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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 Tennessee. This plan received an overall rating of 4.5 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 $17.20. 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 $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 meeting your deductible, you pay the costs for your prescriptions, though the specific costs for each drug tier are not available in this summary. Once your total drug costs reach $2000, you enter the next coverage phase. If you qualify for the low-income subsidy (LIS), your Part D premium is $17.20. After your yearly out-of-pocket drug costs reach $2000, you pay nothing for your Medicare Part D covered drugs.
Additional Benefits
The Cigna TotalCare Plus (HMO D-SNP) plan offers a wide range of benefits with varying cost-sharing. You can expect copays for services like emergency care ($110), and partial hospitalization ($80). Many services such as outpatient blood services, home health services, and lab services have no copay. This plan includes coverage for inpatient and outpatient services, including mental health and substance abuse treatment. It also covers preventive services, hearing, vision, and dental care, with costs varying depending on the specific service. Additionally, the plan offers benefits like ambulance services, home infusion, and medical equipment, each with its own cost-sharing structure.
Inpatient Hospital See details
The Cigna TotalCare Plus (HMO D-SNP) plan covers inpatient hospital stays, including acute and psychiatric care, with a copay. Additional days for inpatient hospital-acute and psychiatric care, along with non-Medicare covered stays and upgrades, 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 under the Cigna TotalCare Plus (HMO D-SNP) plan. Outpatient Hospital Services have a coinsurance between 0% and 20%, while Observation Services have a 20% coinsurance. Ambulatory Surgical Center (ASC) Services have a coinsurance between 0% and 20%. Individual and Group Sessions for Outpatient Substance Abuse have a 20% coinsurance. Outpatient Blood Services are covered with three (3) Pint Deductible Waived.
Partial Hospitalization See details
Partial Hospitalization is covered by the Cigna TotalCare Plus (HMO D-SNP) plan, but requires prior authorization. You will have an $80 copay for this service.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by the Cigna TotalCare Plus (HMO D-SNP) plan. Ground and air ambulance services have a 20% coinsurance, while there is no copay. Transportation Services to a plan-approved health-related location are covered for 24 one-way trips per year. Transportation services to any health-related location are not covered.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered under the Cigna TotalCare Plus (HMO D-SNP) plan. Emergency Services and Worldwide Emergency Coverage, Urgent Coverage, and Transportation have a $110 copay with no coinsurance. Urgently Needed Services have a $45 copay with 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, 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, physical therapy and speech-language pathology services, and other health care professionals have a 20% coinsurance, while the coinsurance for additional telehealth benefits ranges from 0% to 20%. The plan does not cover routine chiropractic care, individual or group sessions for mental health specialty services, individual or group sessions for psychiatric services, and podiatry services.
Preventive Services See details
Preventive services, including services not usually covered by Medicare plans, are covered. Annual physical exams have a 20% coinsurance, while other services like Health Education, Glaucoma Screening, and Diabetes Self-Management Training are covered with no copay or coinsurance. Some preventive services like In-Home Safety Assessment, Personal Emergency Response System (PERS), and Medical Nutrition Therapy (MNT) are not covered.
Hearing Services See details
Hearing services for the Cigna TotalCare Plus (HMO D-SNP) plan include hearing exams with a coinsurance of at most 20% and prescription hearing aids with a copay between $399 and $1800. The plan does not cover prescription hearing aids for the inner ear, outer ear, and over the ear, nor does it cover OTC hearing aids.
Vision Services See details
Vision Services include coverage for eye exams with a coinsurance of 0% to 20%, and eyewear including contact lenses, eyeglasses (lenses and frames), eyeglass lenses, and eyeglass frames; there is a combined maximum benefit of $400 for all eyewear per year. You are also covered for routine eye exams once 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 maximum benefit of $2,500 per year 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), maxillofacial prosthetics, implant services, prosthodontics (fixed), oral and maxillofacial surgery, and orthodontics are also covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered by the Cigna TotalCare Plus (HMO D-SNP) plan. For Medicare Part B Insulin Drugs, there is a $35 copay and 0-20% coinsurance. For Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs, there is 0-20% coinsurance.
Dialysis Services See details
Dialysis Services are covered under the Cigna TotalCare Plus (HMO D-SNP) plan. This benefit requires prior authorization, and has a coinsurance of 20%.
Medical Equipment See details
Medical Equipment benefits include Durable Medical Equipment (DME) with 20% coinsurance, Prosthetics/Medical Supplies with a 20% coinsurance, and Diabetic Therapeutic Shoes/Inserts with 20% coinsurance, all with no copay. Durable Medical Equipment for use outside the home and Diabetic Supplies are not covered.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered under the Cigna TotalCare Plus (HMO D-SNP) plan. Diagnostic Procedures/Tests and Diagnostic Radiological Services have a coinsurance of at most 20%, while 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 by Cigna TotalCare Plus (HMO D-SNP) with no copay and no coinsurance, but additional hours of care and personal care services are not covered. This benefit requires authorization.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered, but specific services including Cardiac Rehabilitation Services, Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, and SET for PAD Services are not covered. Prior authorization is required for covered services, and coinsurance may apply.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) benefits are covered by the Cigna TotalCare Plus (HMO D-SNP) plan, but prior authorization is required. This plan does not cover additional days beyond Medicare-covered SNF stays, nor does it cover non-Medicare-covered SNF stays.
Other Services See details
The Cigna TotalCare Plus (HMO D-SNP) plan covers Over-the-Counter (OTC) items, with a maximum benefit of $150.00 every three months, and also covers meal benefits for chronic illnesses or medical conditions that require the enrollee to remain at home. 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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