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Cigna Preferred Plus Medicare (HMO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Cigna Preferred Plus 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 Plus Medicare (HMO) in 2025, please refer to our full plan details page.
Cigna Preferred Plus 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 Plus 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 Plus 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 Plus Medicare (HMO), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $19.00. 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 $4750.00 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 Plus Medicare (HMO) plan has a $0 deductible for prescription drugs. During the initial coverage phase, you'll pay a copay for your prescriptions, which varies based on the drug tier and whether you use a preferred or standard pharmacy. For example, preferred generic drugs have a $4 copay, while standard generic drugs have a $45 copay. Once your total drug costs reach $2,000, you enter the catastrophic coverage phase, where you will pay nothing for your Part D covered drugs. This plan also offers a Part D premium reduction for those who qualify for the low-income subsidy, with a monthly premium of $11.90.
Additional Benefits
The Cigna Preferred Plus Medicare (HMO) plan offers comprehensive coverage with a variety of benefits. Inpatient hospital stays have a $275 copay for days 1-7, and no copay for days 8-90. Outpatient services have varying copays, and emergency services have a $125 copay. This plan also includes coverage for primary care, hearing, vision, and dental services. Hearing exams have a $10 copay, and vision exams have no copay. Dental services have a $10 copay for Medicare services, with up to $1,500 maximum per year for other services. The plan also covers home health services with no copay, and skilled nursing facility services with no copay for days 1-20.
Inpatient Hospital See details
Inpatient Hospital benefits, including Acute and Psychiatric, are covered with prior authorization. For days 1-7, there is a $275 copay, and for days 8-90, there is no copay.
Outpatient Services See details
Outpatient Services are covered under the Cigna Preferred Plus Medicare (HMO) plan. Outpatient Hospital Services have a copay between $0 and $250, Observation Services have a $250 copay, and Ambulatory Surgical Center (ASC) Services have no copay. Outpatient Substance Abuse services have a $10 copay for both individual and group sessions. Outpatient Blood Services are also covered.
Partial Hospitalization See details
Partial Hospitalization is covered, but requires prior authorization. You will pay a $105 copay for this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by the Cigna Preferred Plus Medicare (HMO) plan. Ground ambulance services have a copay of $255, while air ambulance services have a 20% coinsurance. Transportation Services to a plan-approved health-related location are covered for up to 10 one-way trips per year, but 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 Plus Medicare (HMO) plan. Emergency Services and Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation have a $125 copay, while Urgently Needed Services have a $55 copay. Worldwide Emergency Services has a maximum plan benefit coverage of $50,000.
Primary Care See details
The Cigna Preferred Plus Medicare (HMO) plan covers primary care, chiropractic, occupational therapy, physician specialist, other health care professional, psychiatric, physical therapy, speech-language pathology, additional telehealth, and opioid treatment program services. Chiropractic services have a $10 copay, while routine chiropractic care is not covered. Occupational therapy services have a $10 copay and no coinsurance. Physician specialist services, physical therapy, and speech-language pathology services have a $10 copay. Other health care professional services have a copay between $0 and $10. Additional telehealth benefits have a copay between $0 and $10. Opioid treatment program services have a $10 copay. Mental health specialty services and psychiatric services do not cover individual or group sessions. Podiatry services are not covered.
Preventive Services See details
Preventive Services include coverage for Medicare-covered services, annual physical exams, health education, kidney disease education services, and other preventive services. The 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 are covered with a $10 copay, and routine hearing exams, and fitting/evaluation for hearing aids are covered once per year. Prescription hearing aids are covered, but the copay ranges from $399 to $1800, and only prescription hearing aids (all types) are covered, with a limit of two per year. OTC hearing aids, and prescription hearing aids for the inner ear, outer ear, and over the ear are not covered.
Vision Services See details
The Cigna Preferred Plus Medicare (HMO) plan covers vision services, including routine eye exams with a copay of $0-$10. Eyewear is covered, with a combined maximum benefit of $250 every year for contact lenses, eyeglasses (lenses and frames), eyeglass lenses, eyeglass frames, and upgrades.
Dental Services See details
Dental Services are covered, including Medicare Dental Services with a $10 copay, and other services, with a $1,500 maximum per year. Oral exams, dental x-rays, other diagnostic dental services, prophylaxis (cleaning), fluoride treatments, other preventive dental services, restorative services, adjunctive general services, endodontics, periodontics, prosthodontics (removable), maxillofacial prosthetics, implant services, prosthodontics (fixed), oral and maxillofacial surgery, and orthodontics are covered as well.
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 with a coinsurance between 0% and 20%. Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs have a coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered by the Cigna Preferred Plus Medicare (HMO) plan, but require prior authorization. The coinsurance for dialysis services is 20%.
Medical Equipment See details
The Cigna Preferred Plus Medicare (HMO) plan covers medical equipment, including durable medical equipment, prosthetics, medical supplies, and diabetic equipment, with a 20% coinsurance for some services and no copay. 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 have a copay between $0 and $75, Lab Services have no copay, Diagnostic Radiological Services have a copay up to $100, Therapeutic Radiological Services have a copay of $80, and Outpatient X-Ray Services have no copay.
Home Health Services See details
Home Health Services are covered by the Cigna Preferred Plus 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 Plus Medicare (HMO) plan. Specifically, Medicare-covered Intensive Cardiac Rehabilitation Services, Medicare-covered Pulmonary Rehabilitation Services, Medicare-covered Supervised Exercise Therapy (SET) for Symptomatic Peripheral Artery Disease (PAD) Services, and Additional Cardiac Rehabilitation Services are not covered.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the Cigna Preferred Plus Medicare (HMO) plan. There is no copay for days 1-20, and a $214 copay for days 21-100.
Other Services See details
The Cigna Preferred Plus Medicare (HMO) 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, or Self-Directed Personal Assistance Services. The plan offers a meal benefit for a chronic illness or a medical condition and covers over-the-counter (OTC) items, with a maximum benefit of $50 every three months.
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