Cigna Preferred Savings Medicare (HMO)

Inpatient Hospital See details

Inpatient Hospital services are covered, with a copay of $440 for days 1-5, and no copay for days 6-90 for Inpatient Hospital-Acute services. Inpatient Hospital Psychiatric services are also covered, with a copay of $595 for days 1-3, and no copay for days 4-90. Additional days for Inpatient Hospital-Acute are covered. Non-Medicare-covered stays and upgrades for Inpatient Hospital-Acute, as well as additional days and non-Medicare-covered stays for Inpatient Hospital Psychiatric, are not covered.

Outpatient Services See details

Outpatient Services for Cigna Preferred Savings Medicare (HMO) include coverage for all outpatient hospital services, with a copay between $0 and $425, and observation services with a $425 copay. Ambulatory Surgical Center (ASC) Services have no copay, and outpatient substance abuse services have a $50 copay for both individual and group sessions. Outpatient blood services are also covered, with three pints waived from the deductible.

Partial Hospitalization See details

Partial Hospitalization is covered under the Cigna Preferred Savings Medicare (HMO) plan, 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 Preferred Savings Medicare (HMO) plan, with both ground and air ambulance services covered. 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, Worldwide Urgent Coverage, and Worldwide Emergency Transportation have a $125 copay, while Urgently Needed Services have a $55 copay; all 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, physician specialist services with a $50 copay, and physical therapy and speech-language pathology services with a $45 copay. The plan also covers telehealth benefits with a copay between $0 and $50, and opioid treatment program services with a $50 copay, but does not cover routine chiropractic care, individual or group sessions for mental health specialty services, individual or group sessions for psychiatric services, or podiatry services.

Preventive Services See details

The Cigna Preferred Savings Medicare (HMO) plan covers preventive services, including annual physical exams, health education, kidney disease education services, glaucoma screenings, diabetes self-management training, barium enemas, digital rectal exams, and EKG following Welcome Visits. Some preventive services, such as in-home safety assessments, personal emergency response systems, and several others, 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 also covered once per year. Prescription hearing aids are covered, with a copay between $399 and $1800, 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 include coverage for eye exams and eyewear. Eye exams have a copay between $0 and $50, while eyewear has a combined maximum benefit of $150 per year.

Dental Services See details

Dental Services are covered by the Cigna Preferred Savings Medicare (HMO) plan, with a $50 copay for Medicare Dental Services, and a $500 maximum benefit per year for other dental services. 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 also covered.

Home Infusion bundled Services See details

Home Infusion bundled Services are covered, but prior authorization is required. For Medicare Part B Insulin Drugs, there is a $35 copay, and the coinsurance ranges from 0% to 20%. For Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs, the coinsurance ranges from 0% to 20%.

Dialysis Services See details

Dialysis Services are covered by the Cigna Preferred Savings Medicare (HMO) plan, but require prior authorization. You will pay 20% coinsurance for these services.

Medical Equipment See details

Medical Equipment is covered by Cigna Preferred Savings Medicare (HMO). Durable Medical Equipment (DME) has a 20% coinsurance, while Durable Medical Equipment for use outside the home is not covered.

Prosthetics/Medical Supplies - Non-Medicare benefit, including Prosthetic Devices and Medical Supplies, are covered with 20% coinsurance.

Diabetic Equipment is covered, with Diabetic Supplies not covered, while Diabetic Therapeutic Shoes/Inserts have a 20% coinsurance.

Diagnostic and Radiological Services See details

Diagnostic and Radiological Services are covered, including Diagnostic Procedures/Tests with a copay between $0 and $20, and Lab Services with no copay. Radiological Services are also covered with varying cost-sharing, including Diagnostic Radiological Services with a copay up to $195, Therapeutic Radiological Services with 20% coinsurance, and Outpatient X-Ray Services with 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 prior 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. Prior authorization is required for these services.

Skilled Nursing Facility (SNF) See details

Skilled Nursing Facility (SNF) services are covered, with a copay of $10 for days 1-20, $214 for days 21-60, and no copay for days 61-100. Additional days beyond Medicare-covered for SNF and Non-Medicare-covered stays for SNF are not covered.

Other Services See details

Other Services are partially covered by the Cigna Preferred Savings Medicare (HMO) plan. Acupuncture, Over-the-Counter (OTC) 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.