Cigna Preferred Medicare (HMO)
Cigna Preferred Medicare (HMO) is a HMO Medicare Advantage (Medicare Part C) plan offered by Cigna Healthcare
Plan ID: H3949-035-000
Pennsylvania Medicare beneficiaries may want to consider reviewing their Medicare Advantage (Medicare Part C) plan options. A Medicare Advantage plan combines your Original Medicare (Part A and Part B) benefits into a single plan.
Most Medicare Advantage plans cover prescription drugs, and many plans may offer other extra benefits Original Medicare doesn’t cover.
Learn more about Pennsylvania Medicare Advantage plans like the one below and find a plan that offers the benefits you want at an affordable price.
Basic Costs and Coverage
| Coverage | Details |
|---|---|
| Monthly plan premium | $0.00 |
| Vision coverage | |
| Dental coverage | |
| Hearing coverage | |
| Prescription drugs | |
| Medical deductible | $0.00 |
| Out-of-pocket maximum | $7,200.00 |
| Initial drug coverage limit | $0.00 |
| Catastrophic drug coverage limit | $8,000.00 |
| Primary care doctor visit | $0 |
| Specialty doctor visit | $40 |
| Inpatient hospital care | $225 per day for days 1-9 $0 per day for days 10-90 |
| Urgent care | $50 Copay is waived if hospital admission occurs within: 24 hours Worldwide Urgent Coverage: $100 |
| Emergency room visit | $100 Copay is waived if hospital admission occurs within: 24 hours Worldwide Emergency Coverage: $100 |
| Ambulance transportation | Ambulance - Ground: $195 Ambulance - Air: 20% |
Health Care Services and Medical Supplies
Cigna Preferred Medicare (HMO) covers a range of additional benefits. Learn more about Cigna Preferred Medicare (HMO) benefits, some of which may not be covered by Original Medicare (Part A and Part B).
| Coverage | Details |
|---|---|
| Chiropractic services | $15 Routine Chiropractic (Supplemental): Not covered |
| Diabetes supplies, training, nutrition therapy and monitoring | If you’re managing diabetes, Cigna Healthcare makes it easier and more affordable to get monitoring and testing supplies. Your plan covers preferred brand diabetic supplies plus home delivery options. So you have less to worry about. Diabetic Supplies: $0 Diabetic Therapeutic Shoes or Inserts: 20% |
| Durable medical equipment (DME) | 20% |
| Diagnostic tests, lab and radiology services, and X-rays | Lab Services: 0 - 20% Diagnostic Radiological Services: $0 - $250 X-Ray Services: $40 |
| Home health care | $0 Support for Caregivers of Enrollees: Not covered |
| Mental health inpatient care | $175 per day for days 1-8 $0 per day for days 9-90 |
| Mental health outpatient care | Psychiatric-Individual: $0 Psychiatric-Group: $0 |
| Outpatient services/surgery | In-Network: Outpatient Hospital Services: Copayment for Medicare Covered Outpatient Hospital Services $0.00 to $335.00 Prior Authorization Required for Outpatient Hospital Services Outpatient Observation Services: Copayment for Medicare Covered Observation Services - Per stay $335.00 Prior Authorization Required for Outpatient Observation Services Ambulatory Surgical Center Services: Copayment for Ambulatory Surgical Center Services $0.00 to $250.00 Prior Authorization Required for Ambulatory Surgical Center Services |
| Outpatient substance abuse care | $40 |
| Over-the-counter items | $95 every three months Delivered via Cigna Health Today card |
| Podiatry services | $40 |
| Skilled Nursing Facility (SNF) care | $0 per day for days 1-20 $203 per day for days 21-100 |
Dental Benefits
The following dental services are covered, though there may be provider network restrictions. See the plan Evidence of Coverage.
| Coverage | Details |
|---|---|
| Dental care | Preventive and Comprehensive Plus Maximum Coverage amount for Preventive Dental: $20,000 combined preventive and comprehensive every year Maximum Coverage Amount for Comprehensive Dental: $20,000 combined preventive and comprehensive every year |
Vision Benefits
The following vision services are covered, though there may be provider network restrictions. See the plan Evidence of Coverage.
| Coverage | Details |
|---|---|
| Vision benefits | Routine Eye Exams: $0 for one routine exam every year Eye Exams (Medicare-covered): $0 - $40 Max Coverage Amount for Routine Eye Wear Coverage : $250 every year |
Hearing Benefits
The following hearing services are covered, though there may be provider network restrictions. See the plan Evidence of Coverage.
| Coverage | Details |
|---|---|
| Hearing benefits | $25 Fitting/Evaluation for Hearing Aids: $0 for one fitting evaluation for hearing aid every year Hearing Aids: Hearing aids (all types): two every year Cost Sharing: $399 - $1,800 per device Actual cost-share will depend on hearing aid selected. |
Preventive Services and Health/Wellness Education Programs
The following services are covered, though there may be provider network restrictions. See the plan Evidence of Coverage.
| Coverage | Details |
|---|---|
| Preventive services and health/wellness education programs | In-Network: $0.00 copay for Medicare Covered Preventive Services: Abdominal aortic aneurysm screening Alcohol misuse screenings & counseling Bone mass measurements (bone density) Cardiovascular disease screenings Cardiovascular disease (behavioral therapy) Cervical & vaginal cancer screening Colorectal cancer screenings Depression screenings Diabetes screenings Diabetes self-management training Glaucoma tests Hepatitis B (HBV) infection screening Hepatitis C screening test HIV screening Lung cancer screening Mammograms (screening) Nutrition therapy services Obesity screenings & counseling One-time Welcome to Medicare preventive visit Prostate cancer screenings(PSA) Sexually transmitted infections screening & counseling Shots:
Yearly "Wellness" visit |
When reviewing Pennsylvania Medicare plans, be sure to find out if your doctors are part of the plan network. If a Medicare Advantage plan covers prescription drugs, make sure the plan formulary (list of drugs covered by the plan) includes your drugs.
You may be able to find plans in your part of Pennsylvania that offer similar benefits at similar or lower prices than the plan above. Call 1-855-580-1854 TTY 711, 24/7 to speak with a licensed insurance agent who can help you compare plans.
Plan Documents
| Links to plan documents |
Pennsylvania Counties Served
We represent carriers such as Humana, UnitedHealthcare®, Anthem Blue Cross and Blue Shield, Aetna, Cigna Healthcare, Wellcare, or Kaiser Permanente.
