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Cigna TotalCare (HMO D-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Cigna TotalCare (HMO D-SNP). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Cigna TotalCare (HMO D-SNP) in 2025, please refer to our full plan details page.
Cigna TotalCare (HMO D-SNP) is a HMO D-SNP plan offered by The Cigna Group available for enrollment in 2025 to people living in North Florida. This plan received an overall rating of 3 out of 5 stars in 2025.
It's important to know that Cigna TotalCare (HMO D-SNP) is a Medicare Advantage (MA) Plan with drug coverage. That means that this plan covers both medical services and prescription drugs.
Important:
Cigna TotalCare (HMO D-SNP)is a Special Needs Type (SNP) plan. This means you can only enroll in this plan if you meet specific criteria. See our full plan details page for more information.
Key Plan Facts
Below are a few key facts and commonly-asked questions about Cigna TotalCare (HMO D-SNP).
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 TotalCare (HMO D-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $20.30. 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 a $590.00 drug deductible. You will need to pay this amount towards covered prescriptions before your insurance coverage for prescription medications kicks in.
Out-of-Pocket Maximums
This plan has a Maximum Out-Of-Pocket cost of $5950.00 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 TotalCare (HMO D-SNP) plan has a $590 deductible for prescription drugs. After the deductible is met, you will pay the costs for drugs in each tier until your total drug costs reach $2000, at which point you enter the next coverage phase. This plan's premium may be reduced if you qualify for the low-income subsidy, with a monthly Part D premium of $20.30.
Additional Benefits
The Cigna TotalCare (HMO D-SNP) plan offers a range of benefits with varying cost-sharing. Inpatient hospital stays have a copay, while outpatient services have copays that vary by service. Emergency services have a $125 copay, and ambulance services have a copay or coinsurance. This plan offers additional benefits like dental, vision, and hearing services. Dental services have no copay, with a $2,000 annual maximum, while vision includes routine exams and eyewear with a $225 annual maximum. Hearing services cover exams and hearing aids with copays.
Inpatient Hospital See details
Inpatient Hospital benefits, including acute and psychiatric services, are covered with prior authorization. For inpatient hospital acute services, you will pay a \$199 copay for days 1-5 and no copay for days 6-90; for inpatient hospital psychiatric services, you will pay a \$1850 copay per admission or stay.
Outpatient Services See details
Outpatient services are covered, including outpatient hospital services, observation services, ambulatory surgical center (ASC) services, and outpatient blood services. Outpatient hospital services have a copay between $0 and $195, and observation services have a $195 copay; Ambulatory Surgical Center (ASC) Services have no copay. Individual and group sessions for outpatient substance abuse are not covered.
Partial Hospitalization See details
Cigna TotalCare (HMO D-SNP) covers partial hospitalization with a $105 copay. Prior authorization is required for this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by Cigna TotalCare (HMO D-SNP). Ground ambulance services have a $225 copay, while air ambulance services have 20% coinsurance. Transportation services to plan-approved health-related locations are covered for up to 40 one-way trips per year.
Emergency Services See details
Emergency Services, Urgently Needed Services, Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation are covered under the Cigna TotalCare (HMO D-SNP) plan. Emergency Services and Worldwide Emergency Coverage have a $125 copay, Urgently Needed Services has a $55 copay, and Worldwide Urgent Coverage and Worldwide Emergency Transportation also have a $125 copay.
Primary Care See details
Primary Care Physician Services, Occupational Therapy Services, Physical Therapy and Speech-Language Pathology Services, and Additional Telehealth Benefits are covered with no copay and no coinsurance. Chiropractic Services, Physician Specialist Services, Mental Health Specialty Services, Other Health Care Professional, Psychiatric Services, and Opioid Treatment Program Services are covered, but require prior authorization. However, Routine Chiropractic Care, Individual Sessions for Mental Health Specialty Services, Individual Sessions for Psychiatric Services, and Group Sessions for Psychiatric Services are not covered. Podiatry Services are not covered.
Preventive Services See details
Preventive services, including Medicare-covered preventive services, annual physical exams, health education, kidney disease education services, and other preventive services like glaucoma screenings and diabetes self-management training, are covered. In-home safety assessments, personal emergency response systems, medical nutrition therapy, post-discharge in-home medication reconciliation, re-admission prevention, wigs for hair loss, 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, 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. Fitness benefits are covered, including physical and memory fitness.
Hearing Services See details
Hearing services include routine hearing exams and fitting/evaluation for hearing aids, each covered for one visit per year. Prescription hearing aids are also covered, with a copay between $399 and $1800, for up to two hearing aids per year, but prescription hearing aids for inner ear, outer ear, and over the ear are not covered, and OTC hearing aids are not covered.
Vision Services See details
The Cigna TotalCare (HMO D-SNP) plan covers vision services, including routine eye exams with one visit per year, and eyewear. Eyewear includes contact lenses, eyeglasses (lenses and frames), eyeglass lenses, and eyeglass frames. There is a combined maximum of $225 per year for all eyewear.
Dental Services See details
Cigna TotalCare (HMO D-SNP) covers dental services, including oral exams, dental x-rays, and other diagnostic dental services with no copay, with a maximum plan benefit of $2,000 per year. The plan also covers 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.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered by the Cigna TotalCare (HMO D-SNP) plan. For Medicare Part B Insulin Drugs, there is a $35 copay, and the coinsurance ranges from 0% to 20%. For Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs, the coinsurance ranges from 0% to 20%.
Dialysis Services See details
Dialysis Services are covered by the Cigna TotalCare (HMO D-SNP) plan. The plan requires prior authorization and has a coinsurance of 20%.
Medical Equipment See details
The Cigna TotalCare (HMO D-SNP) plan covers Durable Medical Equipment, Prosthetics, Medical Supplies, and Diabetic Equipment. Durable Medical Equipment has a 20% coinsurance and requires prior authorization, while Durable Medical Equipment for use outside the home is not covered. Prosthetic Devices and Medical Supplies have a 20% coinsurance, but Diabetic Supplies are not covered, and Diabetic Therapeutic Shoes/Inserts have a 20% coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services, including diagnostic procedures/tests, lab services, diagnostic radiological services, therapeutic radiological services, and outpatient X-ray services, are covered. Lab services have no copay, while diagnostic procedures/tests, diagnostic radiological services, and outpatient X-ray services have a coinsurance of at most 20%. Therapeutic radiological services have a coinsurance of at most 20%.
Home Health Services See details
Home Health Services are covered by the Cigna TotalCare (HMO D-SNP) plan. There is no copay or coinsurance for this benefit, but authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are technically covered, but Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, and SET for PAD Services are not covered by the Cigna TotalCare (HMO D-SNP) plan. Prior authorization is required for this benefit.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the Cigna TotalCare (HMO D-SNP) plan, but require prior authorization. For days 1-20, there is no copay, and for days 21-100, the copay is $214. Additional days beyond Medicare-covered and non-Medicare-covered SNF stays are not covered.
Other Services See details
Other Services includes Over-the-Counter (OTC) Items and Meal Benefit coverage. 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. OTC items have a maximum benefit of $140 every three months and include nicotine replacement therapy and Naloxone coverage.
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