Speak with a licensed insurance agent

1-800-557-6059
|
TTY 711, 24/7

Cigna Preferred Savings Medicare (HMO) - H9725-012-000

4.5 out of 5 stars* for plan year 2024

$0.00

Monthly Premium

Cigna Preferred Savings Medicare (HMO) is a HMO Medicare Advantage (Medicare Part C) plan offered by Cigna Healthcare

Plan ID: H9725-012-000

* Every year, the Centers for Medicare & Medicaid Services (CMS) evaluates plans based on a 5-star rating system.

$0.00

Monthly Premium

North Carolina 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 North Carolina 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

CoverageDetails
Monthly plan premium$0.00
Vision coverage
Dental coverage
Hearing coverage
Prescription drugs
Medical deductible$0.00
Out-of-pocket maximum$6,350.00
Initial drug coverage limit$0.00
Catastrophic drug coverage limit$8,000.00
Primary care doctor visit$0
Specialty doctor visit$50
Inpatient hospital care$440 per day for days 1-4
$0 per day for days 5-90
Urgent care$60
Copay is waived if hospital admission occurs within: 24 hours

Worldwide Urgent Coverage: $120
Emergency room visit$120
Copay is waived if hospital admission occurs within: 24 hours

Worldwide Emergency Coverage: $120
Ambulance transportationAmbulance - Ground: $290
Ambulance - Air: 20%

Health Care Services and Medical Supplies

Cigna Preferred Savings Medicare (HMO) covers a range of additional benefits. Learn more about Cigna Preferred Savings Medicare (HMO) benefits, some of which may not be covered by Original Medicare (Part A and Part B).

CoverageDetails
Chiropractic services$20
Routine Chiropractic (Supplemental): Not covered
Diabetes supplies, training, nutrition therapy and monitoringIf 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-raysLab Services: 0 - 20%
Diagnostic Radiological Services: $0 - $195
X-Ray Services: $0 - $50
Home health care$0

Support for Caregivers of Enrollees: Not covered
Mental health inpatient care$595 per day for days 1-3
$0 per day for days 4-90
Mental health outpatient carePsychiatric-Individual: $0
Psychiatric-Group: $0
Outpatient services/surgeryIn-Network:

Outpatient Hospital Services:
Copayment for Medicare Covered Outpatient Hospital Services $0.00 to $425.00
Prior Authorization Required for Outpatient Hospital Services

Outpatient Observation Services:
Copayment for Medicare Covered Observation Services - Per stay $425.00
Prior Authorization Required for Outpatient Observation Services

Ambulatory Surgical Center Services:
Copayment for Ambulatory Surgical Center Services $0.00 to $275.00
Prior Authorization Required for Ambulatory Surgical Center Services
Outpatient substance abuse care$50
Podiatry services$50
Skilled Nursing Facility (SNF) care$10 per day for days 1-20
$203 per day for days 21-60
$0 per day for days 61-100

Dental Benefits

The following dental services are covered, though there may be provider network restrictions. See the plan Evidence of Coverage.

CoverageDetails
Dental careDental Allowance - INN Only

Maximum Coverage amount for Preventive Dental: $500 combined preventive and comprehensive every year

Maximum Coverage Amount for Comprehensive Dental: $500 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

CoverageDetails
Vision careRoutine Eye Exams: $0 for one routine exam every year

Eye Exams (Medicare-covered): $0 - $50

Max Coverage Amount for Routine Eye Wear Coverage : $150 every year

Hearing Benefits

The following hearing services are covered, though there may be provider network restrictions. See the plan Evidence of Coverage.

CoverageDetails
Hearing care$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.

CoverageDetails
Preventive services and health/wellness education programsIn-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:
  • COVID-19 shots
  • Flu shots
  • Hepatitis B shots
  • Pneumococcal shots
  • Tobacco use cessation
    Yearly "Wellness" visit

    When reviewing North Carolina 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 North Carolina that offer similar benefits at similar or lower prices than the plan above. Call 1-800-557-6059 TTY 711, 24/7 to speak with a licensed insurance agent who can help you compare plans.

    Plan Documents

    Links to plan documents

    North Carolina Counties Served

    We represent carriers such as Humana, UnitedHealthcare®, Anthem Blue Cross and Blue Shield*, Aetna, Cigna Healthcare, Wellcare, or Kaiser Permanente.

    Back to plans in North Carolina

    Compare plans today.

    Speak with a licensed sales agent

    1-800-557-6059
    |
    TTY 711, 24/7

    Every minute we help someone compare their Medicare Advantage plan options.2

    Ready to find your plan?

    Or call a licensed insurance agent

    1-800-557-6059
    |
    TTY 711, 24/7