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Cigna Preferred AL Medicare (HMO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Cigna Preferred AL 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 AL Medicare (HMO) in 2025, please refer to our full plan details page.
Cigna Preferred AL Medicare (HMO) is a HMO plan offered by The Cigna Group available for enrollment in 2025 to people living in Alabama. This plan received an overall rating of 4.5 out of 5 stars in 2025.
It's important to know that Cigna Preferred AL 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 AL 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 AL 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 $6900.00 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 AL Medicare (HMO) plan has an "Enhanced Alternative" drug benefit. There is no deductible for prescription drugs. In the initial coverage phase, you will pay a copay for your prescriptions. For example, a preferred generic drug has a $10 copay at a preferred pharmacy. The plan also has a catastrophic coverage phase where you pay nothing for covered drugs after your yearly out-of-pocket drug costs reach $2000.00.
Additional Benefits
The Cigna Preferred AL Medicare (HMO) plan offers a range of benefits, including inpatient hospital stays with copays, outpatient services, and partial hospitalization. Emergency services, primary care, and preventive services like annual physical exams are also covered, with varying copays. The plan provides coverage for hearing, vision, and dental services, with specific copays and annual maximums for some services. This plan includes coverage for ambulance services, diagnostic and radiological services, and home health services with no copay, but requires prior authorization for some services. Additionally, the plan offers other benefits like over-the-counter items and a meal benefit, but excludes certain services such as cardiac rehabilitation services and additional hours of care.
Inpatient Hospital See details
Inpatient Hospital services are covered by the Cigna Preferred AL Medicare (HMO) plan, with a copay of $285 for days 1-7 and no copay for days 8-90 for Inpatient Hospital-Acute services, and a copay of $595 for days 1-3 and no copay for days 4-90 for Inpatient Hospital Psychiatric services. Additional days and upgrades for Inpatient Hospital-Acute and Inpatient Hospital Psychiatric are not covered, and Non-Medicare-covered stays for both are also not covered.
Outpatient Services See details
Outpatient Services include outpatient hospital services with a copay between $0 and $350, observation services with a $300 copay, ambulatory surgical center services with no copay, individual and group outpatient substance abuse sessions with a $35 copay, and outpatient blood services. Prior authorization is required for many of these services.
Partial Hospitalization See details
Partial Hospitalization is covered by the Cigna Preferred AL Medicare (HMO) plan, with an $80 copay. Prior authorization is required for this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by the Cigna Preferred AL Medicare (HMO) plan. Ground ambulance services have a $250 copay, while air ambulance services have 20% coinsurance. Transportation services to any health-related location are not covered.
Emergency Services See details
Emergency Services, Urgently Needed Services, Worldwide Emergency Services, Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation are covered by the Cigna Preferred AL Medicare (HMO) plan. Emergency Services and Worldwide Emergency Coverage have a $110 copay, and Urgently Needed Services have a $45 copay, and there is a $50,000 maximum plan benefit coverage for Worldwide Emergency Services.
Primary Care See details
The Cigna Preferred AL Medicare (HMO) plan covers primary care physician services, chiropractic services (with a $15 copay), occupational therapy (with a $35 copay), physician specialist services (with a $35 copay), physical therapy and speech-language pathology services (with a $35 copay), additional telehealth benefits (with a $0-$35 copay), and opioid treatment program services (with a $35 copay). Routine chiropractic care, individual and group sessions for mental health and psychiatric services, and podiatry services are not covered.
Preventive Services See details
The Cigna Preferred AL Medicare (HMO) plan covers a variety of preventive services, including Medicare-covered preventive services, an annual physical exam, health education, kidney disease education services, and other preventive services like glaucoma screening, diabetes self-management training, barium enemas, digital rectal exams, and EKG following a Welcome Visit. Additional preventive services like 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.
Hearing Services See details
Hearing Services with the Cigna Preferred AL Medicare (HMO) plan include routine hearing exams with a $35 copay, and fitting/evaluation for hearing aids with 1 visit covered every year. Prescription hearing aids (all types) are covered with a copay between $399 and $1800, but Prescription Hearing Aids - Inner Ear, Outer Ear, and Over the Ear, as well as OTC hearing aids are not covered.
Vision Services See details
The Cigna Preferred AL Medicare (HMO) plan covers vision services, including routine eye exams with a copay of $0-$35, and eyewear. The plan offers one routine eye exam per year, and covers contact lenses, eyeglasses (lenses and frames), eyeglass lenses, and eyeglass frames. There is a combined maximum benefit of $150 per year for eyewear.
Dental Services See details
Dental services are covered by Cigna Preferred AL Medicare (HMO), including Medicare Dental Services with a $35 copay, and other dental services up to a $600 maximum per year. 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, with prior authorization required. For Medicare Part B Insulin Drugs, there is a $35 copay and a coinsurance between 0% and 20%. For Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs, there is a coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered under the Cigna Preferred AL Medicare (HMO) plan, but require prior authorization. You will pay 20% coinsurance for these services.
Medical Equipment See details
Medical equipment is covered, including durable medical equipment with 20% coinsurance, prosthetic devices with 20% coinsurance, and medical supplies with 20% coinsurance. Durable medical equipment for use outside the home and diabetic supplies are not covered, and diabetic therapeutic shoes/inserts have a 20% coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services, including Diagnostic Procedures/Tests, Lab Services, and Outpatient X-Ray Services, are covered by the Cigna Preferred AL Medicare (HMO) plan. Diagnostic Procedures/Tests have a copay between $0 and $200, Lab Services have no copay, Diagnostic Radiological Services have a copay up to $225, and Therapeutic Radiological Services have a copay of $80 or more, while Outpatient X-Ray Services have no copay.
Home Health Services See details
Home Health Services are covered by the Cigna Preferred AL Medicare (HMO) 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 under the Cigna Preferred AL Medicare (HMO) plan, but the plan states that these services are not covered. Prior authorization is required.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by Cigna Preferred AL Medicare (HMO) with prior authorization. You will have no copay for days 1-20, and a $214 copay for days 21-100; additional days beyond Medicare-covered and non-Medicare-covered stays are not covered.
Other Services See details
Other Services include coverage for over-the-counter (OTC) items, with a maximum benefit of $35 every three months, and a meal benefit for chronic illnesses or medical conditions requiring the enrollee to stay 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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