A non-government entity
Cigna Courage Medicare (HMO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Cigna Courage Medicare (HMO). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Cigna Courage Medicare (HMO) in 2025, please refer to our full plan details page.
Cigna Courage Medicare (HMO) is a HMO plan offered by The Cigna Group available for enrollment in 2025 to people living in South Carolina. This plan received an overall rating of 4 out of 5 stars in 2025.
It's important to know that Cigna Courage Medicare (HMO) is a Medicare Advantage (MA) Plan without drug coverage. That means that this plan covers medical services but doesn't cover prescription drugs. If you are looking for a plan with prescription drug coverage, please search for other MA and PDP plans offered in your area.
Key Plan Facts
Below are a few key facts and commonly-asked questions about Cigna Courage 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 Courage 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. Additionally, this plan comes with a Part B Premium reduction of $150.00. You must continue to pay paying your reduced Part B Premium.
Deductibles
This plan does not have a health deductible. Your insurance coverage on covered health services will start immediately.
Drugs are not covered by this plan, so a prescription drug deductible is not applicable.
Out-of-Pocket Maximums
This plan has a Maximum Out-Of-Pocket cost of $6700.00 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
Prescription drugs are not covered by Cigna Courage Medicare (HMO).
Additional Benefits
The Cigna Courage Medicare (HMO) plan provides coverage for a wide range of services. Inpatient hospital stays have a copay, with the amount varying based on the type and duration of the stay. Outpatient services have varying copays, while emergency services have a $125 copay. This plan also covers primary care, preventive services, hearing, vision, and dental care, each with its own set of copays, coinsurance, and annual maximums. Additionally, the plan offers benefits for ambulance services, home health, dialysis, and medical equipment, with specific copays or coinsurance percentages.
Inpatient Hospital See details
Inpatient Hospital benefits, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric, are covered with prior authorization required. For Inpatient Hospital-Acute, you will pay a $350 copay for days 1-6, and no copay for days 7-90; for Inpatient Hospital Psychiatric, you will pay a $595 copay for days 1-3, and no copay for days 4-90. Additional days for Inpatient Hospital-Acute are covered, while Non-Medicare-covered stays and upgrades for Inpatient Hospital-Acute, and Additional days and Non-Medicare-covered stays for Inpatient Hospital Psychiatric are not covered.
Outpatient Services See details
Outpatient services are covered, including outpatient hospital services, observation services, ambulatory surgical center services, outpatient substance abuse services, and outpatient blood services. Outpatient hospital services have a copay between $0 and $285, observation services have a $285 copay, ambulatory surgical center services have no copay, and outpatient substance abuse individual and group sessions have a copay of $50.
Partial Hospitalization See details
Cigna Courage Medicare (HMO) covers partial hospitalization with a $105 copay. Prior authorization is required for this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by the Cigna Courage Medicare (HMO) plan. Ground ambulance services have a $270 copay, while air ambulance services have 20% coinsurance. Transportation services to health-related locations are not covered.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered under the Cigna Courage Medicare (HMO) plan. Emergency Services and Worldwide Emergency Coverage have a $125 copay, while Urgently Needed Services has a $55 copay; all services have no coinsurance. Worldwide Emergency Services has a maximum plan benefit coverage of $50,000.
Primary Care See details
The Cigna Courage Medicare (HMO) plan covers Primary Care Physician Services, Chiropractic Services (with a $20 copay), Occupational Therapy Services (with a $45 copay), Physician Specialist Services (with a $50 copay), Physical Therapy and Speech-Language Pathology Services (with a $45 copay), Other Health Care Professional services (with a copay between $0 and $50), and Opioid Treatment Program Services (with a $50 copay). Mental Health Specialty Services and Psychiatric Services are partially covered, but individual and group sessions are not. Additional Telehealth Benefits are covered with a copay between $0 and $50. Podiatry Services are not covered.
Preventive Services See details
Cigna Courage Medicare (HMO) covers preventive services, including annual physical exams, health education, kidney disease education services, and other preventive services such as glaucoma screening, diabetes self-management training, barium enemas, digital rectal exams, and EKGs following Welcome Visits. Some services, such as in-home safety assessments, personal emergency response systems, and medical nutrition therapy, are not covered.
Hearing Services See details
Hearing exams are covered with a $30 copay, and routine hearing exams and fitting/evaluation for hearing aids are each covered once per year. Prescription hearing aids are covered with a copay between $399 and $1800 for all types, 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
Vision services are covered, including routine eye exams with a copay of $0-$50. Eyewear is covered with a combined maximum benefit of $200 every year, and contact lenses, eyeglasses (lenses and frames), eyeglass lenses, eyeglass frames, and upgrades are also covered.
Dental Services See details
Cigna Courage Medicare (HMO) covers dental services with a $50 copay for Medicare dental services, and a $1,000 maximum plan benefit per year. Oral exams, dental x-rays, other diagnostic dental services, prophylaxis (cleaning), fluoride treatment, other preventive dental services, restorative services, adjunctive general services, endodontics, periodontics, prosthodontics (removable and fixed), maxillofacial prosthetics, implant services, oral and maxillofacial surgery, and orthodontics are covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, including Medicare Part B Insulin Drugs with a $35 copay and 0-20% coinsurance, and Other Medicare Part B Drugs and Medicare Part B Chemotherapy/Radiation Drugs with 0-20% coinsurance. Prior authorization is required.
Dialysis Services See details
Dialysis Services are covered by the Cigna Courage Medicare (HMO) plan, but require prior authorization. You will pay a coinsurance of 20% for these services.
Medical Equipment See details
Medical Equipment benefits with the Cigna Courage Medicare (HMO) plan include Durable Medical Equipment (DME), Prosthetics/Medical Supplies, and Diabetic Equipment. DME has a 20% coinsurance, while Prosthetics/Medical Supplies have a 20% coinsurance for Medicare-covered items, and Diabetic Therapeutic Shoes/Inserts also have a 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 the Cigna Courage Medicare (HMO) plan. Diagnostic Procedures/Tests have a copay between $0 and $95, while Lab Services have no copay. Diagnostic Radiological Services have a copay of at most $195, and Therapeutic Radiological Services have a coinsurance of at least 20%. Outpatient X-Ray Services have no copay.
Home Health Services See details
Home Health Services are covered by the Cigna Courage Medicare (HMO) plan with no copay or coinsurance, but Additional Hours of Care and Personal Care Services are not covered. Prior authorization is required for this benefit.
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 is required, and there is a copay for the services that are covered.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered with prior authorization. For days 1-20, the copay is $10, for days 21-60 the copay is $214, and for days 61-100, there is no copay.
Other Services See details
The Cigna Courage Medicare (HMO) plan does not cover acupuncture, over-the-counter items, 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. The plan does provide a meal benefit for a chronic illness or a medical condition that requires the enrollee to remain at home for a period of time.
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