A non-government entity
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 North 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 $174.70. 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 $6000.00 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 a $0 deductible for prescription drugs. During the initial coverage phase, you'll pay a copay for your prescriptions, which varies 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 will pay nothing for your Part D covered drugs. However, you may still pay a share of the costs for excluded drugs covered under any enhanced benefit.
Additional Benefits
The Cigna Preferred Savings Medicare (HMO) plan offers a range of benefits with varying costs. Inpatient hospital stays have a copay, while outpatient services and primary care have copays ranging from $0 to $425. Preventive services and home health services have no copays, while hearing, vision, and dental services are covered with copays or coinsurance. This plan also covers services like ambulance, emergency, and skilled nursing facilities with copays, coinsurance, and prior authorization required for some services. Additional benefits include home infusion, dialysis, and medical equipment, all with associated costs. However, some services like cardiac rehabilitation and certain therapies are not covered.
Inpatient Hospital See details
Inpatient Hospital services, including acute and psychiatric care, are covered by the Cigna Preferred Savings Medicare (HMO) plan. For Inpatient Hospital-Acute, you'll pay a $440 copay for days 1-4 and no copay for days 5-90, while for Inpatient Hospital Psychiatric, the copay is $595 for days 1-3 and no copay for days 4-90; however, additional days and non-Medicare-covered stays for both are not covered.
Outpatient Services See details
Outpatient services, including outpatient hospital services, observation services, ambulatory surgical center services, outpatient substance abuse services, and outpatient blood services, are covered by the Cigna Preferred Savings Medicare (HMO) plan. Outpatient hospital services have a copay between $0 and $425, observation services have a $425 copay, ambulatory surgical center services have no copay, and outpatient substance abuse services have a copay of $50 for both individual and group sessions. Outpatient blood services are also covered with a waived three-pint deductible.
Partial Hospitalization See details
Partial Hospitalization is covered under the Cigna Preferred Savings Medicare (HMO) plan, but requires prior authorization. The copay for this benefit is $105.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered, with prior authorization required for all ambulance services. Ground ambulance services have a $290 copay, while air ambulance services have a 20% coinsurance; however, transportation services to plan-approved and any health-related locations are not covered.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered under the Cigna Preferred Savings Medicare (HMO) plan. Emergency Services and Worldwide Emergency Coverage have a $125 copay, while Urgently Needed Services has a $55 copay, and all services have no coinsurance.
Primary Care See details
The Cigna Preferred Savings Medicare (HMO) plan covers primary care physician services, chiropractic services with a $20 copay, occupational therapy services with a $45 copay, and physician specialist services with a $50 copay. This plan also covers mental health specialty services, physical therapy, and speech-language pathology services with a $45 copay, additional telehealth benefits with a $0-$50 copay, and opioid treatment program services with a $50 copay, but does not cover routine chiropractic care, individual or group sessions for mental health and psychiatric services, or podiatry services.
Preventive Services See details
The Cigna Preferred Savings Medicare (HMO) plan covers preventive services, including Medicare-covered services with no copay, annual physical exams, health education, kidney disease education, and other preventive services like glaucoma screenings and diabetes self-management training. However, in-home safety assessments, personal emergency response systems, and many other services are not covered.
Hearing Services See details
Hearing services include hearing exams with a $25 copay, and fitting/evaluation for hearing aids with no copay. Prescription hearing aids are covered, with a copay between $399 and $1800 depending on the type of hearing aid. OTC hearing aids are not covered.
Vision Services See details
Vision services include routine eye exams with a copay of $0 - $50, and eyewear benefits including contact lenses, eyeglasses (lenses and frames), eyeglass lenses, and eyeglass frames. Eyewear has a combined maximum plan benefit coverage of $150 every year.
Dental Services See details
Dental Services includes coverage for Medicare Dental Services with a $50 copay and other dental services, with a maximum plan benefit of $500 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, requiring prior authorization. For Medicare Part B Insulin Drugs, there is a $35 copay with a coinsurance between 0-20%. For Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs, there is a coinsurance between 0-20%.
Dialysis Services See details
Dialysis Services are covered under the Cigna Preferred Savings Medicare (HMO) plan, but require prior authorization. You will pay 20% coinsurance.
Medical Equipment See details
Medical Equipment is covered by the Cigna Preferred Savings Medicare (HMO) plan, with Durable Medical Equipment (DME) subject to 20% coinsurance and requiring authorization. Prosthetic Devices, and Medical Supplies are covered with 20% coinsurance, and Diabetic Therapeutic Shoes/Inserts are covered with 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 Preferred Savings Medicare (HMO) plan. Diagnostic Procedures/Tests have a copay between $0 and $20, 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 Preferred Savings Medicare (HMO) plan with no copay and no coinsurance, but authorization is required. Additional Hours of Care and Personal Care Services are not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered by the Cigna Preferred Savings Medicare (HMO) plan. Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, and SET for PAD Services are also not covered.
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, the copay is $214; and for days 61-100, there is no copay. Additional days beyond Medicare-covered and non-Medicare-covered stays are not covered.
Other Services See details
Other Services for the Cigna Preferred Savings Medicare (HMO) plan include a meal benefit, 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.
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