Cigna offer a range of Medicare Advantage plans, some of which include vision care. The vision benefits include coverage of a vision exam and at least part of the cost of contact lenses or one pair of glasses per year.
Some Cigna Advantage plans allow a person to use either in-network or out-of-network healthcare providers. However, to get the most vision coverage at the lowest price, an individual must choose from in-network providers.
This article introduces Cigna and describes Medicare Advantage. Then, it examines the coverage of Cigna Advantage plans, including the vision benefits. Lastly, it lists the states where the plans are available and gives some examples of plan costs.
We may use a few terms in this piece that can be helpful to understand when selecting the best insurance plan:
- Deductible: This is an annual amount that a person must spend out of pocket within a certain time period before an insurer starts to fund their treatments.
- Coinsurance: This is a percentage of a treatment cost that a person will need to self-fund. For Medicare Part B, this comes to 20%.
- Copayment: This is a fixed dollar amount that an insured person pays when receiving certain treatments. For Medicare, this usually applies to prescription drugs.
Cigna are an international health insurance company offering services and products in more than 30 countries and all 50 states in the United States. They have more than 17 million policyholders.
The company offer a range of Medicare plans, including Advantage plans, as well as non-Medicare health policies for individuals, families, and business employees.
In 2021, the company will offer six prescription drug plans (PDPs) in all U.S. states, as well as Medicare supplement plans in the District of Columbia and 48 states.
A person can enroll in a Cigna plan during the Medicare annual open enrollment period (AEP), which runs from October 15 to December 7. If a person chooses a plan during the AEP, it becomes effective on January 1, 2021.
To contact Cigna, a person can call 1 (800) 997-1654. A deaf person may call 711 and follow the prompts.
To understand Advantage plans, it helps to know how they fit within Medicare. Original Medicare comprises Part A, which is hospital insurance, and Part B, which is medical insurance. Part C plans, otherwise known as Medicare Advantage plans, are the alternative to original Medicare and provide all the benefits of parts A and B.
In addition, many Advantage plans offer prescription drug coverage, and some include extra benefits, such as vision and dental care. Most plans also have free programs that help people manage their health conditions and develop healthful lifestyle habits.
Medicare Advantage differs from original Medicare in several ways. Advantage plans usually require an individual to choose from in-network providers, while original Medicare lets someone choose from any Medicare-enrolled providers. Advantage plans also put a yearly limit on out-of-pocket costs and include benefits that original Medicare does not cover.
Aside from Medicare parts A, B, and C, Medicare has two other main parts: Part D, which is prescription drug coverage, and Medigap, which is Medicare supplement insurance. A person with an Advantage plan can have neither Part D nor Medigap, as these are only available to those enrolled in original Medicare.
A person may choose from several Cigna Advantage plans, including:
- Health Maintenance Organization (HMO): These plans generally require a person to use in-network providers.
- Health Maintenance Organization Point of Service (HMO-POS): These plans let a person use some out-of-network providers, although often at a higher cost.
- Preferred Provider Organization (PPO): PPO plans give people the flexibility of using either in-network or out-of-network providers. Using the latter will involve higher costs.
- Special Needs Plans (SNPs): SNPs tailor benefits, medications, and providers to the particular needs of individuals with certain chronic diseases.
All the Cigna Advantage plans provide the hospital and medical insurance of Medicare parts A and B. Most also cover prescription drugs.
Plan perks include:
- telehealth services
- free medication management
- free case managers to help individuals manage their health conditions
- free behavioral and emotional support
- discounts on wellness services, such as yoga products and acupuncture
Some plans include:
- over-the-counter drug allowance
- one-way transportation to some health services
- dental care
- vision care
- hearing care
Cigna Medicare Advantage plans include all the vision services that Medicare generally covers, including routine eye exams. Other covered services may include glaucoma and diabetic retinal exams, as well as help toward the yearly costs of vision wear, including contacts.
Coverage details vary among plans:
- Cigna HMO and HMO-SNP Advantage plans cover one visual exam and one set of eyeglass lenses and frames per year. They also include contact lenses.
- The PPO and HMO-POS plans have different coverage rules that depend on whether people use in-network or out-of-network providers.
- If someone with a PPO or HMO-POS plan uses an in-network provider, the coverage is comparable to that of HMO and HMO-SNP plans.
- If a person with a PPO or HMO-POS plan uses an out-of-network provider, they might not get coverage or may have to pay more for the service.
In 2020, Cigna Advantage plans are available within Washington, D. C. and certain other counties in the following 18 states:
- Alabama
- Arizona
- Arkansas
- Colorado
- Delaware
- Florida
- Georgia
- Illinois
- Kansas
- Maryland
- Mississippi
- Missouri
- New Jersey
- North Carolina
- Pennsylvania
- South Carolina
- Tennessee
- Texas
Plan availability will expand to include markets in five new states in 2021:
- New Mexico
- Ohio
- Oklahoma
- Utah
- Virginia
People with an Advantage plan must pay the Medicare Part B premium, which is $148.50 in 2021. Other out-of-pocket costs include the Advantage plan premium, copays, coinsurance, and deductibles. A person’s costs depend on their plan and the state where they live.
The table below shows some plans and costs in several U.S. cities.
A person can compare Cigna Medicare Advantage plans, including the ones below, by using this online search tool and entering the relevant zip code.
| City | Plan name | Monthly premium | Primary care doctor visit copay | Specialist visit copay | Inpatient hospitalization copay | Out-of-pocket yearly limit |
|---|---|---|---|---|---|---|
| Philadelphia, PA Zip: 19019 | Cigna Alliance Medicare (HMO) | $0 | $0 | $25 | $285 per day for days 1–7; $0 for days 8–90 | $6,900 |
| Phoenix, AZ Zip: 85001 | Cigna Achieve Medicare (HMO C-SNP) | $0 | $0 | $20 | $225 per day for days 1–7; $0 for days 8–90 | $3,450 |
| Denver, CO Zip: 80014 | Cigna True Choice Medicare (PPO) | $0 | $0 (in-network) | $35 (in-network) | $330 per day for days 1–5; $0 for days 6–90 (in-network) | $5,900 |
| Mobile, AL Zip: 36525 | Cigna Preferred Plus Medicare (HMO) | $29 | $0 | $0 | $225 per day for days 1–6; $0 for days 7–90 | $4,100 |
| Charlotte, NC Zip: 28202 | Cigna TotalCare (HMO D-SNP) | $29.50 | $0 | $0 | $195 per day for days 1–6; $0 for days 7–90 | $6,700 |
Cigna Medicare Advantage plans offer the same hospital and medical insurance as original Medicare. Many of the Cigna plans also offer prescription drug coverage, and some include extra benefits, such as vision care. The extent of vision coverage varies among the plans.
The costs of the plans vary widely. People looking for a plan may wish to compare the prices of the options in their area before making a choice.