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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. In the initial coverage phase, you will pay a copay for your prescriptions. For example, you'll pay a $4 copay for preferred generic drugs at a preferred or mail-order pharmacy. Once your total drug costs reach $2,000, you enter the catastrophic coverage phase where you will pay nothing for your Medicare Part D covered drugs. This plan may have a reduced premium if you qualify for the low-income subsidy.
Additional Benefits
The Cigna Preferred Plus Medicare (HMO) plan offers a range of benefits, including inpatient and outpatient hospital services with varying copays. You'll find coverage for emergency services, primary care, preventive services with no copay for annual exams, and hearing and vision services. Dental services are also covered, with an annual maximum benefit for other dental services. This plan also includes coverage for ambulance services, home health services, and skilled nursing facilities. You'll also have access to home infusion services, dialysis services, and medical equipment. Other notable benefits include an over-the-counter items benefit and a meal benefit for those with chronic illnesses.
Inpatient Hospital See details
Inpatient Hospital benefits are covered, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric services. For Inpatient Hospital-Acute, you will pay a $275 copay for days 1-7, and no copay for days 8-90, while Inpatient Hospital Psychiatric services have the same cost-sharing. Additional days and upgrades for both services, as well as non-Medicare-covered stays, are not covered.
Outpatient Services See details
Outpatient Services, including all outpatient hospital services, observation services, ambulatory surgical center services, outpatient substance abuse services, and outpatient blood 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, ambulatory surgical center services have no copay, and outpatient substance abuse services have a $10 copay for individual and group sessions. Outpatient blood services include an enhanced benefit, with three pints deductible waived.
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 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 10 one-way trips per year, but 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 under the Cigna Preferred Plus Medicare (HMO) plan. For Emergency Services, there is a $125 copay and no coinsurance, while Urgently Needed Services have a $55 copay and no coinsurance. Worldwide Emergency Services, Worldwide Urgent Coverage, and Worldwide Emergency Transportation each have a $125 copay and no coinsurance, with a maximum plan benefit coverage of $50,000.
Primary Care See details
The Cigna Preferred Plus Medicare (HMO) plan covers primary care physician services, chiropractic services, occupational therapy services, physician specialist services, other health care professional services, psychiatric services, physical therapy, speech-language pathology services, additional telehealth benefits, and opioid treatment program services. Chiropractic services, physician specialist services, mental health specialty services, and psychiatric services require prior authorization. There is a $10 copay for chiropractic services, occupational therapy services, physician specialist services, and physical therapy and speech-language pathology services. Additional telehealth benefits have a copay between $0 and $10. Other health care professional services and opioid treatment program services have a copay between $10.00. Individual and group sessions for mental health specialty services and psychiatric services are not covered, nor are routine chiropractic services. Podiatry services are not covered.
Preventive Services See details
The Cigna Preferred Plus Medicare (HMO) plan covers preventive services, including annual physical exams, with no copay. Health Education, Fitness Benefit, Glaucoma Screening, Diabetes Self-Management Training, Barium Enemas, Digital Rectal Exams, and EKG following Welcome Visit are covered. 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 (including Web/Phone-based technologies and Nursing Hotline), Home and Bathroom Safety Devices and Modifications, and Counseling Services are not covered.
Hearing Services See details
Hearing exams are covered with a $10 copay. Fitting/Evaluation for Hearing Aids is covered, and Prescription Hearing Aids (all types) are covered with a copay between $399 and $1800, but Prescription Hearing Aids - Inner Ear, Outer Ear, and Over the Ear are not covered. OTC Hearing Aids are not covered.
Vision Services See details
Vision services include eye exams, eyewear, and upgrades. Eye exams have a copay of $0-$10 for routine eye exams, and eyewear has a combined maximum benefit of $250 every year; contact lenses, eyeglasses (lenses and frames), eyeglass lenses, and eyeglass frames are also covered with limitations.
Dental Services See details
Dental services are covered, including Medicare dental services with a $10 copay and other dental services with an annual maximum of $1,500. Oral exams, dental x-rays, other diagnostic dental services, prophylaxis (cleaning), fluoride treatment, other preventive dental services, restorative services, adjunctive general services, endodontics, periodontics, prosthodontics (removable and fixed), maxillofacial prosthetics, implant services, oral and maxillofacial surgery, and orthodontics are covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered by the Cigna Preferred Plus Medicare (HMO) plan, and require prior authorization. Medicare Part B Insulin Drugs have a $35 copay and a coinsurance between 0% and 20%, while 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 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, including durable medical equipment, prosthetics, medical supplies, and diabetic equipment, is covered by the Cigna Preferred Plus Medicare (HMO) plan. Durable medical equipment 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, while diabetic supplies are not covered, and diabetic therapeutic shoes/inserts have a 20% coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered, with prior authorization required. Diagnostic Procedures/Tests have a copay between $0 and $75, Lab Services have no copay, Diagnostic Radiological Services have a copay of up to $100, Therapeutic Radiological Services have a copay of $80 or more, 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. Prior 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. This includes 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.
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.
Other Services See details
Other Services includes an Over-the-Counter (OTC) Items benefit with a maximum of $50 every three months, and a meal benefit for chronic illnesses or medical conditions that require the enrollee to remain at home. 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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