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 Tampa. 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.
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 $2700.00 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 used. For example, preferred generic drugs have a $4 copay at preferred pharmacies, while standard generic drugs have a $45 copay at preferred pharmacies. Once your total drug costs reach $2000, you enter the catastrophic coverage phase, where you pay nothing for Part D covered drugs. However, you may still pay a share of the costs for excluded drugs covered under any enhanced benefit. If you qualify for the low-income subsidy (LIS), you will pay $0 for Part D drugs.
Additional Benefits
The Cigna Preferred Medicare (HMO) plan offers a wide range of benefits with varying costs. You'll pay a copay for inpatient hospital stays, outpatient services, and emergency care, with no copay for some services like outpatient surgery and home health. This plan includes coverage for hearing, vision, and dental, as well as transportation to health-related locations. This plan also covers preventive services, primary care, and diagnostic services with copays. You'll have a coinsurance for ambulance, dialysis, and durable medical equipment. Additionally, the plan offers an over-the-counter benefit and a meal benefit.
Inpatient Hospital See details
Inpatient Hospital benefits are covered, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric. For Inpatient Hospital-Acute, you pay a $125 copay for days 1-6, and no copay for days 7-90; Inpatient Hospital Psychiatric has a $150 copay for days 1-6, and no copay for days 7-90. Additional Days for Inpatient Hospital-Acute are covered, while Non-Medicare-covered Stay and Upgrades for Inpatient Hospital-Acute are not covered. Additional Days and Non-Medicare-covered Stay for Inpatient Hospital Psychiatric are not covered.
Outpatient Services See details
Outpatient Services, including all outpatient hospital services, are covered by Cigna Preferred Medicare (HMO). Outpatient Hospital Services have a copay between $0 and $200, Observation Services have a $150 copay, Ambulatory Surgical Center (ASC) Services have no copay, and Outpatient Substance Abuse Services have a $15 copay for both individual and group sessions.
Partial Hospitalization See details
Cigna Preferred Medicare (HMO) covers partial hospitalization with a $100 copay and requires prior authorization.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered, including ground ambulance services with a $275 copay, and air ambulance services with 20% coinsurance. Transportation Services to a plan-approved health-related location are covered for 10 one-way trips per year using rideshare services, bus/subway, medical transport, or other methods, while transportation to any health-related location is not covered.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered under the Cigna Preferred Medicare (HMO) plan. Emergency Services and Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation have a $135 copay, and Urgently Needed Services have a $20 copay.
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 $20 copay), physician specialist services (with a $15 copay), other health care professional services (with a copay between $0 and $15), physical therapy and speech-language pathology services (with a $20 copay), and additional telehealth benefits (with a copay between $0 and $15). This 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 annual physical exams, health education, kidney disease education services, glaucoma screenings, diabetes self-management training, barium enemas, digital rectal exams, and EKGs following a welcome visit. However, in-home safety assessments, personal emergency response systems, medical nutrition therapy, 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 benefits, 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 exams are covered with a $15 copay, and a doctor referral is required. Routine Hearing Exams and Fitting/Evaluation for Hearing Aids are also covered. Prescription Hearing Aids 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
The Cigna Preferred Medicare (HMO) plan covers vision services, including routine eye exams with a copay of $0-$15, and eyewear. Eyewear coverage includes contact lenses, eyeglasses (lenses and frames), eyeglass lenses, and eyeglass frames, with a combined maximum benefit of $300 every year.
Dental Services See details
Dental services are covered under the Cigna Preferred Medicare (HMO) plan. Medicare dental services have a $15 copay, while other dental services have a $1750 maximum benefit every year.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, and prior authorization is required. For Medicare Part B Insulin Drugs, you will pay a $35 copay with a coinsurance between 0% and 20%; for Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs, you will pay a coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered by the Cigna Preferred Medicare (HMO) plan, but require prior authorization and a doctor's referral. You will pay 20% coinsurance for these services.
Medical Equipment See details
Medical Equipment benefits under the Cigna Preferred Medicare (HMO) plan include Durable Medical Equipment (DME) with a 20% coinsurance and Prosthetic Devices and Medical Supplies, also with a 20% coinsurance. Diabetic Therapeutic Shoes/Inserts are covered with a 20% coinsurance, while Durable Medical Equipment for use outside the home and 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, and lab services with no copay. Radiological Services have a copay, with diagnostic radiological services having a maximum copay of $195, while therapeutic radiological services have a 20% coinsurance, and 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 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 Medicare (HMO) plan. This includes Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, and SET for PAD Services.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the Cigna Preferred Medicare (HMO) plan. There is no copay for days 1-20, and a $214 copay for days 21-100.
Other Services See details
Other Services includes coverage for Over-the-Counter (OTC) items, with a maximum benefit of $130.00 every three months, and a meal benefit; however, acupuncture, Dual Eligible SNPs with Highly Integrated Services, and several other services are not covered.
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