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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 Miami-Dade. 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 $1450.00 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. In the initial coverage phase, you'll pay a copay for your prescriptions. The copays vary depending on the drug tier and whether you use a preferred or standard pharmacy. For example, preferred generic drugs have a $4 copay, while standard generic drugs have a $45 copay. Once your total drug costs reach $2,000, you enter the catastrophic coverage phase where you pay nothing for Part D covered drugs.
Additional Benefits
The Cigna Preferred Medicare (HMO) plan offers comprehensive coverage with a focus on keeping costs low. Many services have no copay, including inpatient hospital stays, primary care visits, and home health services. The plan also includes coverage for hearing, vision, and dental services, with specific copays and annual maximums for each. This plan provides additional benefits such as ambulance services, emergency services, and transportation to health-related locations. You'll also find coverage for prescription hearing aids and a quarterly allowance for over-the-counter items. While some services require prior authorization or have cost-sharing, the plan is designed to provide a range of healthcare options with an emphasis on value.
Inpatient Hospital See details
Inpatient Hospital benefits are covered under the Cigna Preferred Medicare (HMO) plan, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric services, both of which have no copay. Additional days for Inpatient Hospital-Acute benefits are covered, but Non-Medicare-covered Stay for Inpatient Hospital-Acute, Upgrades for Inpatient Hospital-Acute, Additional Days for Inpatient Hospital Psychiatric, and Non-Medicare-covered Stay for Inpatient Hospital Psychiatric are not covered.
Outpatient Services See details
Outpatient Services are covered under the Cigna Preferred Medicare (HMO) plan. Outpatient hospital services, observation services, ambulatory surgical center services, and outpatient blood services are covered, while individual and group sessions for outpatient substance abuse are not covered.
Partial Hospitalization See details
Partial Hospitalization is covered with prior authorization. There is no information about cost sharing for this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered, including both ground and air ambulance services. Ground ambulance services have a copay of $75, while air ambulance services have a 20% coinsurance. Transportation services to plan-approved health-related locations are covered for up to 50 one-way trips per year. 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 by the Cigna Preferred Medicare (HMO) plan. Emergency Services and Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation each have a $50 copay, while Urgently Needed Services has no copay.
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 for Occupational Therapy and Physical Therapy and Speech-Language Pathology Services. Chiropractic Services, Mental Health Specialty Services, and Psychiatric Services are partially covered, with Routine Chiropractic Care, Individual Sessions for Mental Health Specialty Services, and Group Sessions for Mental Health Specialty Services not covered. Podiatry Services are not covered.
Preventive Services See details
The Cigna Preferred Medicare (HMO) plan covers a variety of preventive services, including annual physical exams, health education, glaucoma screenings, and diabetes self-management training. Some services, such as In-Home Safety Assessment, Personal Emergency Response System, and others, are not covered.
Hearing Services See details
Hearing services with the Cigna Preferred Medicare (HMO) plan include routine hearing exams and fitting/evaluation for hearing aids, each with one visit per year, and prescription hearing aids (all types) with a copay between $399 and $1800 for 2 hearing aids per year. Prescription hearing aids - inner ear, outer ear, and over the ear are not covered, and OTC hearing aids are not covered.
Vision Services See details
The Cigna Preferred Medicare (HMO) plan covers vision services, including routine eye exams once per year. Eyewear is covered with a combined maximum benefit of $300 per year, while contact lenses are also covered.
Dental Services See details
Cigna Preferred Medicare (HMO) covers a range of dental services, including oral exams, dental x-rays, and other diagnostic services, with a maximum annual benefit of $4,000. Additionally, the plan covers prophylaxis (cleaning), fluoride treatment, and other preventive services, as well as orthodontic, restorative, and surgical services.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered by Cigna Preferred Medicare (HMO), including insulin and Medicare Part B drugs; however, prior authorization is required. For Medicare Part B insulin drugs, there is a $35 copay and 0-20% coinsurance, while other Medicare Part B drugs have a coinsurance of 0-20%.
Dialysis Services See details
Dialysis Services are covered under 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, including Durable Medical Equipment (DME), Prosthetics/Medical Supplies, and Diabetic Equipment, are covered under the Cigna Preferred Medicare (HMO) plan, but some services are not covered. There is no copay or coinsurance for DME and Prosthetics/Medical Supplies, but 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 include coverage for Lab Services with no copay, and Therapeutic Radiological Services with a copay of at most $60.00. Diagnostic Procedures/Tests, Diagnostic Radiological Services, and Outpatient X-Ray Services are not covered.
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
Cigna Preferred Medicare (HMO) 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 for these services.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by Cigna Preferred Medicare (HMO), with a $0 copay for days 1-20 and a $50 copay for days 21-100. Additional days beyond Medicare-covered SNF stays and non-Medicare-covered SNF stays are not covered.
Other Services See details
The Cigna Preferred Medicare (HMO) plan covers Over-the-Counter (OTC) Items with a maximum benefit of $155.00 every three months. The plan also covers a Meal Benefit, but 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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