A non-government entity
Cigna Preferred Savings Medicare (HMO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Cigna Preferred Savings 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 Savings Medicare (HMO) in 2025, please refer to our full plan details page.
Cigna Preferred Savings Medicare (HMO) is a HMO plan offered by The Cigna Group available for enrollment in 2025 to people living in Texas. This plan received an overall rating of 4.5 out of 5 stars in 2025.
It's important to know that Cigna Preferred Savings 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 Savings 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 Savings 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. Additionally, this plan comes with a Part B Premium reduction of $125.00. You must continue to pay paying your reduced 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 $6900.00 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 Savings Medicare (HMO) plan has an enhanced alternative drug benefit with no deductible. During the initial coverage phase, you will pay the following for your prescriptions: preferred generic drugs have no copay at preferred pharmacies and mail order, and a $10 copay at standard pharmacies. Standard generic drugs have a $45 copay at preferred pharmacies and mail order, and a $47 copay at standard pharmacies. Preferred brand drugs have a $100 copay regardless of pharmacy. Non-preferred drugs have 33% coinsurance, regardless of pharmacy. Once your total drug costs reach $2,000, you enter the catastrophic coverage phase where you pay nothing for covered Part D drugs. If you qualify for the low-income subsidy, you may be eligible for a premium reduction.
Additional Benefits
The Cigna Preferred Savings Medicare (HMO) plan offers a range of benefits with varying cost-sharing. Inpatient hospital stays require a $320 copay for days 1-6 and no copay for days 7-90, while outpatient services have copays ranging from $0 to $350. Emergency services have a $110 copay, and primary care visits cost $45. Preventive services and home health services are available with no copay. The plan also includes coverage for hearing, vision, and dental services, as well as home infusion and dialysis services with coinsurance. Other benefits include ambulance services, diagnostic and radiological services, and skilled nursing facility stays.
Inpatient Hospital See details
Inpatient Hospital coverage includes acute and psychiatric care with a $320 copay for days 1-6 and no copay for days 7-90; additional days for inpatient hospital-acute are covered, while non-Medicare-covered stays and upgrades are not covered. Inpatient Hospital Psychiatric coverage has the same cost-sharing structure as acute care.
Outpatient Services See details
Outpatient services with the Cigna Preferred Savings Medicare (HMO) plan include coverage for outpatient hospital services with a copay between $0 and $350, observation services with a $350 copay, and Ambulatory Surgical Center (ASC) services with no copay. The plan also covers outpatient substance abuse services with a $45 copay for both individual and group sessions, and outpatient blood services.
Partial Hospitalization See details
Partial Hospitalization is covered by the Cigna Preferred Savings Medicare (HMO) plan, with an $80 copay. Prior authorization is required.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by the Cigna Preferred Savings Medicare (HMO) plan, with prior authorization required for all ambulance services. Ground ambulance services have a $240 copay, while air ambulance services have a 20% coinsurance. 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 Preferred Savings Medicare (HMO) plan. Emergency Services and Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation have a $110 copay, and Urgently Needed Services have a $35 copay. Worldwide Emergency Services have a maximum plan benefit coverage of $50,000.
Primary Care See details
The Cigna Preferred Savings Medicare (HMO) plan covers primary care physician services, occupational therapy, physician specialist services with a $45 copay, physical therapy and speech-language pathology services with a $35 copay, and opioid treatment program services with a $45 copay. Chiropractic services have a $15 copay, and additional telehealth benefits have a copay that ranges from $0 to $45. 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
The Cigna Preferred Savings Medicare (HMO) plan covers a variety of preventive services, including an annual physical exam, health education, and fitness benefits. Kidney disease education services, glaucoma screening, diabetes self-management training, barium enemas, digital rectal exams, and EKGs following a welcome visit are also covered. However, in-home safety assessments, personal emergency response systems, medical nutrition therapy, and other services are not covered.
Hearing Services See details
Hearing services include routine hearing exams with a $30 copay, as well as fitting/evaluation for hearing aids. Prescription hearing aids are covered, but inner ear, outer ear, and over-the-ear hearing aids are not covered, and OTC hearing aids are not covered.
Vision Services See details
Vision services are covered, including eye exams, eyewear, and upgrades. Eye exams have a copay between $0 and $45, and eyewear has a combined maximum benefit of $200 per year.
Dental Services See details
Dental services are covered, with a $1,500 annual maximum benefit. Medicare dental services require prior authorization and have a $45 copay. Other dental services cover 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 the coinsurance is between 0% and 20%. For Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs, the coinsurance is between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered under the Cigna Preferred Savings Medicare (HMO) plan, requiring prior authorization and a doctor's referral. You will pay 20% coinsurance.
Medical Equipment See details
Medical Equipment is covered by the Cigna Preferred Savings Medicare (HMO) plan, including Durable Medical Equipment (DME) with 20% coinsurance and Prosthetic Devices with 20% coinsurance, but Durable Medical Equipment for use outside the home is not covered. Diabetic Therapeutic Shoes/Inserts are covered with 20% coinsurance, but Diabetic Supplies are not covered.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered. Diagnostic Procedures/Tests have a copay between $0 and $50, and Lab Services have no copay. Diagnostic Radiological Services have a copay up to $325, Therapeutic Radiological Services have a $60 copay, and Outpatient X-Ray Services have a $10 copay.
Home Health Services See details
Home Health Services are covered by the Cigna Preferred Savings Medicare (HMO) 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 Preferred Savings Medicare (HMO) plan. Prior authorization and a doctor referral are required for this benefit.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the Cigna Preferred Savings Medicare (HMO) plan, but require prior authorization. For days 1-20, there is no copay, but for days 21-100, the copay is $214 per day.
Other Services See details
Other Services include a meal benefit, and over-the-counter (OTC) items, with OTC items offering up to $55 every three months. 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.
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1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
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