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Cigna Preferred Savings Medicare (HMO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Cigna Preferred Savings 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 Savings Medicare (HMO) in 2025, please refer to our full plan details page.
Cigna Preferred Savings 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 Preferred Savings 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 Savings 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 Savings 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 $125.00. 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.
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 $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
The Cigna Preferred Savings Medicare (HMO) plan has an enhanced alternative drug benefit. There is no deductible for prescription drugs. In the initial coverage phase, you will pay a copay for your prescriptions, depending on the drug tier and pharmacy. For example, preferred generic drugs have a $5 copay at preferred pharmacies. Once your total drug costs reach $2,000, you enter the catastrophic coverage phase, where you pay nothing for covered drugs.
Additional Benefits
The Cigna Preferred Savings Medicare (HMO) plan offers a range of benefits, including inpatient and outpatient hospital services, with varying copays. You will also have access to services such as ambulance, emergency, and primary care, with copays depending on the specific service. Additional benefits include preventive, hearing, vision, and dental services, with copays or coinsurance applying to some services. The plan also covers home health services, dialysis, medical equipment, and diagnostic services.
Inpatient Hospital See details
Inpatient Hospital benefits are covered, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric. For Inpatient Hospital-Acute, you will pay a copay of $385 for days 1-5, and no copay for days 6-90; for Inpatient Hospital Psychiatric, you will pay a copay of $595 for days 1-3, and no copay for days 4-90. 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, including all outpatient hospital services, observation services, ambulatory surgical center (ASC) services, outpatient substance abuse services, and outpatient blood services. Outpatient hospital services have a copay between $0 and $375, observation services have a $375 copay, ASC services have no copay, individual and group substance abuse sessions have a $40 copay, and outpatient blood services have a waived three (3) pint deductible.
Partial Hospitalization See details
Partial Hospitalization is covered by the Cigna Preferred Savings Medicare (HMO) plan, and requires prior authorization. The copay for this benefit is $105.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by the Cigna Preferred Savings Medicare (HMO) plan, with prior authorization required for all ambulance services. Ground ambulance services have a $290 copay, while air ambulance services have a 20% coinsurance. 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 Savings Medicare (HMO) plan. Emergency Services and Worldwide Emergency Coverage have a $125 copay, while Urgently Needed Services have a $55 copay; all have no coinsurance.
Primary Care See details
Primary Care Physician Services, Occupational Therapy Services, Physician Specialist Services, Physical Therapy and Speech-Language Pathology Services, and Opioid Treatment Program Services are covered under the Primary Care benefit, with copays of $40.00 for Occupational Therapy Services, $40.00 for Physician Specialist Services, and $40.00 for Physical Therapy and Speech-Language Pathology Services. Chiropractic Services are covered with a $20.00 copay, but Routine Chiropractic Care is not covered. Additional Telehealth Benefits are covered with a copay between $0.00 and $40.00. Mental Health Specialty Services and Psychiatric Services are partially covered, as individual and group sessions are not covered. Podiatry Services are not covered. Other Health Care Professional services are covered with a copay between $0.00 and $40.00.
Preventive Services See details
The Cigna Preferred Savings Medicare (HMO) plan covers preventive services, including annual physical exams, health education, kidney disease education services, and other preventive services like glaucoma screenings, diabetes self-management training, barium enemas, digital rectal exams, and EKG following a Welcome Visit. Additional preventive services such as in-home safety assessments, Personal Emergency Response Systems (PERS), and various other services are not covered.
Hearing Services See details
Hearing services are covered, including routine hearing exams with a $30 copay. Prescription hearing aids are also covered with a copay between $399 and $1800, while OTC hearing aids are not covered, and prescription hearing aids for the inner, outer, or over the ear are not covered.
Vision Services See details
Vision services include coverage for eye exams with a copay of $0-$40, and eyewear, including contact lenses, eyeglasses, eyeglass lenses, and eyeglass frames. Contact lenses are unlimited, while eyeglasses, lenses, and frames are limited to one per year, with a combined maximum benefit of $150.
Dental Services See details
Dental Services includes coverage for Medicare Dental Services with a $40 copay, and other dental services with a $500 maximum 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 all covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, and require prior authorization. For Medicare Part B Insulin Drugs, there is a $35 copay and a coinsurance between 0% and 20%. For Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs, there is a coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered by the Cigna Preferred Savings Medicare (HMO) plan, but require prior authorization. You will pay a 20% coinsurance for these services.
Medical Equipment See details
Medical Equipment, including Durable Medical Equipment, Prosthetics, and Medical Supplies, is covered by the Cigna Preferred Savings Medicare (HMO) plan. You will pay 20% coinsurance for Durable Medical Equipment, Prosthetic Devices, and Medical Supplies, and there is no copay for these services.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered. Diagnostic Procedures/Tests have a copay between $0 and $20, Lab Services have no copay, and Diagnostic Radiological Services have a copay up to $195. Therapeutic Radiological Services have a 20% coinsurance, while Outpatient X-Ray Services have no copay.
Home Health Services See details
Home Health Services are covered under the Cigna Preferred Savings Medicare (HMO) plan. There is no copay or coinsurance for this benefit, though authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered by the Cigna Preferred Savings Medicare (HMO) plan, including Medicare-covered Intensive Cardiac Rehabilitation Services, Medicare-covered Pulmonary Rehabilitation Services, Medicare-covered Supervised Exercise Therapy (SET) for Symptomatic Peripheral Artery Disease (PAD) Services, and Additional Cardiac Rehabilitation Services. Prior authorization is required for this benefit.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered, but require prior authorization. For days 1-20, there is a $10 copay, for days 21-60 there is a $214 copay, and for days 61-100 there is no copay.
Other Services See details
Other Services are partially covered, but 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 are not covered. The plan offers a meal benefit for chronic illnesses or medical conditions that require the enrollee to remain at home.
Get Personalized Help from a licensed insurance agent
1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
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Part B premium reduction is not available with all plans. Availability varies by carrier and location. Actual Part B premium reduction could be lower. Deductibles, copays and coinsurance may apply.
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