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Cigna Preferred Medicare (HMO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Cigna Preferred Medicare (HMO). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Cigna Preferred Medicare (HMO) in 2025, please refer to our full plan details page.
Cigna Preferred Medicare (HMO) is a HMO 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 Preferred 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 Preferred 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 Preferred Medicare (HMO), 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 $5800.00 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 Preferred Medicare (HMO) plan has a $0 deductible for prescription drugs. In the initial coverage phase, you'll pay a copay or coinsurance depending on the drug tier and pharmacy type. For example, preferred generic drugs have an $8 copay at preferred pharmacies and $20 at standard pharmacies. Once your total drug costs reach $2000, you enter the catastrophic coverage phase and pay nothing for covered drugs.
Additional Benefits
The Cigna Preferred Medicare (HMO) plan offers a range of benefits with varying costs. Inpatient hospital stays have copays, while outpatient services have copays between $0 and $295. The plan also covers services like ambulance, emergency care, primary care, hearing, vision, and dental, each with specific copays or coinsurance amounts. This plan includes coverage for preventive services, home health services, and skilled nursing facilities. It also provides benefits for medical equipment and diagnostic services. The plan also covers home infusion, dialysis, and "other services" such as over-the-counter items, with additional benefits for chronic illnesses and medical conditions.
Inpatient Hospital See details
Inpatient Hospital services, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric, are covered with prior authorization. For Inpatient Hospital-Acute, you will pay a $290 copay for days 1-6 and no copay for days 7-90; for Inpatient Hospital Psychiatric, you will pay a $298 copay for days 1-7 and no copay for days 8-90. Non-Medicare-covered stays and upgrades for Inpatient Hospital-Acute, as well as additional days and non-Medicare-covered stays for Inpatient Hospital Psychiatric, 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 $295, observation services have a $295 copay, ambulatory surgical center services have no copay, and both individual and group outpatient substance abuse sessions have a $30 copay.
Partial Hospitalization See details
Cigna Preferred Medicare (HMO) covers partial hospitalization with a $105 copay. Prior authorization is required.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by the Cigna Preferred Medicare (HMO) plan, including ground ambulance services with a $255 copay and air ambulance services with 20% coinsurance. Transportation services to health-related locations are not covered.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered by the Cigna Preferred Medicare (HMO) plan. Emergency Services and Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation have a $125 copay, while Urgently Needed Services has a $55 copay; all services have no coinsurance.
Primary Care See details
The Cigna Preferred Medicare (HMO) plan covers primary care physician services, chiropractic services with a $20 copay, occupational therapy services with a $30 copay, physician specialist services with a $30 copay, other health care professional services with a copay between $0 and $30, physical therapy and speech-language pathology services with a $30 copay, additional telehealth benefits with a copay between $0 and $30, and opioid treatment program services with a $30 copay. Mental health specialty services and psychiatric services are partially covered, with individual and group sessions not covered, and podiatry services are not covered.
Preventive Services See details
The Cigna Preferred Medicare (HMO) plan covers preventive services, including annual physical exams, health education, kidney disease education, fitness benefits, glaucoma screenings, diabetes self-management training, barium enemas, digital rectal exams, and EKGs following a Welcome Visit. However, 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, additional sessions of smoking cessation counseling, enhanced disease management, telemonitoring services, remote access technologies, home and bathroom safety devices, and counseling services are not covered.
Hearing Services See details
Hearing services are covered by the Cigna Preferred Medicare (HMO) plan, including routine hearing exams with a $25 copay. Prescription hearing aids (all types) are covered with a copay between $399 and $1800, while hearing aids for the inner ear, outer ear, and over the ear are not covered. OTC hearing aids are not covered.
Vision Services See details
Cigna Preferred Medicare (HMO) covers vision services, including routine eye exams with a copay of $0-$30, and eyewear, including contact lenses, eyeglasses (lenses and frames), eyeglass lenses, and eyeglass frames, with a combined maximum benefit of $200 every year. Routine eye exams are limited to one per year.
Dental Services See details
Dental Services are covered, including Medicare Dental Services with a $30 copay, and other dental services, with a maximum plan benefit of $1650 per year. The plan 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.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered under the Cigna Preferred Medicare (HMO) plan, with a copay of $35 for Medicare Part B Insulin Drugs and a coinsurance between 0% and 20% for all services. Prior authorization is required for this benefit.
Dialysis Services See details
Dialysis Services are covered by the Cigna Preferred Medicare (HMO) plan, but require prior authorization. You will pay 20% coinsurance.
Medical Equipment See details
Medical Equipment benefits include Durable Medical Equipment, Prosthetics/Medical Supplies, and Diabetic Equipment. Durable Medical Equipment has a 20% coinsurance, and Durable Medical Equipment for use outside the home is not covered. Prosthetic Devices and Medical Supplies have a 20% coinsurance, and Diabetic Supplies are not covered, while Diabetic Therapeutic Shoes/Inserts have a 20% coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services include coverage for all diagnostic services, with a copay between $0 and $75 for diagnostic procedures/tests, and no copay for lab services. Diagnostic radiological services have a copay of at most $200, therapeutic radiological services have a copay of $80 or more, and outpatient X-ray services have no copay.
Home Health Services See details
Home Health Services are covered by the Cigna Preferred 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 Preferred Medicare (HMO) plan. Prior authorization is required for this benefit.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the Cigna Preferred Medicare (HMO) plan, but require prior authorization. For days 1-20, the copay is $10 per day, and for days 21-100, the copay is $214 per day; additional days beyond Medicare-covered for SNF and non-Medicare-covered stays for SNF are not covered.
Other Services See details
The Cigna Preferred Medicare (HMO) plan's "Other Services" benefit covers Over-the-Counter (OTC) items, with a maximum benefit of $30 every three months, and includes nicotine replacement therapy and Naloxone coverage. 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. The plan also provides a meal benefit for chronic illnesses and medical conditions.
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