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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 Alabama. 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 $23.10. 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 $5000.00 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 the deductible, you will pay the costs for drugs in each tier until your total drug costs reach $2000, at which point you enter the next coverage phase. If you qualify for the low-income subsidy, your Part D premium will be $23.10. During the catastrophic coverage phase, after your yearly out-of-pocket drug costs reach $2000, you pay nothing for Medicare Part D covered drugs.
Additional Benefits
The Cigna TotalCare Plus (HMO D-SNP) plan offers a wide range of benefits with a focus on keeping costs low for members. Many services, including inpatient hospital stays, primary care, and preventive services, have no copay. Emergency services and ambulance services are also covered, with no copay for emergency services and all ambulance services. The plan also includes coverage for hearing, vision, and dental services. Hearing aids have a copay, while vision services include routine eye exams and eyewear. Dental services have a yearly maximum benefit. Additionally, the plan covers home health services, medical equipment, and certain outpatient services, often with no copay or coinsurance.
Inpatient Hospital See details
Inpatient Hospital benefits, including acute and psychiatric care, are covered by the Cigna TotalCare Plus (HMO D-SNP) plan with no copay. However, additional days, and non-Medicare covered stays for both acute and psychiatric care are not covered.
Outpatient Services See details
Outpatient Services, including Outpatient Hospital Services, Observation Services, Ambulatory Surgical Center (ASC) Services, and Outpatient Blood Services, are covered under the Cigna TotalCare Plus (HMO D-SNP) plan. Individual and group sessions for Outpatient Substance Abuse are not covered.
Partial Hospitalization See details
Partial Hospitalization is covered by the Cigna TotalCare Plus (HMO D-SNP) plan, but requires prior authorization. This benefit does not specify any cost information.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by Cigna TotalCare Plus (HMO D-SNP). All ambulance services are covered with no copay, but with coinsurance for Medicare-covered ground ambulance services, and air ambulance services have a 20% coinsurance.
Transportation Services are partially covered, with coverage for transportation to a plan-approved health-related location, up to 50 one-way trips per year, and no copay. 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 by the Cigna TotalCare Plus (HMO D-SNP) plan. Emergency Services and Urgently Needed Services have no copay or coinsurance, while Worldwide Emergency Services has a $125 copay for Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation, with a maximum plan benefit coverage amount of $50,000.
Primary Care See details
Primary Care Physician Services, Occupational Therapy Services, Physician Specialist Services, Physical Therapy and Speech-Language Pathology Services, and Additional Telehealth Benefits are covered with no copay and no coinsurance, while Chiropractic Services, Mental Health Specialty Services, Psychiatric Services, and Opioid Treatment Program Services are covered, but require prior authorization. Podiatry Services are not covered.
Preventive Services See details
The Cigna TotalCare Plus (HMO D-SNP) plan covers preventive services, including annual physical exams, health education, kidney disease education services, and other preventive services like glaucoma screening, diabetes self-management training, barium enemas, digital rectal exams, and EKGs following a Welcome Visit. However, in-home safety assessments, personal emergency response systems, medical nutrition therapy, and other services are not covered. The plan also offers a fitness benefit.
Hearing Services See details
Hearing exams, routine hearing exams, and fitting/evaluation for hearing aids are covered. Prescription hearing aids are covered with a copay between $399 and $1800, while inner ear, outer ear, and over-the-ear prescription hearing aids, and OTC hearing aids are not covered.
Vision Services See details
The Cigna TotalCare Plus (HMO D-SNP) plan covers vision services, including routine eye exams with one visit every year, and eyewear with a combined maximum benefit of $350 every year. Contact lenses, eyeglasses (lenses and frames), eyeglass lenses, eyeglass frames, and upgrades are also covered.
Dental Services See details
Dental services are covered with a maximum plan benefit of $3,000 every 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 and fixed), maxillofacial prosthetics, implant services, oral and maxillofacial surgery, and orthodontics are 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 with prior authorization required. There is no copay or coinsurance for this benefit.
Medical Equipment See details
Medical Equipment is covered by Cigna TotalCare Plus (HMO D-SNP), including Durable Medical Equipment (DME) and Prosthetics/Medical Supplies, with no copay or coinsurance; however, Durable Medical Equipment for use outside the home, Prosthetic Devices, Medical Supplies, Diabetic Supplies, and Diabetic Therapeutic Shoes/Inserts are not covered. Diabetic Equipment requires prior authorization.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are partially covered under the Cigna TotalCare Plus (HMO D-SNP) plan. Lab Services are covered with no copay, while Diagnostic Procedures/Tests, Diagnostic Radiological Services, Therapeutic Radiological Services, and Outpatient X-Ray Services are not covered.
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. Prior authorization is required for this benefit.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are technically covered, but not covered in practice. The plan does not cover Cardiac Rehabilitation Services, Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, or SET for PAD Services.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the Cigna TotalCare Plus (HMO D-SNP) plan, with no copay for days 1-100. Additional days beyond Medicare-covered, and non-Medicare-covered stays are not covered.
Other Services See details
The Cigna TotalCare Plus (HMO D-SNP) plan covers Over-the-Counter (OTC) items up to $225 every three months, including Nicotine Replacement Therapy (NRT) 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. The plan also covers a meal benefit for chronic illness or medical conditions requiring the member to remain at home.
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1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
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