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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 Southeast 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 $1.10. 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 the deductible, you will pay the costs for drugs in each tier until your total drug costs reach $2000, at which point you enter the next coverage phase. If you qualify for the low-income subsidy (LIS), you will pay $1.10 for Part D drugs. After your yearly out-of-pocket drug costs reach $2000, you will pay nothing for Medicare Part D covered drugs.
Additional Benefits
The Cigna TotalCare Plus (HMO D-SNP) plan offers comprehensive coverage with no copay for inpatient hospital stays, emergency services, and home health services. The plan also includes coverage for outpatient services, primary care, preventive services, vision, and dental, with specific cost-sharing details outlined for each. Other benefits include hearing exams and hearing aids, over-the-counter items, and a meal benefit for chronic illnesses.
Inpatient Hospital See details
Inpatient hospital services are covered by the Cigna TotalCare Plus (HMO D-SNP) plan, with no copay for a Medicare-covered stay. Additional days, non-Medicare-covered stays, and upgrades for inpatient hospital acute and psychiatric services are not covered.
Outpatient Services See details
Outpatient Services are covered by the Cigna TotalCare Plus (HMO D-SNP) plan, including outpatient hospital services, observation services, ambulatory surgical center services, and outpatient blood services. Outpatient substance abuse services are partially covered, as individual and group sessions for outpatient substance abuse are not covered.
Partial Hospitalization See details
Partial Hospitalization is covered under the Cigna TotalCare Plus (HMO D-SNP) plan, but requires prior authorization. There is no mention of cost information for this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by the Cigna TotalCare Plus (HMO D-SNP) plan. Air Ambulance Services are covered with a 20% coinsurance, while Ground Ambulance Services are not covered. 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 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
Primary Care services include coverage for 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. Chiropractic Services, Mental Health Specialty Services (Individual and Group Sessions), Psychiatric Services (Individual and Group Sessions) are partially covered, while 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 services such as Health Education, In-Home Support Services, and Fitness Benefits are also covered, while In-Home Safety Assessment, Personal Emergency Response System (PERS), and several other services are not covered.
Hearing Services See details
The Cigna TotalCare Plus (HMO D-SNP) plan covers hearing exams, including routine exams and fitting/evaluation for hearing aids, with each limited to one visit 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, nor are OTC hearing aids.
Vision Services See details
Vision services include routine eye exams with no copay, and a yearly allowance of $150 for eyewear. Contact lenses, eyeglasses (lenses and frames), eyeglass lenses, eyeglass frames, and upgrades are also covered.
Dental Services See details
The Cigna TotalCare Plus (HMO D-SNP) plan covers a variety of dental services, including oral exams, x-rays, cleaning, and orthodontics, with a maximum annual benefit of $1,500. Orthodontic services are covered under Diagnostic and Preventive Dental.
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. Medicare Part B Insulin Drugs have a $35 copay with 0-20% coinsurance, while Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs have 0-20% coinsurance.
Dialysis Services See details
Dialysis Services are covered by the Cigna TotalCare Plus (HMO D-SNP) plan, but require prior authorization and a doctor referral. The plan does not specify any cost-sharing for this benefit.
Medical Equipment See details
Medical Equipment is covered by the Cigna TotalCare Plus (HMO D-SNP) plan, including Durable Medical Equipment (DME) and Prosthetics/Medical Supplies, with no copay or coinsurance, but Durable Medical Equipment for use outside the home, Prosthetic Devices, Medical Supplies, Diabetic Supplies, and Diabetic Therapeutic Shoes/Inserts are not covered. Diabetic Equipment is also covered, but the plan limits diabetic supplies and services to those from specified manufacturers.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are partially covered by the Cigna TotalCare Plus (HMO D-SNP) plan. While Lab Services have no copay, 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 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 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 referral are required.
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. Additional days beyond Medicare-covered SNF and non-Medicare-covered SNF stays are not covered.
Other Services See details
The Cigna TotalCare Plus (HMO D-SNP) plan covers Over-the-Counter (OTC) Items with a maximum benefit of $130 every three months, including Nicotine Replacement Therapy (NRT) and Naloxone coverage. The plan also covers a Meal Benefit for chronic illnesses or medical conditions requiring home care. Acupuncture, Dual Eligible SNPs with Highly Integrated Services, and many other services are not covered.
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