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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 Tennessee. This plan received an overall rating of 4.5 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 $5100.00 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 for your prescriptions, depending on the drug tier and the pharmacy you use. For example, preferred generic drugs have a $4 copay at preferred pharmacies. Once your total drug costs reach $2,000, you enter the catastrophic coverage phase where you pay nothing for Medicare Part D covered drugs. If you qualify for the low-income subsidy, you may have reduced premiums.
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 that vary by service type. Emergency and urgent care services have copays, and ambulance services have copays or coinsurance. This plan also includes coverage for primary care, hearing, vision, and dental services, each with its own cost structure. You'll find coverage for services like home health, skilled nursing facilities, and medical equipment, with copays or coinsurance applying in certain cases. Additionally, the plan covers diagnostic, radiological, and dialysis services.
Inpatient Hospital See details
Inpatient Hospital benefits, including acute and psychiatric, are covered. For Inpatient Hospital-Acute, you will pay a $280 copay for days 1-6, and no copay for days 7-90; for Inpatient Hospital Psychiatric, you will pay a $325 copay for days 1-6, and no copay for days 7-90.
Outpatient Services See details
Outpatient Services includes coverage for all outpatient hospital services, with a copay between $0 and $275, and observation services with a $275 copay. Ambulatory Surgical Center (ASC) Services have no copay, and outpatient substance abuse services have a $15 copay for both individual and group sessions. Outpatient blood services are also covered.
Partial Hospitalization See details
Cigna Preferred Medicare (HMO) covers partial hospitalization with a $105 copay. Prior authorization is required for this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by the Cigna Preferred Medicare (HMO) plan. Ground Ambulance Services have a $275 copay, and Air Ambulance Services have a 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 under 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 have a $30 copay. There is no coinsurance for any of these services.
Primary Care See details
The Cigna Preferred Medicare (HMO) plan covers primary care physician services, chiropractic services (with a $20 copay), occupational therapy (with a $20 copay), and physical therapy and speech-language pathology services (with a $20 copay). The plan also covers physician specialist services (with a $15 copay), other health care professionals (with a copay between $0 and $15), additional telehealth benefits (with a copay between $0 and $15), and opioid treatment program services (with a $15 copay). However, routine chiropractic care, individual and group sessions for mental health specialty services, individual and group sessions for psychiatric services, and podiatry services are not covered.
Preventive Services See details
Preventive Services, including Medicare-covered services, Annual Physical Exams, and other services are covered. Additional services such as In-Home Safety Assessment, Personal Emergency Response System (PERS), Medical Nutrition Therapy (MNT), 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 Benefit, 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 (including Web/Phone-based technologies and Nursing Hotline), Home and Bathroom Safety Devices and Modifications, and Counseling Services are not covered.
Hearing Services See details
Hearing services include hearing exams with a $15 copay, fitting/evaluation for hearing aids, and prescription hearing aids. Prescription hearing aids (all types) have a copay between $399 and $1800, while prescription hearing aids for inner ear, outer ear, and over the ear are not covered, nor are OTC hearing aids.
Vision Services See details
Vision services include coverage for eye exams with a copay of $0-$15, and eyewear, including contact lenses, eyeglasses (lenses and frames), eyeglass lenses, and eyeglass frames. Eyewear has a combined maximum plan benefit coverage of $200 every year.
Dental Services See details
Dental Services are covered, with a $2,050 annual maximum benefit. Medicare Dental Services require prior authorization and have a $15 copay.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered under the Cigna Preferred Medicare (HMO) plan and require prior authorization. Insulin has a $35 copay and a coinsurance between 0% and 20% for Medicare Part B drugs, while Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs have a coinsurance between 0% and 20%.
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 is covered by Cigna Preferred Medicare (HMO), with a 20% coinsurance for Durable Medical Equipment (DME), Prosthetic Devices, and Medical Supplies, and no copay. Durable Medical Equipment for use outside the home and Diabetic Supplies are not covered, while Diabetic Therapeutic Shoes/Inserts are covered with a 20% coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered by the Cigna Preferred Medicare (HMO) plan. Diagnostic Procedures/Tests have a copay between $0 and $150, while Lab Services have no copay. Diagnostic Radiological Services have a copay up to $200, and Therapeutic Radiological Services have a 20% coinsurance. 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. 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. There is no copay for days 1-20, and a $214 copay for days 21-100. Additional days beyond Medicare-covered for SNF and non-Medicare-covered stays for SNF are not covered.
Other Services See details
Other Services include Over-the-Counter (OTC) Items and Meal Benefits, but 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 have a maximum plan benefit coverage amount of $60.00 every three months.
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