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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 Alabama. 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 $4900.00 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. During the initial coverage phase, you will 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 and $20 at standard pharmacies. Once your total drug costs reach $2,000, you enter the catastrophic coverage phase, where you pay nothing for your Part D covered drugs. If you qualify for the low-income subsidy, you will pay $0 for your prescriptions.
Additional Benefits
The Cigna Preferred Medicare (HMO) plan offers comprehensive coverage, including inpatient and outpatient services, with varying copays. Emergency services and transportation are covered, and preventive services are available with no copay. Vision and dental benefits, including exams and eyewear, are included, and there's coverage for hearing exams and hearing aids. This plan also provides benefits for home health, skilled nursing, and home infusion services, often with copays or coinsurance. Additional benefits include coverage for OTC items and meal benefits, while some services like cardiac rehabilitation and certain therapies are not covered.
Inpatient Hospital See details
Inpatient Hospital coverage includes both Inpatient Hospital-Acute and Inpatient Hospital Psychiatric services, with prior authorization required. For Inpatient Hospital-Acute, you'll pay a $310 copay for days 1-6, and no copay for days 7-90, while Inpatient Hospital Psychiatric has a $290 copay for days 1-6, and no copay for days 7-90. Additional days and upgrades for Inpatient Hospital-Acute, and additional days and non-Medicare-covered stays for Inpatient Hospital Psychiatric are not covered.
Outpatient Services See details
Outpatient Services includes coverage for Outpatient Hospital Services with a copay between $0 and $295, Observation Services with a $310 copay, Ambulatory Surgical Center (ASC) Services with no copay, and Outpatient Substance Abuse Services. Also covered are Individual and Group Sessions for Outpatient Substance Abuse, each with a $20 copay, and Outpatient Blood Services.
Partial Hospitalization See details
Cigna Preferred Medicare (HMO) covers partial hospitalization with a $105 copay. Prior authorization is required.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by the Cigna Preferred Medicare (HMO) plan. Ground ambulance services have a copay of $255, while air ambulance services have a 20% coinsurance. Transportation to plan-approved health-related locations is covered for up to 10 one-way trips per year, while transportation to any health-related location is not covered.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered by the Cigna Preferred Medicare (HMO) plan. Emergency Services and Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation each have a $125 copay, and Urgently Needed Services has a $55 copay; all have no coinsurance.
Primary Care See details
The Cigna Preferred Medicare (HMO) plan covers primary care, chiropractic services with a $20 copay, occupational therapy services with a $20 copay, and physician specialist services with a $15 copay. This plan does not cover individual or group sessions for mental health specialty services, podiatry services, individual or group sessions for psychiatric services, or routine chiropractic care. The plan also covers physical therapy and speech-language pathology services with a $20 copay, additional telehealth benefits with a copay between $0 and $15, and opioid treatment program services with a copay between $20 and $20.
Preventive Services See details
The Cigna Preferred Medicare (HMO) plan covers preventive services, including Medicare-covered services with no copay, annual physical exams, health education, kidney disease education services, glaucoma screening, diabetes self-management training, barium enemas, digital rectal exams, EKG following Welcome Visit, and fitness benefits. However, this plan does not cover 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, Home and Bathroom Safety Devices and Modifications, or Counseling Services.
Hearing Services See details
Hearing exams are covered with a $15 copay. Prescription hearing aids are covered, with a copay between $399 and $1800, but inner ear, outer ear, and over the ear hearing aids are not covered.
Vision Services See details
The Cigna Preferred Medicare (HMO) plan covers vision services, including routine eye exams with a copay of $0 - $15, and eyewear with a combined maximum benefit of $300 every year. Contact lenses and upgrades are also covered.
Dental Services See details
Dental services are covered under the Cigna Preferred Medicare (HMO) plan, including Medicare Dental Services with a $15 copay, and other dental services with a $1,500 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 and fixed), maxillofacial prosthetics, implant services, oral and maxillofacial surgery, and orthodontics are also covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, and require prior authorization. For Medicare Part B Insulin Drugs, you pay a $35 copay and between 0% and 20% coinsurance; other Medicare Part B drugs have between 0% and 20% coinsurance.
Dialysis Services See details
Dialysis Services are covered by the Cigna Preferred Medicare (HMO) plan, but require prior authorization. You will pay 20% coinsurance for these services.
Medical Equipment See details
Medical Equipment benefits include Durable Medical Equipment (DME) with 20% coinsurance and Prosthetic Devices 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 20% coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered, including diagnostic procedures/tests with a copay between $0 and $75, lab services with no copay, diagnostic radiological services with a copay up to $100, therapeutic radiological services with a copay up to $80, and outpatient X-ray services with no copay. Prior authorization is required for all diagnostic and radiological services.
Home Health Services See details
Home Health Services are covered by the Cigna Preferred Medicare (HMO) plan with no copay and no coinsurance, but authorization is required. 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 Cigna Preferred Medicare (HMO), but require prior authorization. For days 1-20, there is no copay, and for days 21-100, the copay is $214.
Other Services See details
The Cigna Preferred Medicare (HMO) plan covers Over-the-Counter (OTC) Items, with a maximum benefit coverage amount of $85 every three months. The plan also covers Meal Benefits for chronic illnesses or medical conditions requiring the enrollee to stay home. Acupuncture, Dual Eligible SNPs with Highly Integrated Services, and several other services are not covered.
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