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 $7200.00 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 offers drug coverage with a $0 deductible. In the initial coverage phase, you'll pay a copay for your prescriptions depending on the drug tier and pharmacy. For example, preferred generic drugs have no copay at preferred pharmacies, while standard generic drugs have a $45 copay. Once your total drug costs reach $2,000, you enter the catastrophic coverage phase, where you pay nothing for Part D covered drugs. Please note that if you qualify for the low-income subsidy (LIS), your premium may be reduced.
Additional Benefits
The Cigna Preferred Savings Medicare (HMO) plan offers a range of benefits with varying costs. Inpatient hospital stays have a $350 copay for the first five days, and no copay for days 6-90. Outpatient services have copays ranging from $0-$350, and emergency services have a $110 copay. The plan covers primary care with copays between $15 and $50, and preventive services are included. Hearing services include hearing exams with a $20 copay, and prescription hearing aids are covered with a copay between $399 and $1800. Vision services have eye exams with a $0-$45 copay, and eyewear is covered up to $150 per year.
Inpatient Hospital See details
Inpatient Hospital benefits are covered, with a copay of $350 per admission for days 1-5, and no copay for days 6-90. Additional days for Inpatient Hospital-Acute are covered, while the Non-Medicare-covered stay and Upgrades are not covered. Inpatient Hospital Psychiatric benefits are covered, with a copay of $350 for days 1-5, and no copay for days 6-90; however, additional days and the Non-Medicare-covered stay are not covered.
Outpatient Services See details
Outpatient Services includes coverage for all outpatient hospital services, observation services, ambulatory surgical center (ASC) services, outpatient substance abuse services, and outpatient blood services. Outpatient Hospital Services have a copay between $0 and $350, Observation Services have a $350 copay, and ASC services have no copay. Individual and Group Sessions for Outpatient Substance Abuse have a copay of $50. Outpatient blood services are also covered.
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. Ground ambulance services have a $250 copay, while air ambulance services have a 20% coinsurance, and transportation services are not covered.
Emergency Services See details
Emergency Services are covered under the Cigna Preferred Savings Medicare (HMO) plan, and include a $110 copay, with no coinsurance. Urgently Needed Services have a $35 copay, with no coinsurance. Worldwide Emergency Services, including Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation, each have a $110 copay, with no coinsurance, and a maximum plan benefit of $50,000.
Primary Care See details
The Cigna Preferred Savings Medicare (HMO) plan covers primary care physician services, chiropractic services with a $15 copay, occupational therapy services with a $35 copay, physician specialist services with a $50 copay, physical therapy and speech-language pathology services with a $35 copay, and opioid treatment program services with a $50 copay. The plan does not cover routine chiropractic care, individual or group sessions for mental health specialty services or psychiatric services, and podiatry services. Additional telehealth benefits are covered with a copay between $0 and $50, and other healthcare professional services are covered with a copay between $0 and $50.
Preventive Services See details
The Cigna Preferred Savings Medicare (HMO) plan covers a range of preventive services, including annual physical exams, health education, and glaucoma screenings. Some services, such as in-home safety assessments, personal emergency response systems, and several others, are not covered.
Hearing Services See details
Hearing services with the Cigna Preferred Savings Medicare (HMO) plan include hearing exams with a $20 copay, and routine hearing exams and fitting/evaluation for hearing aids, both covered once per year. Prescription hearing aids are covered with a copay between $399 and $1800, but inner ear, outer ear, and over the ear prescription hearing aids are not covered, and OTC hearing aids are not covered.
Vision Services See details
Cigna Preferred Savings Medicare (HMO) covers vision services, including eye exams with a copay of $0-$45. Eyewear, including contact lenses, eyeglasses, eyeglass lenses, and frames, are also covered, with a combined maximum benefit of $150 per year for eyewear.
Dental Services See details
The Cigna Preferred Savings Medicare (HMO) plan covers Medicare dental services with a $50 copay, and other dental services, including oral exams (4 visits per year) and dental x-rays (1 set of complete series x-rays and panoramic x-rays every three years, and 4 bitewing x-rays per year). The plan does not cover maxillofacial prosthetics, implant services, or orthodontics.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, including Medicare Part B Insulin Drugs, Medicare Part B Chemotherapy/Radiation Drugs, and Other Medicare Part B Drugs. For Medicare Part B Insulin Drugs, there is a $35 copay and a coinsurance between 0% and 20%, while the other drugs have a coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered under the Cigna Preferred Savings Medicare (HMO) plan, but require prior authorization and a doctor's referral. You will pay 20% coinsurance for these services.
Medical Equipment See details
Medical Equipment is covered, with 20% coinsurance for Durable Medical Equipment and Prosthetic Devices, and 20% coinsurance for Medical Supplies. Diabetic Supplies are not covered, while Diabetic Therapeutic Shoes/Inserts have 20% coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services, including diagnostic procedures and tests, lab services, and radiological services, are covered. Diagnostic procedures and tests have a copay between $0 and $50, 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. This benefit requires authorization.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered by the Cigna Preferred Savings Medicare (HMO) plan. Prior authorization and a doctor's referral are required for these services.
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, and for days 21-100, the copay is $214.
Other Services See details
Other Services include coverage for Over-the-Counter (OTC) items with a maximum benefit of $50 every three months, 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.
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