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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 Orlando/Tampa. 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 $18.50. 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 $2950.00 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. If you qualify for the low-income subsidy, you will pay $18.50. After the deductible is met, you will pay costs for drugs in each tier until your total drug costs reach $2000. Once you reach that amount, you enter the next coverage phase. After your yearly out-of-pocket drug costs reach $2000, you pay nothing for Medicare Part D covered drugs.
Additional Benefits
The Cigna TotalCare (HMO D-SNP) plan offers comprehensive coverage with a range of benefits. This plan includes inpatient hospital stays with a $175 copay for days 1-5, and no copay for days 6-90, as well as outpatient services with varying copays and coinsurance. You can also expect coverage for emergency services with a $135 copay, along with primary care, preventive services, hearing, vision, and dental care, all with associated copays or coinsurance. Additional benefits of this plan include coverage for ambulance services, home health services with no copay, and skilled nursing facility stays. The plan also provides coverage for durable medical equipment, diagnostic services, and other services, such as over-the-counter items and a meal benefit. However, it's important to note that some services, such as certain hearing aids and additional hours of care, may not be covered.
Inpatient Hospital See details
Inpatient Hospital services, including those not usually covered by Medicare, are covered. You will pay a $175 copay for days 1-5, and no copay for days 6-90 for Inpatient Hospital-Acute and Inpatient Hospital Psychiatric.
Outpatient Services See details
Outpatient Services, including outpatient hospital services, observation services, and ambulatory surgical center services, are covered. Outpatient hospital services have a copay between $0 and $175, while observation services have a $175 copay, and ambulatory surgical center services have no copay. Outpatient substance abuse services, including individual and group sessions, are covered with a 20% coinsurance. Outpatient blood services are also covered.
Partial Hospitalization See details
Cigna TotalCare (HMO D-SNP) covers partial hospitalization with a $100 copay, and prior authorization is required.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered. Ground and air ambulance services have a 20% coinsurance, and transportation services to a plan-approved health-related location are covered.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered. Emergency Services, Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation each have a $135 copay, and no coinsurance.
Primary Care See details
The Cigna TotalCare (HMO D-SNP) plan covers primary care physician services, chiropractic services with 20% coinsurance, occupational therapy services with 20% coinsurance, physician specialist services with 20% coinsurance, and physical therapy and speech-language pathology services with 20% coinsurance. This plan also covers additional telehealth benefits with 0% to 20% coinsurance and opioid treatment program services with 20% coinsurance; however, individual and group sessions for mental health and psychiatric services, and routine chiropractic care are not covered.
Preventive Services See details
The Cigna TotalCare (HMO D-SNP) plan covers preventive services, including annual physical exams, health education, fitness benefits, kidney disease education, glaucoma screening, diabetes self-management training, barium enemas, digital rectal exams, and EKGs with a welcome visit. However, in-home safety assessments, personal emergency response systems, medical nutrition therapy, and other services are not covered.
Hearing Services See details
Hearing services include hearing exams and prescription hearing aids. Hearing exams have a coinsurance of at most 20%, and routine hearing exams and fitting/evaluation for hearing aids are covered annually. Prescription Hearing Aids (all types) have a copay between $399 and $1800, while inner ear, outer ear, and over the ear hearing aids are not covered.
Vision Services See details
The Cigna TotalCare (HMO D-SNP) plan covers vision services, including eye exams with a coinsurance of 0% - 20% and routine eye exams once per year. Eyewear is also covered with a combined maximum amount of $300 every year, while contact lenses and upgrades are also covered.
Dental Services See details
Cigna TotalCare (HMO D-SNP) covers dental services, with a 20% coinsurance for Medicare Dental Services, and other dental services covered up to a maximum of $2,500 per year. The plan covers oral exams, dental x-rays, other diagnostic dental services, prophylaxis (cleaning), fluoride treatments, other preventive dental services, restorative services, adjunctive general services, endodontics, periodontics, prosthodontics (removable and fixed), maxillofacial prosthetics, implant services, and orthodontics.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, and require prior authorization. For Medicare Part B Insulin Drugs, you will pay a $35 copay and between 0% and 20% coinsurance. For Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs, you will pay between 0% and 20% coinsurance.
Dialysis Services See details
Dialysis Services are covered with a 20% coinsurance, and require prior authorization and a doctor referral.
Medical Equipment See details
Medical Equipment coverage includes Durable Medical Equipment with 20% coinsurance and no copay, Prosthetics/Medical Supplies with 20% coinsurance and no copay, and Diabetic Therapeutic Shoes/Inserts with 20% coinsurance. 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 by Cigna TotalCare (HMO D-SNP), including Diagnostic Procedures/Tests with a coinsurance of up to 20%, Lab Services with no copay, Diagnostic Radiological Services with a coinsurance of up to 20%, Therapeutic Radiological Services with a 20% coinsurance, and Outpatient X-Ray Services with a 20% coinsurance. Prior authorization and a doctor's referral are required for all diagnostic and radiological services.
Home Health Services See details
Home Health Services are covered by the Cigna TotalCare (HMO D-SNP) 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 covered, but the plan does not cover Cardiac Rehabilitation Services, Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, or SET for PAD Services. Prior authorization and a doctor's referral are required.
Skilled Nursing Facility (SNF) See details
The Cigna TotalCare (HMO D-SNP) plan covers Skilled Nursing Facility (SNF) services, but prior authorization is required. For days 1-20, there is no copay, and for days 21-100, the copay is $214 per day; additional days beyond Medicare-covered are not covered.
Other Services See details
The Cigna TotalCare (HMO D-SNP) plan covers Over-the-Counter (OTC) items with a maximum benefit of $70 every three months, and also offers a meal benefit for chronic illnesses or medical conditions requiring the enrollee to stay at home. Acupuncture, Dual Eligible SNPs with Highly Integrated Services, and many other services are not covered.
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