A non-government entity
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:
Sign up for Cigna Preferred Plus Medicare (HMO)
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Drug Coverage
The Cigna Preferred Plus Medicare (HMO) plan has an enhanced alternative drug benefit. This plan has no deductible for prescription drugs. In the initial coverage phase, you will pay a copay for your prescriptions depending on the drug tier and the pharmacy you use. Preferred Generic drugs have a $4 copay, while Standard Generic drugs have a $45 copay. After your yearly out-of-pocket drug costs reach $2000, you pay nothing for covered drugs.
Additional Benefits
The Cigna Preferred Plus Medicare (HMO) plan offers a range of benefits with varying costs. You can expect a $275 copay for inpatient hospital stays for the first 7 days, with no copay for days 8-90. Outpatient services can range from no copay to a $250 copay depending on the service. This plan includes coverage for emergency services with a $125 copay, and primary care services with a $10 copay for many services. Hearing services are covered, including hearing exams with a $10 copay, and vision services are covered, including routine eye exams with no copay. The plan also offers dental services and covers over-the-counter items with a maximum benefit of $55 every three months.
Inpatient Hospital See details
Inpatient Hospital benefits, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric, are covered. For Inpatient Hospital-Acute, you pay a $275 copay for days 1-7, and no copay for days 8-90; for Inpatient Hospital Psychiatric, you also pay a $275 copay for days 1-7, and no copay for days 8-90. Additional days for Inpatient Hospital-Acute are covered, while Non-Medicare-covered stays and upgrades for Inpatient Hospital-Acute, and additional days and non-Medicare-covered stays for Inpatient Hospital Psychiatric, are not covered.
Outpatient Services See details
Outpatient Services are covered, including outpatient hospital services with a copay between $0 and $250, observation services with a $250 copay, ambulatory surgical center services with no copay, outpatient substance abuse services with a $10 copay for both individual and group sessions, and outpatient blood services.
Partial Hospitalization See details
Partial Hospitalization is covered under the Cigna Preferred Plus Medicare (HMO) plan, but requires prior authorization. You will have a $105 copay for this service.
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 plan-approved health-related locations are covered for up to 10 one-way trips per year, and transportation to any health-related location is not covered.
Emergency Services See details
Emergency Services are covered by the Cigna Preferred Plus Medicare (HMO) plan with a $125 copay, and no coinsurance. Urgently Needed Services have a $55 copay and 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.
Primary Care See details
Primary Care benefits include coverage for Primary Care Physician Services, Chiropractic Services, Occupational Therapy Services, Physician Specialist Services, Mental Health Specialty Services, Other Health Care Professional, Psychiatric Services, Physical Therapy and Speech-Language Pathology Services, Additional Telehealth Benefits, and Opioid Treatment Program Services. Chiropractic Services have a $10 copay, Occupational Therapy Services have a $10 copay, Physician Specialist Services have a $10 copay, Physical Therapy and Speech-Language Pathology Services have a $10 copay, and Additional Telehealth Benefits have a copay between $0 and $10. Individual and Group Sessions for Mental Health Specialty Services, Individual and Group Sessions for Psychiatric Services, and Routine Chiropractic Care are not covered. Podiatry Services are not covered.
Preventive Services See details
Preventive Services, including Medicare-covered services and annual physical exams, are covered. Additional preventive services include Health Education, and Fitness Benefit, while In-Home Safety Assessment, Personal Emergency Response System (PERS), Medical Nutrition Therapy (MNT), 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 Benefit, 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, and Counseling Services are not covered.
Hearing Services See details
Hearing services are covered, including hearing exams with a $10 copay. Routine hearing exams and fitting/evaluation for hearing aids are covered once per year. Prescription hearing aids (all types) are covered with a copay between $399 and $1800, but inner ear, outer ear, and over the ear hearing aids 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, and eyewear with a combined maximum benefit of $250 per year. Contact lenses, eyeglasses (lenses and frames), eyeglass lenses, eyeglass frames, and upgrades are also covered.
Dental Services See details
Dental services are covered under the Cigna Preferred Plus Medicare (HMO) plan. Medicare Dental Services have a $10 copay, and other services are covered with a $1500 maximum benefit per year.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered by the Cigna Preferred Plus Medicare (HMO) plan, with prior authorization required. 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 Plus Medicare (HMO) plan, but require prior authorization. You will pay 20% coinsurance for these services.
Medical Equipment See details
The Cigna Preferred Plus Medicare (HMO) plan covers Durable Medical Equipment (DME) with 20% coinsurance and requires authorization, and Prosthetics/Medical Supplies with no copay and 20% coinsurance. Diabetic Equipment is covered, but Diabetic Supplies are not covered.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered, including diagnostic procedures and tests with a copay between $0 and $75, lab services with no copay, diagnostic radiological services with a copay up to $100, therapeutic radiological services with a copay of $80, and outpatient X-ray services with no copay. Prior authorization is required for all diagnostic and radiological services.
Home Health Services See details
Home Health Services are covered with no copay and no 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 not covered by the Cigna Preferred Plus Medicare (HMO) plan. Although the plan covers Cardiac Rehabilitation Services in general, it 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.
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, but there is a $214 copay per day 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 does not cover acupuncture, 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 covers over-the-counter (OTC) items with a maximum benefit of $55 every three months, including nicotine replacement therapy (NRT) and Naloxone. The plan also provides a meal benefit for chronic illnesses or medical conditions requiring the enrollee to stay home, with no maximum benefit.
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1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
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