A non-government entity
Cigna TotalCare Plus (HMO D-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Cigna TotalCare Plus (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 Plus (HMO D-SNP) in 2025, please refer to our full plan details page.
Cigna TotalCare Plus (HMO D-SNP) is a HMO D-SNP 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 TotalCare Plus (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 Plus (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 Plus (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 Plus (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 $1500.00 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 TotalCare Plus (HMO D-SNP)
Need help deciding? Talk with one of our licensed insurance specialists 1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
Drug Coverage
The Cigna TotalCare Plus (HMO D-SNP) plan has a $590 deductible for prescription drugs. After you meet your deductible, you will pay costs for your prescriptions based on their tier until your total drug costs reach $2,000. Once you reach $2,000, you enter the next coverage phase. If you qualify for the low-income subsidy, you will pay $20.30 per month for your Part D premium. During the catastrophic coverage phase, you pay nothing for Medicare Part D covered drugs after your yearly out-of-pocket drug costs reach $2,000.
Additional Benefits
The Cigna TotalCare Plus (HMO D-SNP) plan offers comprehensive coverage with a focus on minimizing out-of-pocket costs. Many services, including inpatient hospital stays, primary care, emergency services, and home health services, are covered with no copay. The plan also covers hearing, vision, and dental services, with specific allowances for hearing aids, eyewear, and a $3,000 annual maximum for dental care. Additional benefits include coverage for ambulance and transportation services, home infusion bundled services, and medical equipment. The plan provides coverage for preventive services, diagnostic and radiological services, and skilled nursing facility stays. The plan also offers over-the-counter benefits and meal benefits.
Inpatient Hospital See details
Inpatient Hospital benefits, including acute and psychiatric care, are covered with no copay. Additional days, non-Medicare-covered stays, and upgrades for both acute and psychiatric care are not covered.
Outpatient Services See details
Outpatient Services, including outpatient hospital services, observation services, ambulatory surgical center (ASC) services, and outpatient blood services, are covered by the Cigna TotalCare Plus (HMO D-SNP) plan. Outpatient Substance Abuse Services are partially covered, as individual and group sessions are not covered.
Partial Hospitalization See details
Partial Hospitalization is covered by the Cigna TotalCare Plus (HMO D-SNP) plan and requires prior authorization.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by the Cigna TotalCare Plus (HMO D-SNP) plan. Air ambulance services have a 20% coinsurance, while ground ambulance services are not covered. Transportation services to a plan-approved health-related location are covered, 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 under the Cigna TotalCare Plus (HMO D-SNP) plan. Emergency and Urgently Needed Services have no copay or coinsurance, while Worldwide Emergency Services has a $135 copay for Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation, with a maximum plan benefit coverage amount of $50,000.
Primary Care See details
The Cigna TotalCare Plus (HMO D-SNP) plan covers primary care physician services, occupational therapy services, physician specialist services, physical therapy and speech-language pathology services, additional telehealth benefits, and opioid treatment program services with no copay and no coinsurance for occupational therapy and physical therapy/speech-language pathology services. However, routine chiropractic care, individual and group sessions for mental health specialty services, individual and group sessions for psychiatric services, and podiatry services are not covered.
Preventive Services See details
The Cigna TotalCare Plus (HMO D-SNP) plan covers various preventive services, including health education, glaucoma screening, diabetes self-management training, and more. Some preventive services, like in-home safety assessments, personal emergency response systems, and others, are not covered.
Hearing Services See details
Hearing services are covered, including routine hearing exams and fitting/evaluation for hearing aids, each with one visit per year. Prescription hearing aids are covered with a copay between $399 and $1800, and the plan covers two hearing aids per year.
Vision Services See details
Vision services are covered, including routine eye exams, eyewear, and upgrades. Routine eye exams are covered once per year. Eyewear has a combined maximum benefit of $300 per year, and contact lenses are covered.
Dental Services See details
Dental Services are covered, with a maximum plan benefit of $3,000 per year. 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 all covered. Medicare Dental Services require prior authorization.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered by the Cigna TotalCare Plus (HMO D-SNP) plan and require prior authorization. For Medicare Part B Insulin Drugs, there is a $35 copay and a coinsurance between 0% and 20%. Other services have a coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered under the Cigna TotalCare Plus (HMO D-SNP) plan. Prior authorization and a doctor referral are required to receive coverage for this benefit.
Medical Equipment See details
Medical Equipment is covered by the Cigna TotalCare Plus (HMO D-SNP) plan, with no copay or coinsurance for Durable Medical Equipment and Prosthetics/Medical Supplies, but Durable Medical Equipment for use outside the home, Diabetic Supplies, and Diabetic Therapeutic Shoes/Inserts are not covered. Prior authorization is required for Diabetic Equipment.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered, but Diagnostic Procedures/Tests and Diagnostic Radiological Services, Therapeutic Radiological Services, and Outpatient X-Ray Services are not covered. Lab Services have no copay, while all other services may have a copay.
Home Health Services See details
Home Health Services are covered by the Cigna TotalCare Plus (HMO D-SNP) plan with no copay and no coinsurance, but additional hours of care and personal care services are not covered. This benefit requires authorization.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered, but none of the sub-services are covered. Prior authorization and a doctor referral are required for this benefit.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the Cigna TotalCare Plus (HMO D-SNP) plan with no copay for days 1-100, but additional days beyond what Medicare covers and non-Medicare-covered stays are not covered. Prior authorization is required.
Other Services See details
Other Services in the Cigna TotalCare Plus (HMO D-SNP) plan covers Over-the-Counter (OTC) Items with a maximum benefit coverage amount of $180.00 every three months, as well as Meal Benefits. Acupuncture, Dual Eligible SNPs with Highly Integrated Services, and several other services are not covered.
Get Personalized Help from a licensed insurance agent
1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
*/SMID: MULTIPLAN_HCIHNMEDADVRX25_HCI_M
MedicareAdvantageRX.com is owned and operated by Dog Media Solutions LLC.
This is a promotional communication.
Every year, Medicare evaluates plans based on a 5-star rating system.
Part B premium reduction is not available with all plans. Availability varies by carrier and location. Actual Part B premium reduction could be lower. Deductibles, copays and coinsurance may apply.
* Benefit(s) mentioned may be part of a special supplemental program for chronically ill members with one of the following conditions: Diabetes mellitus, Cardiovascular disorders, Chronic and disabling mental health conditions, Chronic lung disorders, Chronic heart failure. This is not a complete list of qualifying conditions. Having a qualifying condition alone does not mean you will receive the benefit(s). Other requirements may apply.
Enrollment in Medicare/Medicare Advantage may be limited to certain times of the year unless you qualify for a Special Enrollment Period
We do not offer every plan available in your area. Currently, we represent 18 organizations, which offer 52,101 products in your area. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all of your options.
We represent Medicare Advantage HMO, PPO and PFFS organizations and stand-alone PDP prescription drug plans that are contracted with Medicare. Enrollment depends on the plan's contract renewal.
Not all plans offer all of these benefits. Benefits may vary by carrier and location. Limitations and exclusions may apply.
Please contact Medicare.gov ,1-800-MEDICARE , or your local State Health Insurance Program (SHIP) to get information on all of your options.
Medicare has neither approved nor endorsed any information on this site.
Speak with a licensed insurance agent: 1-877-649-2073 / TTY 711 | 8am - 11pm ET | 7 days a week
© 2023 Dog Media Solutions LLC. All rights reserved