergency Services and Worldwide Emergency Coverage, Urgent Coverage, and Emergency Transportation have a $110 copay, while Urgently Needed Services have a $45 copay; all have no coinsurance.
Primary Care See details
The Cigna TotalCare Plus (HMO D-SNP) plan covers primary care physician services, chiropractic services, occupational therapy services, physician specialist services, mental health specialty services, other health care professional services, psychiatric services, physical therapy and speech-language pathology services, additional telehealth benefits, and opioid treatment program services. Primary care physician services, chiropractic services, physician specialist services, and physical therapy and speech-language pathology services have a 20% coinsurance. Individual and group sessions for Mental Health Specialty Services, Podiatry services, and individual and group sessions for Psychiatric Services are not covered. Additional telehealth benefits have a coinsurance between 0% and 20%.
Preventive Services See details
The Cigna TotalCare Plus (HMO D-SNP) plan covers preventive services, including Medicare-covered services, and other services like health education, glaucoma screenings, and diabetes self-management training. However, some services, like in-home safety assessments, personal emergency response systems, and weight management programs, are not covered.
Hearing Services See details
Hearing services include routine hearing exams with a coinsurance of at most 20%, and prescription hearing aids with a copay between $399 and $1800, while fitting and evaluation for hearing aids is covered. Prescription hearing aids for the inner ear, outer ear, and over the ear, as well as OTC hearing aids are not covered.
Vision Services See details
The Cigna TotalCare Plus (HMO D-SNP) plan covers vision services, including routine eye exams with a coinsurance of 0% to 20%. The plan also covers eyewear, including contact lenses, eyeglasses (lenses and frames), eyeglass lenses, and eyeglass frames, with a combined maximum benefit of $300 per year.
Dental Services See details
The Cigna TotalCare Plus (HMO D-SNP) plan covers dental services with a 20% coinsurance for Medicare dental services, and a $3,000 annual maximum 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 and fixed), maxillofacial prosthetics, implant services, oral and maxillofacial surgery, and orthodontics are all covered.
Home Infusion bundled Services See details
Home Infusion bundled Services, including Medicare Part B Insulin Drugs, Medicare Part B Chemotherapy/Radiation Drugs, and Other Medicare Part B Drugs, are covered under the Cigna TotalCare Plus (HMO D-SNP) plan. The plan has a $35 copay for Medicare Part B Insulin Drugs, with a coinsurance between 0-20% for all of these services.
Dialysis Services See details
Dialysis Services are covered, but require prior authorization. You will pay 20% coinsurance for these services.
Medical Equipment See details
Medical equipment is covered under the Cigna TotalCare Plus (HMO D-SNP) plan. Durable Medical Equipment (DME) has a 20% coinsurance and no copay, while Durable Medical Equipment for use outside the home is not covered. Prosthetics/Medical Supplies have a 20% coinsurance, with no copay. Diabetic Equipment has a coinsurance for Medicare-covered diabetic supplies, while Diabetic Supplies are not covered, but Diabetic Therapeutic Shoes/Inserts have a 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 up to 20%, while Lab Services have no copay. Therapeutic Radiological Services and Outpatient X-Ray Services have a coinsurance of at least 20%.
Home Health Services See details
Home Health Services are covered by the Cigna TotalCare Plus (HMO D-SNP) 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 covered, but the specific services of Cardiac Rehabilitation, Intensive Cardiac Rehabilitation, Pulmonary Rehabilitation, and SET for PAD Services are not covered. Prior authorization is required.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered, but prior authorization is required. The plan charges the Medicare-defined cost share for tier 1, but additional days beyond Medicare-covered SNF stays and non-Medicare-covered SNF stays are not covered.
Other Services See details
The Cigna TotalCare Plus (HMO D-SNP) plan's other services include Over-the-Counter (OTC) Items with a maximum benefit of $155 every three months, which includes Nicotine Replacement Therapy (NRT) and Naloxone coverage. Acupuncture, Dual Eligible SNPs with Highly Integrated Services, Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services, and many other additional services are not covered.
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