by Russell Noga | Updated February 4th, 2024
Navigating Medicare options? The Cigna HealthSpring Preferred HMO offers an array of health services under Medicare Advantage, including supplementary dental and vision benefits. This article breaks down the plan’s features, costs, and how to enroll, providing a clear pathway for making an informed decision on your healthcare coverage.
Key Takeaways
- The Cigna HealthSpring Preferred HMO Plan is a Medicare Advantage HMO plan offering a wide range of medical services, including additional benefits like dental, vision, and hearing coverage beyond Original Medicare, with eligibility limited to certain geographic locations.
- Costs associated with the Cigna HealthSpring Preferred HMO Plan include a monthly premium averaging $35.95, copayments for healthcare services, an annual deductible of $0, and an out-of-pocket maximum of $3,650 for in-network providers.
- Enrollment into the Cigna HealthSpring Preferred HMO Plan is available online, by phone, mail, or fax, during the Annual Enrollment Period or Special Enrollment Periods under certain qualifying conditions, requiring potential members to have Medicare Part A and B and reside within the plan service area.
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Exploring the Cigna HealthSpring Preferred HMO
One of the many offerings in the Medicare realm is the Cigna HealthSpring Preferred HMO plan, a Cigna Preferred Medicare healthcare plan. Offered by Cigna, a company with a rich history of over 200 years, this plan is specifically structured to deliver coordinated Medicare-covered health services to its members.
Cigna HealthSpring Preferred HMO distinguishes itself from other Medicare HMO plans through its higher member experience ratings and diverse offering of Medicare Advantage plans, including HMOs and PPOs, tailored to accommodate various healthcare requirements.
What is a Medicare HMO?
A Medicare HMO, or Health Maintenance Organization plan, is a type of Medicare plan offered by private entities that provide coverage for a majority of Part A and Part B benefits, as opposed to Original Medicare. The Cigna HealthSpring Preferred HMO plan falls under this category and offers coverage for a variety of health-related services, including non-emergency transportation to approved locations.
It also includes additional benefits such as dental, vision, and hearing beyond the coverage provided by Original Medicare.
Cigna HealthSpring Preferred HMO Overview
With a better understanding of what a Medicare HMO is, we can further explore the distinctive aspects of the Cigna HealthSpring Preferred HMO plan. This plan is a Medicare Advantage HMO plan designed to offer coverage for a wide range of medical services, including healthcare services, medical supplies, and supplementary benefits. It offers coverage for a variety of health-related services and includes additional benefits such as dental, vision, and hearing beyond the coverage provided by Original Medicare. However, it’s important to note that the plan is not accessible nationwide; it is limited to 18 states, so you’ll need to verify if it’s offered in your area.
Key Features of the Cigna HealthSpring Preferred HMO Plan
The Cigna HealthSpring Preferred HMO plan offers:
- Adaptable coverage
- Various tools and resources
- A unique blend of HMO and PPO plans
- A more limited provider network
- Reduced expenses for in-network medical services
It is more than just a health insurance plan – it’s a comprehensive healthcare solution.
We will now examine the significant features, including the star rating, that make this 2024 plan a standout option.
Comprehensive Healthcare Coverage
The extensive healthcare coverage in the Cigna HealthSpring Preferred HMO Plan includes a broad range of services, although not all are listed. For specific details about the coverage, it is advisable to consult the Summary of Benefits offered by Cigna.
Apart from basic healthcare needs, this coverage also includes preventive care services and mental health services. Restrictions do apply on coverage for premiums, balance-billing charges, and specific healthcare services not included in the out-of-pocket limit.
Dental, Vision, and Hearing Benefits
The Cigna HealthSpring Preferred HMO plan offers coverage for:
- Healthcare
- Dental services (up to $750 for a combination of preventive and comprehensive dental services annually)
- Vision services
- Hearing services
When it comes to vision, the plan provides a $0 copay for one routine eye exam per year and offers up to 0 coverage for routine eyewear annually. And let’s not forget about hearing – the plan provides coverage for two hearing aids (all types) annually, with a cost sharing of $399 to $1,800 per device for members.
Prescription Drug Coverage
One of the key features of the Cigna HealthSpring Preferred HMO Plan is its prescription drug coverage. The plan includes:
- Prescription drug formulary
- Coverage for prescription medications included in the drug list
- Coverage for medically necessary prescriptions
- Coverage for prescriptions filled at a Cigna pharmacy.
The prescription drug coverage is tiered according to the Cigna Healthcare National Preferred Prescription Drug List. If a prescription medication is not included in the plan or has limitations on coverage, it is possible to request coverage for it.
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Cost Considerations: Premiums, Copays, and Deductibles
While the services and benefits of the Cigna HealthSpring Preferred HMO plan are certainly impressive, one must also factor in the associated costs, such as the monthly premium, copays, and deductibles.
The monthly premium for the Cigna HealthSpring Preferred HMO plan is $35.95. Here are the details of the plan:
- Copayment of $5 for each Medicare-covered visit to a primary care physician
- Copayment of $15 for visits to a specialist
- Annual deductible of $0
- Out-of-pocket maximum of $3,650 for services obtained from in-network providers.
Monthly Premium
The monthly premium for the Cigna HealthSpring Preferred HMO plan is $0.00. This premium is influenced by factors such as:
- location
- age
- tobacco use
- plan category
- whether the plan covers dependents
On average, the cost of a Cigna Medicare Advantage plan is $7 per month, and in certain areas, Cigna provides plans with no monthly cost. Premium tax credits, Medicare’s ‘extra help’, and several Cigna Medicare Advantage plans with $0 monthly premiums are accessible.
Furthermore, Medicare Supplement plans provide premium discounts for households. The monthly premium has the potential to change on an annual basis.
Copays and Coinsurance
Under the Cigna HealthSpring Preferred HMO Plan, members are expected to pay a predetermined copay amount when they visit in-network primary care physicians and specialists. Most Cigna Medicare Advantage plans provide zero copayments for annual physical exam visits with in-network primary care providers.
The coinsurance for specialist visits under the plan is a copayment of $25 for each Medicare-covered visit. The copayment amount for mental health services under the plan is $20 per visit. The copayment for prescription drugs may vary but is generally lower at a preferred network pharmacy.
Annual Deductible and Out-of-Pocket Maximum
The Cigna HealthSpring Preferred HMO Plan features an annual deductible amount of $0. This deductible specifically covers preferred brand diabetic supplies. The out-of-pocket maximum for the plan is $2,700, and this encompasses the plan deductible in reaching the out-of-pocket limit.
In contrast to other Medicare plans, such as Original Medicare, the Cigna HealthSpring Preferred HMO Plan does not have an annual deductible and includes a maximum out-of-pocket limit to assist in controlling healthcare expenses.
How to Enroll in the Cigna HealthSpring Preferred HMO Plan
If the Cigna HealthSpring Preferred HMO Plan appears to be the right choice for you, your next step would be to enroll. Enrollment can be accomplished through various methods, including:
- Online enrollment
- Enrollment by phone
- Enrollment by mail
- Enrollment by fax
For detailed information on each method, individuals can visit the Cigna website or directly contact the company. Cigna has agents or representatives ready to provide aid.
For customized assistance, you may reach out to a Cigna representative or a licensed agent.
Eligibility Criteria
Certain eligibility criteria must be met before you can enroll in the Cigna HealthSpring Preferred HMO. You must possess Medicare Part A and be actively enrolled in Medicare Part B. Furthermore, you must reside within the HMO plan’s service area. While an individual’s income does not have a direct impact on their basic eligibility for the plan, higher income individuals may be subject to paying an Income Related Monthly Adjustment Amount (IRMAA) for Medicare Part B and Part D.
Enrollment Periods
After confirming your eligibility, the subsequent step is to ascertain when you can enroll. Individuals are eligible to enroll in the plan during the Annual Enrollment Period, which occurs annually from October 15 to December 7. However, certain circumstances may allow you to qualify for a Special Enrollment Period, such as:
- turning 65
- loss of employer coverage
- relocation outside the plan’s service area
- changes in Medicaid eligibility
- other extraordinary situations.
How to Enroll
With the knowledge of when to enroll, the next topic is how to enroll. You can complete your enrollment online via the Cigna online account portal, through the phone at 800.88Cigna (882.4462), or via mail or fax. When enrolling, you may be required to complete an online application on the Cigna website, a printed application to mail or fax, or provide information through CAQH.
The approval process generally requires 45 to 60 days to be completed after enrolling.
Summary
We’ve covered a lot of ground in this blog post, diving deep into the Cigna HealthSpring Preferred HMO plan. This plan offers comprehensive healthcare coverage, including dental, vision, and hearing benefits, as well as prescription drug coverage. It’s a standout option due to its blend of HMO and PPO elements, providing a limited provider network and reduced expenses for in-network medical services. With a reasonable monthly premium and a $0 annual deductible, it’s an affordable choice for those seeking comprehensive health insurance coverage.
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Frequently Asked Questions
What is the monthly premium for the Cigna HealthSpring Preferred HMO plan?
The monthly premium for the Cigna HealthSpring Preferred HMO plan is $0.00, making it a cost-effective option for healthcare coverage.
What services are covered under the comprehensive healthcare coverage of the Cigna HealthSpring Preferred HMO Plan?
The Cigna HealthSpring Preferred HMO Plan covers a wide range of services, including preventive care and mental health services. This includes comprehensive healthcare coverage.
What are the dental, vision, and hearing benefits of the Cigna HealthSpring Preferred HMO plan?
The Cigna HealthSpring Preferred HMO plan includes dental coverage, a $0 copay for one yearly eye exam, and coverage for two hearing aids each year. This makes it a comprehensive option for addressing dental, vision, and hearing needs.
Does the Cigna HealthSpring Preferred HMO Plan offer prescription drug coverage?
Yes, the Cigna HealthSpring Preferred HMO Plan does offer prescription drug coverage.
How can I enroll in the Cigna HealthSpring Preferred HMO Plan?
You can enroll in the Cigna HealthSpring Preferred HMO Plan online, over the phone, or by mail or fax. Online enrollment can be done through the Cigna online account portal.
Speak to the Professionals about Medigap Plans and Original Medicare
If you find understanding the benefits involved with Original Medicare and Medigap Plans challenging, you’re not alone. Whether it’s a Medigap plan, or you want to know more about Cigna HealthSpring Preferred HMO Plan, we can help. Call our team at 1-888-891-0229 for a free consultation or complete the contact form on this site, and an expert will call you back at a convenient time.
We have decades of experience advising our clients on the complexities of Medicare and Medigap plans, the benefits, cost and deductibles. We’ll ensure you get the best rate in your state and advice you can trust.
Russell Noga is the CEO and Medicare editor of Medisupps.com. His 15 years of experience in the Medicare insurance market includes being a licensed Medicare insurance broker in all 50 states. He is frequently featured as a featured as a keynote Medicare event speaker, has authored hundreds of Medicare content pages, and hosts the very popular Medisupps.com Medicare Youtube channel. His expertise includes Medicare, Medigap insurance, Medicare Advantage plans, and Medicare Part D.