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Cigna TotalCare (HMO D-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Cigna TotalCare (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 (HMO D-SNP) in 2025, please refer to our full plan details page.
Cigna TotalCare (HMO D-SNP) is a HMO D-SNP plan offered by The Cigna Group available for enrollment in 2025 to people living in Corpus Christi. This plan received an overall rating of 4.5 out of 5 stars in 2025.
It's important to know that Cigna TotalCare (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 (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 (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 (HMO D-SNP), 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 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 $3400.00 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 (HMO D-SNP) plan has an enhanced alternative drug benefit. You must first satisfy a deductible of $590. After the deductible, you will pay a copay for your prescriptions based on the drug tier and pharmacy. For preferred generic drugs, the copay is $12 at a preferred pharmacy or mail order, and $20 at a standard pharmacy. For standard generic drugs, the copay is $47, and for preferred brand drugs, the copay is $100. Non-preferred drugs have a 25% coinsurance. Once your total drug costs reach $2000, you enter the catastrophic coverage phase where you pay nothing for covered drugs.
Additional Benefits
The Cigna TotalCare (HMO D-SNP) plan offers a variety of benefits with varying costs. Hospital stays require a copay of $320 for the first five days, with no copay for the following days, and outpatient services have copays ranging from $0-$100. Emergency and urgent care services have copays of $140 and $10, respectively. The plan also covers primary care, preventive, vision, and dental services, often with no copay. Hearing aids have a copay between $399 and $1800. Transportation services have a copay for ground ambulance services and covers a limited number of trips to health-related locations.
Inpatient Hospital See details
Inpatient Hospital benefits, including Acute and Psychiatric, are covered with a $320 copay for days 1-5, and no copay for days 6-90. Additional days for Inpatient Hospital-Acute are covered, but Non-Medicare-covered stays and upgrades for Inpatient Hospital-Acute are not covered, as well as Additional Days for Inpatient Hospital Psychiatric and Non-Medicare-covered Stay for Inpatient Hospital Psychiatric.
Outpatient Services See details
Outpatient services are covered, including outpatient hospital services, observation services, ambulatory surgical center (ASC) services, and outpatient blood services. Outpatient hospital services have a copay between $0 and $100, observation services have a $100 copay, and ASC services have no copay; outpatient substance abuse services are not covered.
Partial Hospitalization See details
Cigna TotalCare (HMO D-SNP) covers partial hospitalization services, but prior authorization is required. The copay for this service is $130.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered. Ground ambulance services have a $100 copay, while air ambulance services have a 20% coinsurance. Transportation Services to a plan-approved health-related location are covered for up to 50 one-way trips per year. 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. For Emergency Services and Worldwide Emergency Coverage, the copay is $140, and for Urgently Needed Services, the copay is $10; all services have no coinsurance.
Primary Care See details
Primary Care Physician Services, Occupational Therapy Services, Physician Specialist Services, Physical Therapy and Speech-Language Pathology Services, Additional Telehealth Benefits, and Opioid Treatment Program Services are covered with no coinsurance, while Chiropractic Services, Mental Health Specialty Services, and Psychiatric Services require prior authorization and/or referral. Routine Chiropractic Care, Individual Sessions for Mental Health Specialty Services, Individual Sessions for Psychiatric Services, and Podiatry Services are not covered.
Preventive Services See details
The Cigna TotalCare (HMO D-SNP) plan covers preventive services with no copay, including annual physical exams, health education, and fitness benefits. Additional preventive services are covered, but 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, 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 are not covered. Kidney disease education services, and other preventive services are covered, but some require a referral.
Hearing Services See details
Hearing Services include routine hearing exams, fitting/evaluation for hearing aids, and prescription hearing aids. Routine hearing exams and fitting/evaluation for hearing aids are covered once per year, and prescription hearing aids are covered with a copay between $399 and $1800. Prescription hearing aids - inner ear, outer ear, and over the ear are not covered, and OTC hearing aids are not covered.
Vision Services See details
Vision services include routine eye exams, covered annually, and eyewear with a combined maximum benefit of $475 every year, including contact lenses, eyeglasses (lenses and frames), eyeglass lenses (1 pair annually), and eyeglass frames (1 pair annually). There is no copay or coinsurance for these benefits.
Dental Services See details
The Cigna TotalCare (HMO D-SNP) plan covers a range of dental services, including oral exams (up to 4 per year), dental x-rays (limited to 1 complete series or panoramic x-ray every three years, and 4 bitewing x-rays per year), other diagnostic services, prophylaxis (cleaning) (up to 2 per year), fluoride treatments (up to 2 per year), other preventive services, restorative services, adjunctive general services, endodontics, periodontics, prosthodontics (removable), and oral and maxillofacial surgery. The plan has a maximum benefit of $20,000 per year for dental services, and does not cover maxillofacial prosthetics, implant services, prosthodontics (fixed), or orthodontics.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, but require prior authorization. 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 TotalCare (HMO D-SNP) plan, but require prior authorization and a doctor referral. You will pay 20% coinsurance for these services.
Medical Equipment See details
Medical Equipment is covered, with Durable Medical Equipment (DME) and Prosthetics/Medical Supplies covered, and no copay or coinsurance for DME. Prosthetics and Medical Supplies have a 20% coinsurance. Diabetic equipment is covered, but Diabetic Supplies and Diabetic Therapeutic Shoes/Inserts are not covered.
Diagnostic and Radiological Services See details
The Cigna TotalCare (HMO D-SNP) plan covers lab services with no copay, but diagnostic procedures/tests, diagnostic radiological services, and outpatient X-ray services are not covered. Therapeutic radiological services are covered with a coinsurance of at most 20%.
Home Health Services See details
Home Health Services are covered by the Cigna TotalCare (HMO D-SNP) plan, with no copay and no coinsurance. However, Additional Hours of Care and Personal Care Services are not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are generally covered, but Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, and SET for PAD Services are not covered. Prior authorization and a doctor's referral are required for this benefit.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the Cigna TotalCare (HMO D-SNP) plan, but require prior authorization. For days 1-20, the copay is $20 per day, and for days 21-100, the copay is $214 per day.
Other Services See details
Other Services are partially covered by Cigna TotalCare (HMO D-SNP), with Over-the-Counter (OTC) Items and Meal Benefit benefits covered, 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 not covered. The OTC benefit has a maximum coverage amount of $250 every three months.
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