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Cigna Premier Medicare (HMO-POS)

4 out of 5 stars* for plan year 2024
$0.00 Monthly Premium

Cigna Premier Medicare (HMO-POS) is a HMO-POS Medicare Advantage (Medicare Part C) plan offered by Cigna Healthcare

Plan ID: H4513-084-000

$0.00 Monthly Premium

Illinois 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 Illinois 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$4,200.00
Initial drug coverage limit$0.00
Catastrophic drug coverage limit$8,000.00
Primary care doctor visit$0

Out of Network
30%
Specialty doctor visit$35

Out of Network
30%
Inpatient hospital care$265 per day for days 1-7
$0 per day for days 8-90

Out of Network
40%
Urgent care$30
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: $260
Ambulance - Air: 20%

Out of Network
Ambulance - Ground: $260
Ambulance - Air: 20%

Health Care Services and Medical Supplies

Cigna Premier Medicare (HMO-POS) covers a range of additional benefits. Learn more about Cigna Premier Medicare (HMO-POS) 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

Out of Network
30%
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%

Out of Network
30%
Diabetic Therapeutic Shoes or Inserts: 30%
Durable medical equipment (DME)20%

Out of Network
30%
Diagnostic tests, lab and radiology services, and X-raysLab Services: 0 - 20%
Diagnostic Radiological Services: $0 - $200
X-Ray Services: $0

Out of Network
Lab Services: 30%
Diagnostic Radiological Services: 30%
X-Ray Services: 30%
Home health care$0

Support for Caregivers of Enrollees: Not covered


Out of Network
30%
Mental health inpatient care$265 per day for days 1-7
$0 per day for days 8-90

Out of Network
40%
Mental health outpatient carePsychiatric-Individual: $0
Psychiatric-Group: $0

Out of Network
Psychiatric-Individual: 30%
Psychiatric-Group: 30%
Outpatient services/surgery
POS (Out-of-Network):

Outpatient Hospital and ASC Services:
Coinsurance for Medicare Covered Ambulatory Surgical Center Services 30%
Outpatient substance abuse care$35

Out of Network
30%
Over-the-counter items$45 every three months

Delivered via Cigna Health Today card
Podiatry services$35

Out of Network
30%
Skilled Nursing Facility (SNF) care$10 per day for days 1-20
$203 per day for days 21-100

Out of Network
30%

Dental Benefits

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

Coverage Details
Dental carePreventive 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 benefitsRoutine Eye Exams: $0 for one routine exam every year

Eye Exams (Medicare-covered): $0 - $35

Max Coverage Amount for Routine Eye Wear Coverage : $200 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$35

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.

Out of Network
30%
Fitting/Evaluation for Hearing Aids: Not covered
Hearing Aids: Not covered
Cost Sharing: Not covered
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
POS (Out-of-Network):

Medicare-covered Zero Dollar Preventive Services:
Coinsurance for Medicare Covered Medicare-covered Preventive Services 30%

When reviewing Illinois 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 Illinois 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

Illinois Counties Served

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

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