A non-government entity
Cigna Premier Medicare (HMO-POS)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Cigna Premier Medicare (HMO-POS). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Cigna Premier Medicare (HMO-POS) in 2025, please refer to our full plan details page.
Cigna Premier Medicare (HMO-POS) is a HMO-POS 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 Premier Medicare (HMO-POS) 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 Premier Medicare (HMO-POS).
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 Premier Medicare (HMO-POS), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $51.00. 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 $6150.00 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 Premier Medicare (HMO-POS) plan has an enhanced alternative drug benefit. There is no deductible for prescription drugs. During the initial coverage phase, you will pay a copay for your prescriptions, which varies depending on the drug tier and the pharmacy you use. For example, preferred generic drugs have a $10 copay at preferred pharmacies. After your total drug costs reach $2,000, you enter the catastrophic coverage phase where you pay nothing for your Part D covered drugs.
Additional Benefits
The Cigna Premier Medicare (HMO-POS) plan offers a variety of benefits with varying costs. Hospital stays cost $295 for days 1-6, with no copay for days 7-90. Outpatient services and primary care visits have copays ranging from $0-$30, while emergency services have a $125 copay. This plan covers preventive services, routine hearing and vision exams, and dental services, with specific copays or coinsurance for each. Additional benefits include home health services with no copay, and some coverage for medical equipment and durable medical equipment with 20% coinsurance.
Inpatient Hospital See details
Inpatient Hospital benefits are covered, with a copay of $295 for days 1-6, and no copay for days 7-90. Additional days for Inpatient Hospital-Acute, Non-Medicare-covered Stay for Inpatient Hospital-Acute, Upgrades for Inpatient Hospital-Acute, Additional Days for Inpatient Hospital Psychiatric, and Non-Medicare-covered Stay 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, while observation services have a $295 copay. Ambulatory surgical center services have no copay, and individual and group sessions for outpatient substance abuse have a copay of $30. Outpatient blood services are also covered.
Partial Hospitalization See details
Partial Hospitalization is covered under the Cigna Premier Medicare (HMO-POS) plan, but prior authorization is required. The copay for this benefit is $105.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by the Cigna Premier Medicare (HMO-POS) plan, with prior authorization required for all ambulance services. Ground ambulance services have a $270 copay, while air ambulance services have a 20% coinsurance. Transportation services to any health-related location are not covered.
Emergency Services See details
The Cigna Premier Medicare (HMO-POS) plan covers emergency services with a $125 copay and no coinsurance, and urgently needed services with a $30 copay and no coinsurance. Worldwide emergency services, including Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation, are covered with a $125 copay and no coinsurance, with a maximum plan benefit coverage of $50,000.
Primary Care See details
The Cigna Premier Medicare (HMO-POS) 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, physical therapy and speech-language pathology services with a $30 copay, and additional telehealth benefits with a copay between $0 and $30. This plan does not cover routine chiropractic care, individual or group sessions for mental health specialty services, podiatry services, or individual or group sessions for psychiatric services. Other health care professional and opioid treatment program services are covered, with a copay that varies between $0 and $30.
Preventive Services See details
The Cigna Premier Medicare (HMO-POS) plan covers preventive services including Medicare-covered services, annual physical exams, health education, kidney disease education services, glaucoma screenings, diabetes self-management training, barium enemas, digital rectal exams, EKG following Welcome Visit, and fitness benefits, but does not cover in-home safety assessments, personal emergency response systems, medical nutrition therapy, 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 benefits, home-based palliative care, in-home support services, support for caregivers, 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 $30 copay, and fitting/evaluation for hearing aids. 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
Vision services include eye exams with a copay of $0-$30, and also cover routine eye exams. Eyewear is covered with a combined maximum of $300 per year, and includes contact lenses, eyeglasses (lenses and frames), eyeglass lenses, and eyeglass frames. Upgrades are also covered.
Dental Services See details
The Cigna Premier Medicare (HMO-POS) plan offers dental services, including Medicare Dental Services with a $30 copay, and other dental services with a $1,600 annual maximum. Oral exams, dental x-rays, and other diagnostic dental services have no copay.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered by the Cigna Premier Medicare (HMO-POS) plan. For Medicare Part B Insulin Drugs, there is a $35 copay, and the coinsurance is between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered by the Cigna Premier Medicare (HMO-POS) plan, but require prior authorization. You will pay a 20% coinsurance for these services.
Medical Equipment See details
The Cigna Premier Medicare (HMO-POS) plan covers Durable Medical Equipment (DME) with a 20% coinsurance and requires prior authorization, but does not cover DME for use outside the home. Prosthetic Devices and Medical Supplies are covered with a 20% coinsurance, and Diabetic Therapeutic Shoes/Inserts are covered with a 20% coinsurance, while Diabetic Supplies are not covered.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered, including Diagnostic Procedures/Tests with a minimum copay of $0 and a maximum copay of $150, Lab Services with no copay, Diagnostic Radiological Services with a copay of at most $200, Therapeutic Radiological Services with a minimum copay of $30, and Outpatient X-Ray Services with no copay. Prior authorization is required for all services.
Home Health Services See details
Home Health Services are covered by the Cigna Premier Medicare (HMO-POS) plan with no copay or coinsurance, but prior 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 Premier Medicare (HMO-POS) plan. Prior authorization is required for these services.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the Cigna Premier Medicare (HMO-POS) plan, but require prior authorization. For days 1-20, there is no copay, and for days 21-100, there is a $214 copay.
Other Services See details
Under the Cigna Premier Medicare (HMO-POS) plan, 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. Over-the-counter (OTC) items are covered with a maximum benefit of $50 every three months. The plan also offers a meal benefit for chronic illness or conditions that require the enrollee to stay at home.
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1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
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