- You might be able to get a Medicare Advantage plan through Cigna at a low cost.
- Cigna offers several types of Medicare Advantage plans, such as HMOs, PPOs, SNPs, and PFFS.
- Cigna offers separate Medicare Part D plans.
- Cigna Medicare Advantage plans are available in 18 states.
Cigna is one of the largest health insurance companies in the world, serving over 170 million customers globally. In the United States, Cigna offers health insurance to customers through their employers, through the Health Insurance Marketplace, and through Medicare.
The company offers Medicare Advantage plans in 18 states and in Washington, D.C. Cigna also offers Medicare Part D plans in all 50 states.
Cigna’s Medicare plans are often branded as Cigna-Healthspring and can be found using Medicare’s plan selection tool.
Currently, Cigna offers Medicare Advantage plans in:
- The District of Columbia
- New Jersey
- North Carolina
- South Carolina
Cigna offers Medicare Advantage plans in a variety of formats. Not all formats are available in all states. If you live in a state that has Cigna Medicare Advantage plans, you might be able to choose from a few different formats. Plans available to you might include the following options.
Cigna Medicare Advantage HMO plans
A Health Maintenance Organization (HMO) plan works with a set network of providers. You’ll need to go to doctors, hospitals, and other providers within the plan’s network to have your services covered. However, if you have an emergency, the plan will likely pay even if you go out of network.
Depending on the plan you choose, you’ll need to select a primary care physician (PCP). Your PCP must be an in-network provider and will be the person who refers you to specialists for any other services you might need.
Cigna Medicare Advantage PPO plans
A Preferred Provider Organization (PPO) plan has a network of providers just like an HMO. However, unlike an HMO, you’ll be covered when you see doctors and specialists outside the plan’s network. The plan will still pay, but you’ll pay a higher coinsurance or copay amount than you would with an in-network provider.
As an example, a visit to an in-network physical therapist might cost you $40, while a visit to an out-of-network provider might cost $80.
Cigna Medicare Advantage PFFS plans
Private Fee-For-Service (PFFS) plans are flexible. Unlike an HMO or PPO, PFFS plans don’t have a network. You can see any Medicare-approved doctor using a PFFS plan. You don’t need to have a PCP or get referrals, either. Instead, you’ll pay a set amount for each service you receive.
However, providers can decide whether or not to accept your PFFS plan on a case-by-case basis. This means that you can’t count on a service always being covered, even if you stick with the same doctor. PFFS plans are also available in fewer locations than HMOs or PPOs.
Cigna Medicare Saving Account plans (MSA)
You might not be as familiar with Medicare Saving Account (MSA) plans as with other types of healthcare plans. With an MSA, your healthcare plan is combined with a bank account. Cigna will deposit a preset amount of money into the bank account, and that money will be used to pay all of your Medicare Part A and Part B costs. MSA plans generally do not include prescription coverage.
Cigna Medicare prescription plans (Part D plans)
Medicare Part D is prescription drug coverage. Part D plans help you pay for your prescriptions. You’ll pay a small premium for most Part D plans, and there is normally a deductible before coverage kicks in.
You might need to use an in-network pharmacy to get your prescriptions covered. How much of your prescription’s price is covered will depend on whether the drug is generic, brand name, or specialty.
Other Cigna Medicare plans
Depending on where you live and your circumstances, you might be able to purchase a Cigna Special Needs Plan (SNP). SNPs are designed for customers with specific needs. These needs could be medical or financial. Examples of times an SNP might be a good choice include:
- You have a limited income and qualify for Medicaid. You’ll pay much lower costs if you qualify for a Medicaid and Medicare combined SNP.
- You have a condition that needs regular care, such as diabetes. Your SNP can help you manage your condition and cover some of your care costs.
- You live in a nursing facility. You can find SNPs to help manage the costs of living in a long-term care facility.
Cigna also offers a few Health Maintenance Organizations with a Point of Service Option (HMO POS) plans. You’ll have slightly more flexibility with an HMO POS than a traditional HMO plan. These plans allow you to go out of network for certain services. However, going out of network comes with a higher cost.
The cost of your Cigna Medicare Advantage plan will depend on where you live and the type of plan you choose. Keep in mind that any Advantage plan premium will be charged in addition to the standard Medicare Part B premium.
In 2020, most people pay $144.60 as a Part B premium. This means that if an Advantage plan lists a premium of $40, you’ll be responsible for a total premium payment of $184.60.
Some Cigna plan types and prices from around the country can be found in the table below:
|City||Plan name||Monthly premium||Deductible||PCP visit cost||Specialist visit cost||ER visit cost|
|Cigna-Health-Spring Preferred (HMO)||$0||$0||$0||$45||$90|
|Dallas, TX||Cigna-Health-Spring Advantage (PPO)||$0||$750||$10 (in-network)||$30 (in network)||$120|
|Miami, FL||Cigna-Leon Medical Centers Health Plans – Leon||$0||$0||$0||$0||$50|
|San Antonio, TX||Cigna-Health-Spring Preferred (HMO)||$0||$0||$0||$20||$120|
|Chicago, IL||Cigna-Health-Spring True Choice (PPO)||$0||$0||$0 (in-network)||$30 (in-network)||$120|
Medicare Advantage plans are also called Medicare Part C coverage. An Advantage plan is a healthcare plan offered by a private company like Cigna that contracts with Medicare to provide coverage. Advantage plans take the place of Medicare Part A (hospital insurance) and Medicare Part B (medical insurance). Together, Medicare parts A and B are referred to as “original Medicare.” An Advantage plan pays for all the services covered by original Medicare. Most Advantage plans include additional coverage.
Advantage plans often include coverage for:
- vision exams
- hearing exams
- dental care
- wellness and fitness memberships
Many Medicare Advantage plans also include prescription drug coverage. A Medicare Advantage plan that includes coverage for your prescriptions is known as an MAPD plan. You can purchase separate Part D (prescription drug) coverage if your Advantage plan doesn’t offer prescription coverage.
The Advantage plans available to you will depend on your state. You can use the plan finder on the Medicare website to see what’s available in your area.
You can purchase a Medicare Advantage plan once you’re eligible for Medicare. You’ll need to be enrolled in Medicare parts A and B in order to purchase an Advantage plan. You can enroll in Medicare if you meet one of these three requirements:
- You are within 3 months of your 65th birthday.
- You have a disability and have been receiving Social Security Disability benefits for 2 years.
- You have Amyotrophic Lateral Sclerosis (ALS).
It’s important to note that you generally won’t be able to purchase an Advantage plan if you have end stage renal disease (ESRD). People with ESRD are only eligible for original Medicare in most cases.
Medicare Advantage Enrollment Deadlines
- As many as 3 months after your 65th birthday — You’ll pay a late fee if you don’t enroll within the 3 months following your birthday. You can start enrollment as early as 3 months before your birthday. It’s best to enroll as soon as you’re eligible in order to avoid any possible penalties.
- January 1st to March 31st — You can switch your plan during this yearly open enrollment. You can use this time to enroll in separate Part D coverage or switch from one Advantage plan to another. You can’t switch from original Medicare to an Advantage plan in this window.
- April 1st to June 30th — You can switch from original Medicare to an Advantage plan during this window as long as you’re enrolled in Part B coverage.
- October 15th to December 7th — You can make changes to your Medicare coverage during this enrollment period. You can use this time to switch from one type of Advantage plan to another, purchase Part D coverage, or switch from original Medicare to an Advantage plan.
Cigna is one of many companies that contract with Medicare to provide Advantage plans. Cigna offers Medicare Advantage plans at a variety of price points. Not all plans are available in all states.
You can choose a plan that fits your healthcare needs and budget by using the Medicare website’s plan finder. Cigna also has options for people who want to purchase separate Part D plans.