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 Chicago. 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 $100.00. 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 $4500.00 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 a $0 deductible. During the initial coverage phase, you will pay a copay for your prescriptions. The copay for preferred generic drugs is $4.00, while standard generic drugs have a $45.00 copay at preferred pharmacies. For preferred brand drugs, the copay is $100.00, and non-preferred drugs have a 33% coinsurance. Once your total drug costs reach $2000.00, you enter the catastrophic coverage phase, where you pay nothing for covered drugs.
Additional Benefits
The Cigna Preferred Savings Medicare (HMO) plan offers a variety of benefits. Inpatient hospital stays have copays ranging from $0 to $395, and outpatient services have copays between $0 and $395. The plan also covers emergency services with a $125 copay, and primary care visits have copays between $20 and $40. Additional benefits include coverage for hearing and vision services, with hearing exams costing $25 and vision exams having a $0-$40 copay. Dental services are also covered, with a $40 copay for Medicare-covered dental and other services with a $20,000 maximum benefit. The plan also includes home health services with no copay, and skilled nursing facility stays with copays that vary depending on the length of stay.
Inpatient Hospital See details
Inpatient Hospital benefits are covered, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric services, but Non-Medicare-covered Stay and Upgrades for Inpatient Hospital-Acute, and Additional Days and Non-Medicare-covered Stay for Inpatient Hospital Psychiatric are not covered. For Inpatient Hospital-Acute, you pay a $345 copay for days 1-6, and no copay for days 7-90; for Inpatient Hospital Psychiatric, you pay a $395 copay for days 1-5, and no copay for days 6-90.
Outpatient Services See details
The Cigna Preferred Savings Medicare (HMO) plan covers outpatient services, including all outpatient hospital services, with a copay ranging from $0 to $395, and observation services with a $350 copay. The plan also covers ambulatory surgical center services with no copay, outpatient substance abuse services with a $40 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 a $105 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, which includes coverage for both ground and air ambulance services. Ground ambulance services have a $250 copay, while air ambulance services have a 20% coinsurance, and transportation services to any health-related location are not covered.
Emergency Services See details
Emergency Services are covered under the Cigna Preferred Savings Medicare (HMO) plan with a $125 copay and no coinsurance, and urgently needed services have a $55 copay with no coinsurance. Worldwide emergency services, including Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation, are covered with a $125 copay and no coinsurance, up to a maximum of $50,000.
Primary Care See details
Primary Care benefits include coverage for Primary Care Physician Services. Chiropractic services have a $20 copay, and Routine Chiropractic Care also has a $20 copay for up to 6 visits per year. Occupational therapy services have a $40 copay, while Physician Specialist Services and Physical Therapy and Speech-Language Pathology Services have a $40 copay. Mental Health Specialty Services and Psychiatric Services do not cover individual or group sessions. Other Health Care Professional services may have a copay between $0 and $40. Podiatry Services and Opioid Treatment Program Services require a $40 copay. Additional Telehealth Benefits have a copay between $0 and $40.
Preventive Services See details
Preventive Services, including annual physical exams, are covered. Health Education, Glaucoma Screenings, Diabetes Self-Management Training, Barium Enemas, Digital Rectal Exams, and EKGs following a Welcome Visit are covered, while In-Home Safety Assessments, Personal Emergency Response Systems, Medical Nutrition Therapy, and several other services are not covered.
Hearing Services See details
Hearing exams are covered with a $25 copay, and routine hearing exams and fitting/evaluation for hearing aids are also covered, with one visit allowed per year for each. Prescription hearing aids are covered with a copay between $399 and $1800 for all types of hearing aids, 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 eye exams with a copay of $0-$40, and eyewear with a combined maximum benefit of $175 per year. Contact lenses are covered, and so are eyeglasses (lenses and frames), eyeglass lenses and eyeglass frames, with the plan covering one of each every year.
Dental Services See details
Dental services include coverage for Medicare dental services with a $40 copay, and other dental services with a $20,000 maximum benefit. Oral exams are covered with a $0 copay for up to 4 visits per year, and dental x-rays are covered with a $0 copay, limited to 1 per year, and other diagnostic services are covered with no copay. Prophylaxis (cleaning) and fluoride treatments are covered with no copay for 2 visits per year. Other preventive dental services are covered with no copay. Restorative services have a copay that ranges from $0 to $550, adjunctive general services have a copay that ranges from $0 to $285, endodontics have a copay that ranges from $0 to $675, periodontics have a copay that ranges from $0 to $595, prosthodontics (removable) have a copay that ranges from $25 to $615, and prosthodontics (fixed) have a copay that ranges from $50 to $525. Maxillofacial prosthetics and implant services are not covered, and orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, and 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 by the Cigna Preferred Savings Medicare (HMO) plan, requiring prior authorization and a doctor's referral. The coinsurance for dialysis services is 20%.
Medical Equipment See details
Medical Equipment is covered by Cigna Preferred Savings Medicare (HMO), including Durable Medical Equipment (DME) with a 20% coinsurance, and Prosthetic Devices with a 20% coinsurance. Durable Medical Equipment for use outside the home, Medical Supplies, Diabetic Supplies, and Diabetic Therapeutic Shoes/Inserts are not covered.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered, with a doctor referral and prior authorization required. Diagnostic Procedures/Tests have a copay between $0 and $100, while Lab Services have no copay. Diagnostic Radiological Services have a copay of at most $300, and Therapeutic Radiological Services have a 20% coinsurance. Outpatient X-Ray Services have no copay.
Home Health Services See details
Home Health Services are covered by the Cigna Preferred Savings Medicare (HMO) plan with no copay or coinsurance, but additional hours of care and personal care services are not covered. Authorization is required for this benefit.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered, but 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. A doctor referral and prior authorization are required.
Skilled Nursing Facility (SNF) See details
The Cigna Preferred Savings Medicare (HMO) plan covers Skilled Nursing Facility (SNF) services, but requires prior authorization. For days 1-20, the copay is $10, and for days 21-100, the copay is $214.
Other Services See details
The Cigna Preferred Savings Medicare (HMO) plan covers Over-the-Counter (OTC) Items, with a maximum benefit of $105.00 every three months, and includes Nicotine Replacement Therapy and Naloxone coverage. Acupuncture, Dual Eligible SNPs with Highly Integrated Services, and several other services are not covered.
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