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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 an "Enhanced Alternative" drug benefit. The plan has no deductible for prescription drugs. In the initial coverage phase, you will pay a copay for your prescriptions, which varies based on the drug tier and pharmacy type. For example, preferred generic drugs have a $4 copay at preferred pharmacies and $20 at standard pharmacies. After your total drug costs reach $2000, you enter the catastrophic coverage phase where you pay nothing for Part D covered drugs.
Additional Benefits
The Cigna Preferred Plus Medicare (HMO) plan offers a range of benefits, including inpatient and outpatient hospital services with varying copays, as well as coverage for emergency, primary care, preventive, hearing, vision, and dental services. You'll find coverage for services like ambulance, home health, and skilled nursing facilities, with specific copays or coinsurance amounts depending on the service. This plan also provides additional benefits such as coverage for Over-the-Counter (OTC) items and a meal benefit for those with chronic illnesses or medical conditions. While the plan covers many services, it's important to note that some services may require prior authorization, and certain services, like routine chiropractic care, are not covered.
Inpatient Hospital See details
Inpatient Hospital benefits, including acute and psychiatric services, are covered. For Inpatient Hospital-Acute and Inpatient Hospital Psychiatric, you will pay a $275 copay for days 1-7, and no copay for days 8-90.
Outpatient Services See details
Outpatient services for the Cigna Preferred Plus Medicare (HMO) plan include coverage for all outpatient hospital services with a copay between $0 and $250, observation services with a $250 copay, and ambulatory surgical center services with no copay. Outpatient substance abuse services are covered with a $15 copay for individual or group sessions, and outpatient blood services are also covered.
Partial Hospitalization See details
Partial Hospitalization is covered by the Cigna Preferred Plus Medicare (HMO) plan, with a $105 copay. Prior authorization is required 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 $290 copay, 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, while 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 Plus Medicare (HMO) plan. Emergency services have a $125 copay, and urgently needed services have a $55 copay, with no coinsurance for either. Worldwide emergency services have a $125 copay for worldwide emergency coverage, worldwide urgent coverage, and worldwide emergency transportation, with 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 $15 copay, physician specialist services have a $10 copay, occupational therapy and physical therapy services have a $15 copay, and other health care professional services have a copay between $0 and $10. Additional telehealth services have a copay between $0 and $10, and opioid treatment program services have a copay between $15 and $15. Routine chiropractic care, individual and group sessions for mental health and psychiatric specialty services, and podiatry services are not covered.
Preventive Services See details
Preventive services, including annual physical exams, Medicare-covered services, and additional preventive services like health education and fitness benefits, are covered. However, 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 $10 copay. Prescription hearing aids are covered, with a copay between $399 and $1800, depending on the type of hearing aid.
Vision Services See details
Vision services are covered, including eye exams, eyewear, and upgrades. Eye exams have a copay of $0-$10, and you are eligible for one routine eye exam every year. Eyewear is covered up to a combined maximum of $250 every year, contact lenses are covered, and you are eligible for one pair of eyeglasses (lenses and frames, lenses, and frames) every year.
Dental Services See details
Dental services, including Medicare dental services, other dental services, and orthodontic services, are covered by the Cigna Preferred Plus Medicare (HMO) plan. Medicare dental services have a $10 copay, and other services have a $1,500 maximum benefit each year.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, and prior authorization is required. The cost sharing includes a $35 copay for Medicare Part B Insulin Drugs, with a coinsurance between 0% and 20% for Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs.
Dialysis Services See details
Dialysis Services are covered under the Cigna Preferred Plus Medicare (HMO) plan, but require prior authorization. You will pay 20% coinsurance for these services.
Medical Equipment See details
Medical Equipment is covered by Cigna Preferred Plus Medicare (HMO), including Durable Medical Equipment (DME), Prosthetics/Medical Supplies, and Diabetic Equipment. DME has a 20% coinsurance, while Durable Medical Equipment for use outside the home is not covered; Prosthetic Devices and Medical Supplies have a 20% coinsurance, and Diabetic Therapeutic Shoes/Inserts have a 20% coinsurance.
Diagnostic and Radiological Services See details
The Cigna Preferred Plus Medicare (HMO) plan covers diagnostic and radiological services, but prior authorization is required. Diagnostic Procedures/Tests have a copay between $0 and $75, while Lab Services have no copay. Diagnostic Radiological Services have a copay of at most $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, though 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 covered, but none of the sub-services are covered. Prior authorization is required.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the Cigna Preferred Plus Medicare (HMO) plan, 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 SNF stays and non-Medicare-covered SNF stays are not covered.
Other Services See details
The Cigna Preferred Plus Medicare (HMO) plan covers Over-the-Counter (OTC) Items with a maximum benefit of $50.00 every three months, including Nicotine Replacement Therapy (NRT) and Naloxone coverage, but 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. The plan also offers a Meal Benefit for chronic illnesses or medical conditions requiring home confinement.
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