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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 Arkansas. 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 $20.90. 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 $7700.00 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 a $590 deductible for prescription drugs. After the deductible, you will pay the costs for your drugs based on the tier and pharmacy type, until your total drug costs reach $2000. Once you reach $2000 in total drug costs, you pay nothing for your Part D covered drugs. If you qualify for the low-income subsidy (LIS), your monthly premium for Part D will be $20.90. Please refer to the plan's formulary for specific drug coverage details and costs at each tier.
Additional Benefits
The Cigna TotalCare (HMO D-SNP) plan offers comprehensive coverage, including inpatient and outpatient hospital services with varying copays and coinsurance. Emergency services have a copay, while preventive services are covered. This plan also provides benefits for vision, dental, and hearing services, along with coverage for home health, medical equipment, and ambulance services. However, it's important to note that certain services like cardiac rehabilitation, some mental health services, and additional hours of care are not covered.
Inpatient Hospital See details
Inpatient Hospital benefits, including acute and psychiatric, are covered. For Inpatient Hospital-Acute, you will pay a copay of $222 for days 1-10, and no copay for days 11-90; additional days, non-Medicare covered stays, and upgrades are not covered. For Inpatient Hospital Psychiatric, you will pay a copay of $187 for days 1-10, and no copay for days 11-90; additional days and non-Medicare covered stays are not covered.
Outpatient Services See details
Outpatient Services, including outpatient hospital services and observation services, are covered. Outpatient hospital services have a coinsurance between 0% and 20%, while observation services have a 20% coinsurance. Ambulatory Surgical Center (ASC) Services and Outpatient Substance Abuse Services are covered, with coinsurance between 0% and 20% for ASC services and 20% for both individual and group sessions.
Partial Hospitalization See details
Partial Hospitalization is covered by the Cigna TotalCare (HMO D-SNP) plan, with a copay of $80.00. Prior authorization is required for this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered, with a 20% coinsurance for both ground and air ambulance services and no copay. Transportation Services to any health-related location are covered for up to 40 one-way trips per year. Transportation Services to any other health-related location are not covered.
Emergency Services See details
Emergency Services, including Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation, are covered by the Cigna TotalCare (HMO D-SNP) plan with a $110 copay and no coinsurance, while Urgently Needed Services have a $45 copay and no coinsurance. Worldwide Emergency Services has a maximum plan benefit coverage of $50,000.
Primary Care See details
The Cigna TotalCare (HMO D-SNP) plan covers primary care physician services, chiropractic services (20% coinsurance), occupational therapy (20% coinsurance), physician specialist services (20% coinsurance), and physical therapy and speech-language pathology services (20% coinsurance). The plan does not cover routine chiropractic care, individual or group sessions for mental health specialty services, podiatry services, or individual/group sessions for psychiatric services.
Preventive Services See details
The Cigna TotalCare (HMO D-SNP) plan covers preventive services including Medicare-covered services, annual physical exams, health education, kidney disease education services, and other preventive services like glaucoma screening and diabetes self-management training. However, this plan does not cover 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 modifications, or counseling services.
Hearing Services See details
Hearing exams, routine hearing exams, and fitting/evaluation for hearing aids are covered, with one routine hearing exam and fitting/evaluation per year. Prescription hearing aids are partially covered, with a copay between $399 and $1800 for all types, but not for inner ear, outer ear, or over-the-ear hearing aids. OTC hearing aids are not covered.
Vision Services See details
Vision services include routine eye exams and eyewear. The plan covers one routine eye exam per year, and eyewear, including contact lenses, eyeglass lenses and frames, and upgrades, with a combined maximum benefit of $400 per year.
Dental Services See details
The Cigna TotalCare (HMO D-SNP) plan covers dental services, including Medicare Dental Services with 20% coinsurance and other dental services with a maximum benefit of $2500 per year. This plan also covers 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.
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, but require prior authorization. You will pay 20% coinsurance for these services.
Medical Equipment See details
Medical Equipment benefits include coverage for Durable Medical Equipment (DME) with 20% coinsurance, Prosthetic Devices with 20% coinsurance, and Medical Supplies with 20% coinsurance. Diabetic Therapeutic Shoes/Inserts are covered with 20% coinsurance, while Durable Medical Equipment for use outside the home and Diabetic Supplies are not covered.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered. Diagnostic Procedures/Tests and Diagnostic Radiological Services have a coinsurance of up to 20%, and Lab Services have no copay. Therapeutic Radiological Services and Outpatient X-Ray Services have a coinsurance of at least 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, 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 not covered by the Cigna TotalCare (HMO D-SNP) plan. The plan does not cover Medicare-covered Intensive Cardiac Rehabilitation Services, Medicare-covered Pulmonary Rehabilitation Services, Medicare-covered Supervised Exercise Therapy (SET) for Symptomatic Peripheral Artery Disease (PAD) Services, or Additional Cardiac Rehabilitation Services.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by Cigna TotalCare (HMO D-SNP), 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
The Cigna TotalCare (HMO D-SNP) plan does not cover 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. Over-the-counter (OTC) items are covered with a maximum of $100 every three months, and meal benefits are covered for chronic illnesses or medical conditions that require the enrollee to stay at home.
Get Personalized Help from a licensed insurance agent
1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
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