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 North 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 $115.00. 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 $6750.00 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 offers a range of benefits, including inpatient hospital stays with a copay, outpatient services with varying copays, and emergency services with a $125 copay. You will have access to primary care with no copay, as well as vision and dental coverage with copays. This plan also includes coverage for hearing exams, and hearing aids. It provides coverage for home health services with no copay, but other services like cardiac rehabilitation are not covered.
Inpatient Hospital See details
Inpatient Hospital services, including those not usually covered by Medicare, are covered. For Inpatient Hospital-Acute, you will pay a $300 copay for days 1-7, and no copay for days 8-90. Inpatient Hospital Psychiatric services are covered with a $595 copay for days 1-3, and no copay for days 4-90.
Outpatient Services See details
Outpatient Services with the Cigna Courage Medicare (HMO) plan includes coverage for all outpatient hospital services with a copay ranging from $0 to $290, observation services with a $290 copay, and ambulatory surgical center services with no copay. Outpatient substance abuse services, including individual and group sessions, have a copay of $50. Outpatient blood services are also covered.
Partial Hospitalization See details
Cigna Courage Medicare (HMO) covers partial hospitalization with a $105 copay. Prior authorization is required for coverage.
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 a 20% coinsurance; however, 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 Courage Medicare (HMO) plan. For emergency services, there is a $125 copay and no coinsurance; for urgently needed services, there is a $55 copay and no coinsurance; and for worldwide emergency coverage, worldwide urgent coverage, and worldwide emergency transportation, there is a $125 copay and no coinsurance, up to a maximum plan benefit coverage of $50,000.
Primary Care See details
The Cigna Courage Medicare (HMO) plan covers primary care physician services with no copay, chiropractic services with a $20 copay, occupational therapy services with a $45 copay, and physician specialist services with a $50 copay. The plan's mental health specialty and psychiatric services do not cover individual or group sessions. Physical therapy and speech-language pathology services have a $45 copay. Additional telehealth benefits have a copay between $0 and $50. Opioid treatment program services have a $50 copay.
Preventive Services See details
The Cigna Courage Medicare (HMO) plan covers preventive services, including annual physical exams, health education, and fitness benefits. However, in-home safety assessments, personal emergency response systems, medical nutrition therapy, post-discharge in-home medication reconciliation, re-admission prevention, wigs for hair loss, weight management programs, alternative therapies, therapeutic massage, adult day health services, nutritional/dietary benefits, home-based palliative care, in-home support services, support for caregivers, additional smoking cessation, enhanced disease management, telemonitoring services, remote access technologies, home and bathroom safety devices, and counseling services are not covered.
Hearing Services See details
Hearing exams are covered with a $25 copay, and routine hearing exams and fitting/evaluation for hearing aids are each covered once per year. Prescription hearing aids (all types) are covered with a copay between $399 and $1800 for 2 hearing aids per year, but hearing aids for the inner, outer, or over the ear are not covered, nor are OTC hearing aids.
Vision Services See details
The Cigna Courage Medicare (HMO) plan covers vision services, including routine eye exams with a copay of $0-$50. The plan also covers eyewear, with a combined maximum benefit of $200 every year, and contact lenses with no limitations. Eyeglasses (lenses and frames), eyeglass lenses, and eyeglass frames are also covered, with one pair of each covered every year.
Dental Services See details
Cigna Courage Medicare (HMO) covers dental services, including oral exams, dental x-rays, and other diagnostic services with no copay. You will pay a $50 copay for Medicare dental services. Other preventive dental services, restorative services, and orthodontics are also covered. There is a $1000 maximum plan benefit for dental services each year.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, but require prior authorization. For Medicare Part B Insulin Drugs, you will pay a $35 copay and between 0-20% coinsurance. For Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs, you will pay between 0-20% coinsurance.
Dialysis Services See details
Dialysis Services are covered by the Cigna Courage Medicare (HMO) plan, but require prior authorization. You will pay 20% coinsurance for these services.
Medical Equipment See details
Medical Equipment is covered, including Durable Medical Equipment (DME) with 15% coinsurance and Prosthetic Devices with 15% coinsurance; however, Durable Medical Equipment for use outside the home is not covered. Diabetic Therapeutic Shoes/Inserts are covered with a 20% coinsurance, but Diabetic Supplies are not covered.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered, with a minimum copay of $0 and a maximum copay of $95 for Diagnostic Procedures/Tests, and a $0 copay for Lab Services and Outpatient X-Ray Services. Therapeutic Radiological Services have a coinsurance of at least 20%, while Diagnostic Radiological Services have a maximum copay of $195.
Home Health Services See details
Home Health Services are covered by the Cigna Courage 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
Cardiac Rehabilitation Services are not covered by the Cigna Courage Medicare (HMO) plan. Prior authorization is required.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered, but require 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. Additional days beyond Medicare-covered for SNF and Non-Medicare-covered stays for SNF are not covered.
Other Services See details
Other Services offered by Cigna Courage Medicare (HMO) are partially covered, with acupuncture, over-the-counter (OTC) items, 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 not covered. The plan does offer a meal benefit for chronic illnesses or medical conditions that require the enrollee to remain at home.
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