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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 Arkansas. 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 $20.90. 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 $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 as outlined in the plan's formulary. This plan's premium may be reduced if you qualify for the low-income subsidy. With this subsidy, your monthly premium for Part D is $20.90.
Additional Benefits
The Cigna TotalCare Plus (HMO D-SNP) plan offers a range of benefits with varying costs. Many services have a coinsurance, including outpatient, primary care, preventive, and diagnostic services, which can be up to 20%. Emergency services have a $110 copay, while urgently needed services have a $45 copay. The plan also covers hearing, vision, and dental services, with specific copays and coinsurance amounts depending on the service. Additionally, the plan includes transportation services, medical equipment, and home health services, as well as coverage for OTC items. Some services may require prior authorization, and some services have no copay, such as home health services.
Inpatient Hospital See details
Inpatient Hospital benefits, including acute and psychiatric care, are covered under the Cigna TotalCare Plus (HMO D-SNP) plan, but additional days for both acute and psychiatric care, and non-Medicare-covered stays are not covered. You will have a copay for these services.
Outpatient Services See details
Outpatient services are covered under the Cigna TotalCare Plus (HMO D-SNP) plan, with varying coinsurance depending on the service. Outpatient Hospital Services have a coinsurance between 0% and 20%, and Observation Services have a 20% coinsurance. Individual and group sessions for outpatient substance abuse have a coinsurance of 20%.
Partial Hospitalization See details
Cigna TotalCare Plus (HMO D-SNP) covers partial hospitalization with a 20% coinsurance, and prior authorization is required.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered under the Cigna TotalCare Plus (HMO D-SNP) plan. Ground and air ambulance services have a 20% coinsurance, and there is no copay. Transportation Services to a plan-approved health-related location are covered for up to 40 one-way trips per year. Transportation services to any health-related location are not covered.
Emergency Services See details
Emergency Services, Urgently Needed Services, Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation are covered. Emergency Services, Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation have a $110 copay with no coinsurance. Urgently Needed Services has a $45 copay with no coinsurance.
Primary Care See details
The Cigna TotalCare Plus (HMO D-SNP) plan covers a variety of primary care services, including Primary Care Physician Services, Chiropractic Services, Occupational Therapy Services, Physician Specialist 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, have a 20% coinsurance, while Telehealth Services have a coinsurance between 0% and 20%. Routine Chiropractic Care, Individual and Group Sessions for Mental Health and Psychiatric Services, and Podiatry Services are not covered.
Preventive Services See details
Preventive services are covered, including Medicare-covered services with no copay; 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 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 of enrollees, additional sessions of smoking and tobacco cessation counseling, enhanced disease management, telemonitoring services, remote access technologies, home and bathroom safety devices, and counseling services are not covered. Annual physical exams have a 20% coinsurance, and fitness benefits are covered.
Hearing Services See details
Hearing services include routine hearing exams with a coinsurance of at most 20%, as well as fitting/evaluation for hearing aids. Prescription hearing aids are partially covered, with a copay between $399 and $1800 for all types of hearing aids, but inner ear, outer ear, and over the ear prescription hearing aids are not covered.
Vision Services See details
Vision services are covered, including eye exams, eyewear, and upgrades. Routine eye exams have a coinsurance of 0% to 20% and are limited to one exam per year. Eyewear has a combined maximum benefit of $400 every year, and contact lenses are covered.
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 $2950 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 and fixed), maxillofacial prosthetics, implant services, and oral and maxillofacial surgery are covered with no coinsurance.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, but prior authorization is required. For Medicare Part B Insulin Drugs, there is a $35 copay and coinsurance between 0% and 20%. For Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs, there is coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered, but require prior authorization. You will pay a 20% coinsurance for these services.
Medical Equipment See details
Medical Equipment coverage includes Durable Medical Equipment (DME) with 20% coinsurance and no copay, Prosthetics/Medical Supplies with 20% coinsurance and no copay, and Diabetic Therapeutic Shoes/Inserts with a 20% coinsurance and no copay, but does not cover Durable Medical Equipment for use outside the home or Diabetic Supplies.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered. 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 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 Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, and SET for PAD Services are not covered. Prior authorization is required, and coinsurance applies.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the Cigna TotalCare Plus (HMO D-SNP) plan, but prior authorization is required. The plan does not cover additional days beyond Medicare-covered SNF stays or 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 $100 every three months, including Nicotine Replacement Therapy and Naloxone. 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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