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 $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.
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 this plan. In the initial coverage phase, you'll pay a copay for your prescriptions. For example, a preferred generic drug has a $5 copay. Once your total drug costs reach $2000, 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 hospital stays with copays, outpatient services with varying copays, and ambulance services with copays or coinsurance. Emergency, urgent, and worldwide emergency services are covered with copays, while primary care, specialist visits, and therapies have copays. Preventive, hearing, vision, and dental services are included, with copays and annual limits for some. The plan also covers home infusion, dialysis, and medical equipment with copays or coinsurance. Skilled nursing facility stays have copays, and home health services have no copay.
Inpatient Hospital See details
Inpatient Hospital benefits are covered, with a $300 copay for days 1-5 and no copay for days 6-90 for Inpatient Hospital-Acute, and a $595 copay for days 1-3 and no copay for days 4-90 for Inpatient Hospital Psychiatric; however, Non-Medicare-covered Stay and Upgrades for Inpatient Hospital-Acute, and Additional Days and Non-Medicare-covered Stay for Inpatient Hospital Psychiatric are not covered.
Outpatient Services See details
Outpatient services are covered, including outpatient hospital services with a copay ranging from $0 to $425, observation services with a $425 copay, ambulatory surgical center services with no copay, and outpatient substance abuse services with a $50 copay 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 by the Cigna Preferred Savings Medicare (HMO) plan, requiring prior authorization and a $105 copay.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered under the Cigna Preferred Savings Medicare (HMO) plan. Ground Ambulance Services have a $290 copay, while Air Ambulance Services have a 20% coinsurance, and Transportation Services are not covered.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered. Emergency Services and Worldwide Emergency Coverage have a $125 copay, while Urgently Needed Services have a $55 copay, and 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 with a $45 copay, specialist services with a $50 copay, physical therapy and speech-language pathology services with a $45 copay, and other health care professional services with a copay between $0 and $50. Mental health and psychiatric individual and group sessions are not covered, nor are podiatry services. Additional telehealth benefits are covered with a copay between $0 and $50, and Opioid Treatment Program Services are covered with a $50 copay.
Preventive Services See details
Preventive Services include coverage for Medicare-covered services with no copay, as well as annual physical exams, health education, kidney disease education, glaucoma screenings, diabetes self-management training, barium enemas, digital rectal exams, and EKG following Welcome Visit. This plan does not cover in-home safety assessments, personal emergency response systems, medical nutrition therapy, post-discharge in-home medication reconciliation, readmission prevention, wigs for hair loss related to chemotherapy, 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 of enrollees, additional sessions of smoking and tobacco cessation counseling, enhanced disease management, telemonitoring services, remote access technologies, home and bathroom safety devices and modifications, or counseling services.
Hearing Services See details
Hearing Services are covered, including hearing exams, fitting/evaluation for hearing aids, and prescription hearing aids. Hearing exams have a $25 copay, and prescription hearing aids have a copay between $399 and $1800, while OTC hearing aids are not covered.
Vision Services See details
Vision Services include coverage for eye exams and eyewear. Eye exams have a copay of $0-$50, and routine eye exams are covered once per year. Eyewear, including contact lenses, eyeglasses (lenses and frames), eyeglass lenses, and eyeglass frames, are covered with a combined maximum plan benefit of $150 per year, while contact lenses are unlimited, and eyeglasses (lenses and frames), eyeglass lenses and eyeglass frames are covered once per year.
Dental Services See details
Dental services include coverage for Medicare Dental Services with a $50 copay, and other dental services, all with a maximum benefit of $500 per year. The plan covers 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.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered by the Cigna Preferred Savings Medicare (HMO) plan. 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 under the Cigna Preferred Savings Medicare (HMO) plan. This benefit requires prior authorization and has a coinsurance of 20%.
Medical Equipment See details
Medical Equipment is covered, including Durable Medical Equipment (DME) with a 20% coinsurance and Prosthetics/Medical Supplies with a 20% coinsurance, but 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 by the Cigna Preferred Savings Medicare (HMO) plan. Diagnostic Procedures/Tests have a copay between $0 and $20, and Lab Services have no copay. Diagnostic Radiological Services have a copay of up to $195, and Therapeutic Radiological Services have a coinsurance of at least 20%, while 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 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 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 there is a $214 copay, and for days 61-100, there is no copay.
Other Services See details
The Cigna Preferred Savings 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, or Self-Directed Personal Assistance Services. The plan covers a meal benefit for chronic illnesses and medical conditions that require the enrollee to remain at home for a period of time.
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1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
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