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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 South Florida. 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 $18.10. 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:
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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 the costs for your drugs as defined by the plan's formulary. Once your total drug costs reach $2000, you will enter the catastrophic coverage phase, where you will pay nothing for your Part D covered drugs. If you qualify for the low-income subsidy, your monthly premium for Part D will be $18.10.
Additional Benefits
The Cigna TotalCare Plus (HMO D-SNP) plan offers a wide range of benefits with varying costs. Many services, like inpatient hospital stays, primary care, and home health services, have no copay. Emergency services and ambulance services are also covered, with no copay for ground ambulance, and a 20% coinsurance for air ambulance. The plan also includes coverage for hearing and vision services, with no copay for routine hearing exams and eye exams, and a combined maximum benefit of $200 per year for eyewear. Dental services are covered up to a maximum of $4,000 per year, and orthodontic services are covered as well. The plan provides coverage for home infusion services, and skilled nursing facility services with no copay for days 1-100.
Inpatient Hospital See details
Inpatient Hospital benefits, including both Acute and Psychiatric, are covered under the Cigna TotalCare Plus (HMO D-SNP) plan with no copay. Additional days for Inpatient Hospital Acute and Psychiatric, and Non-Medicare-covered stays and upgrades are not covered.
Outpatient Services See details
Outpatient Services, including outpatient hospital services, observation services, ambulatory surgical center services, and outpatient blood services, are covered by the Cigna TotalCare Plus (HMO D-SNP) plan. Individual and group sessions for outpatient substance abuse are not covered.
Partial Hospitalization See details
Partial Hospitalization is covered by the Cigna TotalCare Plus (HMO D-SNP) plan, but requires prior authorization. No specific cost information is provided in this snippet.
Ambulance and Transportation Services See details
The Cigna TotalCare Plus (HMO D-SNP) plan covers all ambulance services, with no copay, and a coinsurance for Medicare-covered ground ambulance services. Air ambulance services are covered with a 20% coinsurance. Transportation services to a plan-approved health-related location are covered, while transportation to any health-related location is not covered.
Emergency Services See details
Emergency Services, including Emergency Services, Urgently Needed Services, and Worldwide Emergency Services, are covered by the Cigna TotalCare Plus (HMO D-SNP) plan. Emergency Services 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.
Primary Care See details
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 are covered with no copay and no coinsurance, while Chiropractic Services, Mental Health Specialty Services, and Psychiatric Services are covered, but Individual and Group Sessions are not. Podiatry Services are not covered.
Preventive Services See details
Preventive Services, including annual physical exams, are covered by the Cigna TotalCare Plus (HMO D-SNP) plan. Additional preventive services are partially covered; In-Home Safety Assessment, Personal Emergency Response System (PERS), Medical Nutrition Therapy (MNT), 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 Benefit, 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 (including Web/Phone-based technologies and Nursing Hotline), Home and Bathroom Safety Devices and Modifications, and Counseling Services are not covered.
Hearing Services See details
The Cigna TotalCare Plus (HMO D-SNP) plan covers hearing exams, routine hearing exams (1 per year), and fitting/evaluation for hearing aids (1 per year) with no copay. Prescription hearing aids (all types) are covered with a copay between $399 and $1800, but prescription hearing aids for the 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 Plus (HMO D-SNP) plan covers vision services, including eye exams, eyewear, and upgrades, but excludes a limit of one routine eye exam per year. Eyewear has a combined maximum benefit of $200 per year, and includes contact lenses, eyeglasses (lenses and frames), eyeglass lenses, and eyeglass frames.
Dental Services See details
The Cigna TotalCare Plus (HMO D-SNP) plan covers a variety of dental services, including oral exams, dental x-rays, and other diagnostic and preventive services, with a maximum benefit of $4,000 per year. Orthodontic services are also covered, and some services require prior authorization.
Home Infusion bundled Services See details
Home Infusion bundled Services, including Medicare Part B Insulin Drugs, Medicare Part B Chemotherapy/Radiation Drugs, and Other Medicare Part B Drugs, are covered. For Medicare Part B Insulin Drugs, there is a $35 copay with coinsurance between 0% and 20%; for Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs, there is coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered by the Cigna TotalCare Plus (HMO D-SNP) plan, but require both prior authorization and a doctor's referral. The plan does not specify any cost information for this benefit.
Medical Equipment See details
Medical Equipment benefits are covered under the Cigna TotalCare Plus (HMO D-SNP) plan. Durable Medical Equipment (DME) and Prosthetics/Medical Supplies have no copay or coinsurance, but require authorization, while Durable Medical Equipment for use outside the home, Prosthetic Devices, Medical Supplies, Diabetic Supplies, and Diabetic Therapeutic Shoes/Inserts are not covered.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are partially covered by the Cigna TotalCare Plus (HMO D-SNP) plan. Lab Services have no copay, while Diagnostic Procedures/Tests, Diagnostic Radiological Services, Therapeutic Radiological Services, and Outpatient X-Ray Services are not covered.
Home Health Services See details
Home Health Services are covered by the Cigna TotalCare Plus (HMO D-SNP) plan with no copay or 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 covered, but none of the specific services are covered. This includes Cardiac Rehabilitation Services, 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 under the Cigna TotalCare Plus (HMO D-SNP) plan, with no copay for days 1-100. Additional days beyond Medicare-covered and non-Medicare-covered stays for SNF are not covered.
Other Services See details
The Cigna TotalCare Plus (HMO D-SNP) plan covers Over-the-Counter (OTC) Items, up to $95 every three months, including Nicotine Replacement Therapy (NRT) and Naloxone. 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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