A non-government entity
Cigna Preferred Medicare (HMO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Cigna Preferred 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 Medicare (HMO) in 2025, please refer to our full plan details page.
Cigna Preferred Medicare (HMO) is a HMO plan offered by The Cigna Group available for enrollment in 2025 to people living in Orlando. This plan received an overall rating of 3 out of 5 stars in 2025.
It's important to know that Cigna Preferred 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 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 Medicare (HMO), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $0.00. This is the amount you must pay every month. Additionally, this plan comes with a Part B Premium reduction of $5.00. You must continue to pay paying your reduced 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 $2650.00 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 Medicare (HMO) plan has a $0 deductible for prescription drugs. During the initial coverage phase, you will pay a copay for each prescription, depending on the drug tier and the pharmacy you use. For example, a preferred generic drug has a $4 copay at preferred pharmacies, while a standard generic drug has a $45 copay. Once your total drug costs reach $2000, you enter the catastrophic coverage phase, where you pay nothing for covered drugs.
Additional Benefits
The Cigna Preferred Medicare (HMO) plan offers comprehensive coverage with a range of services. It covers inpatient and outpatient services, including mental health, with varying copays. Emergency services are covered with a copay, and ambulance services have a copay or coinsurance. This plan also provides coverage for primary care, preventive services, hearing, vision, and dental. Additional benefits include home health services, medical equipment, and diagnostic services. There is also coverage for skilled nursing facilities, dialysis, and home infusion bundled services.
Inpatient Hospital See details
Inpatient Hospital services are covered, with a $40 copay for days 1-5, and no copay for days 6-90. Additional days for Inpatient Hospital-Acute are covered with no copay, while Non-Medicare-covered Stay for Inpatient Hospital-Acute and Upgrades for Inpatient Hospital-Acute are not covered. Inpatient Hospital Psychiatric services are covered, with a $40 copay for days 1-5, and no copay for days 6-90. Additional days for Inpatient Hospital Psychiatric and Non-Medicare-covered Stay 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 $40, observation services with a $40 copay, ambulatory surgical center services with no copay, outpatient substance abuse services with a $10 copay for individual and group sessions, and outpatient blood services.
Partial Hospitalization See details
Cigna Preferred Medicare (HMO) covers partial hospitalization with a $100 copay. Prior authorization is required.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered, with prior authorization required. Ground ambulance services have a $260 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. Transportation services to any health-related location are not covered.
Emergency Services See details
Emergency Services, including Urgently Needed Services and Worldwide Emergency Services, are covered. Emergency Services and Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation have a $135 copay, while Urgently Needed Services has a $10 copay; all have no coinsurance.
Primary Care See details
The Cigna Preferred Medicare (HMO) plan covers Primary Care Physician Services, Chiropractic Services (with a $15 copay), Occupational Therapy Services (with a $10 copay), Physician Specialist Services (with a $10 copay), Physical Therapy and Speech-Language Pathology Services (with a $10 copay), Additional Telehealth Benefits (with a $0-$10 copay), and Opioid Treatment Program Services (with a $10 copay). The plan does not cover Routine Chiropractic Care, Individual or Group Sessions for Mental Health or Psychiatric Services, or Podiatry Services.
Preventive Services See details
The Cigna Preferred Medicare (HMO) plan covers preventive services, including Medicare-covered services, annual physical exams, and additional services like health education and fitness benefits. Some services, such as in-home safety assessments and several others, are not covered.
Hearing Services See details
Hearing services include hearing exams with a $10 copay, and routine hearing exams and fitting/evaluation for hearing aids, each covered once per year. Prescription hearing aids are covered with a copay between $399 and $1800, but inner ear, outer ear, and over the ear prescription hearing aids are not covered, and OTC hearing aids are not covered.
Vision Services See details
Vision services include coverage for eye exams with a copay of $0-$10, and coverage for eyewear, including contact lenses, eyeglasses, eyeglass lenses, eyeglass frames, and upgrades. Eyewear has a combined maximum plan benefit coverage amount of $300 per year.
Dental Services See details
The Cigna Preferred Medicare (HMO) plan covers dental services, including Medicare dental services with a $10 copay, and other dental services with a $2,500 maximum benefit per year. Oral exams, dental x-rays, other diagnostic dental services, cleaning, fluoride treatment, other preventive dental services, restorative services, adjunctive general services, endodontics, periodontics, removable prosthodontics, maxillofacial prosthetics, implant services, fixed prosthodontics, oral and maxillofacial surgery, and orthodontics are also covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, with prior authorization required. Medicare Part B Insulin Drugs have a $35 copay and between 0% and 20% coinsurance, while Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs have between 0% and 20% coinsurance.
Dialysis Services See details
Dialysis Services are covered under the Cigna Preferred Medicare (HMO) plan and require prior authorization and a doctor's referral. You will pay a coinsurance of 20% for these services.
Medical Equipment See details
Medical equipment is covered under the Cigna Preferred Medicare (HMO) plan. Durable Medical 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, 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 $95. Lab services have no copay, and therapeutic radiological services have a coinsurance of at least 20%. Outpatient X-Ray services have no copay.
Home Health Services See details
Home Health Services are covered by the Cigna Preferred Medicare (HMO) plan with no copay and no coinsurance, but prior authorization is required. Additional Hours of Care and Personal Care Services are not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered by the Cigna Preferred Medicare (HMO) plan. Prior authorization and a doctor's referral are required for coverage.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by Cigna Preferred Medicare (HMO), but require prior authorization. There is no copay for days 1-20, and a $214 copay for days 21-100.
Other Services See details
The Cigna Preferred Medicare (HMO) plan's "Other Services" benefit covers over-the-counter items, with a maximum benefit coverage amount of $210.00 every three months, and a meal benefit for chronic illnesses or conditions requiring the enrollee to stay 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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