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Cigna Health Insurance (Complete Guide)

Cigna Health Insurance (Complete Guide) | Very Good Coverage

What is Cigna Health Insurance? And what type of health insurance and Medicare services do they offer in the US?

Cigna is one of the top health insurance companies in the USA. Asides from the company’s health services, it offers Medicare Insurance. Cigna has a huge network for its Medicare services. And it accounts for about 2% of US Medicare Advantage Members.

Cigna Medicare insurance covers Original Medicare, Medicare Advantage, Drug Prescription and a lot of Medigap Plan. Their plans come with important benefits and features for Medicare eligible members.

The information provided for these guides are sourced online and from Cigna Health Insurance coverage materials.

Cigna Health Insurance Medicare

The social security administration of the USA enacted Medicare in 1965 with the main purpose of securing health insurance for qualified beneficiaries. Seniors who are 65 or more will qualify for Medicare. Those that are not yet 65 can also be eligible for Medicare if they have long-term disability.

Only citizens of the US and legalized permanent members will be able to collect social security benefits and will qualify for Medicare.

The social security administration takes care of Medicare costs, but there are a lot of benefits from the scheme via private companies in the health sector like Cigna Health insurance.

The basic aspect of Medicare that the Social Security Administration will pay for is Part A Medicare and Part B Medicare. Together, both of them are referred to as Original Medicare, and their services are also delivered by private health insurance companies like Cigna.

One of the private Medicare schemes that seniors and eligible individuals can benefit from is Part C Medicare known as Medicare Advantage. It was enacted in 2006.

The next private scheme from health insurance companies is Part D Medicare known as Prescription Drug Plan.

Part A Medicare

Part A is the first part of the original Medicare that the social security administration provides coverage for. It mostly involves hospitalization cost and inpatient care.

Health Services that Part A Will Cover

All the costs that Part A Medicare will cover include the following:

  • Hospital inpatient care
  • Skilled nurse services
  • Short stay services offered in a nursing facility
  • Home care services
  • Hospices services

Upon admission to a hospital, Part A Medicare will cover your hospital cost, as long as a doctor orders the admission. Cigna will render services for original Medicare.

Some of the benefits that Cigna will offer you when admitted under Part A Medicare includes the following:

  • Long term hospital services
  • Access to rehabilitation amenities
  • Access to psychiatric facilities if need be.
  • All inpatient care services.
  • The daily cost for room services, either private or shared
  • Meal services such as diet foods and appetizers
  • Medications and drug administration
  • Miscellaneous expenses as a result of the hospital stay

All these benefits are under the coverage of social security for Part A Medicare.

Cost for Part A Medicare

As long as you are 65 years old already, and you have paid social security fees for a minimum of 10 years, you will automatically qualify for Part A Medicare. You will also not have to pay monthly premiums for the service you receive.

If you have not paid for social security for the expected ten years, and you do not have any long-term disability, you do not qualify for social security.

This means that you will have to pay Cigna a premium fee for receiving Part A Medicare. The cost for this will be between $252 and $458, depending on the services you receive, the number of years you have worked for, and Medicare taxes.

Even though you do not have to pay any monthly premium for Part A Medicare, there are still a lot of costs that the plan does not provide coverage for. This can leave a beneficiary with deductible costs ranging to $1,408 per benefit period.

The benefit period could be more than once a year. The period starts counting from when you get admitted to the hospital and it stops counting when you are discharged, or after 60 days of admission.

An example of a benefit period is if you are admitted into Cigna on September 1 and discharged on September 8, then you get admitted again on September 20. This will only be one benefit period and will carry a single deductible cost.

If after you were discharged on September 8, you got admitted again in December, then you will enter a new benefit period and will have to pay another deductible cost.

Another cost that Part A Medicare covers is the coinsurance requirement. This entails the following:

  • There is a zero cost on the first 2 months of your admission and inpatient care.
  • From the end of the second month till the third month, you will be required to pay $352 per day
  • From the end of the third month, the cost will rise to about $704 per day until 60 lifetime reserve days.

People that are eligible for Medicare will have an allocation of up to 60 lifetime days that they can use post the 90 days’ benefit period. Part A Medicare will offer coverage for 60 days, and will not be replaced. Once you exhaust these 60 days’ window, they will become responsible for the remaining stay of their hospital admission.

Also, Part A Medicare does not cover all drug prescriptions. So if a doctor prescribes a drug not covered, you will have to settle the payment from your pocket. You can avoid this by discussing drug medications with your doctor so that he will only prescribe drugs that your Part A Medicare will cover. However, if you have enrolled for Cigna Medicare scheme and you have more than original Medicare, you will not have to bother about this.

Part B Medicare

Part B Medicare is also part of Original Medicare. It oversees outpatient care and health services such as home care, hospital visits, ambulance services, etc.

Health Services that Part B Will Cover for

Part B Medicare will cover all cost for the following care and services:

  • Important health services such as supplies for examination and treatment of a health issue.
  • Preventive services such as medical checkups and diagnosis visits.
  • Outpatient medications like Immunization, vaccination, antibiotics, and all other prescriptions that you do not need to receive within a hospital. Part B Medicare does not offer coverage for drugs from pharmacies.
  • Metal health services such as rehab centers for alcohol and drug addiction. It will also cover the cost for every outpatient clinic observation.
  • Medically authorized transportation, regardless of if it is for an emergency situation or not.
  • Clinical investigation and research work like test drugs for disease research such as Alzheimer, or investigational therapy for health conditions like dementia.

What is the cost for Part B Medicare?

There are monthly premium costs for Part B Medicare regardless of if you are a social security beneficiary or not. The US congress usually adjusts the cost of these premiums, copayments, coinsurance, and deductibles at the beginning of every year. This is according to the social security act of the country.

In 2020, the monthly premium cost for Part B Medicare by congress was $144.6. Compared to the year before, there was an increase of $9.1.

This increase is a result of what is known as Income-related monthly adjustment amount (IRMMA). Part B Medicare monthly premium has steadily been on a rise since 2007 because of high earning beneficiaries with income above the national average.

Part B premiums are deductible from seniors' pensions such as social security benefits, railroad retirement board, and office personnel management. Seniors who do not have any retirement benefits from the aforementioned sources will get sorted by the Social Security administration that will pay for the Part B Medicare.

Apart from these monthly premiums, Medicare beneficiaries are obliged to pay a deductible of $198. Compared to the previous year, this is an increase of $13.

When you completely settle the deductible, you will be required to pay only 20% of all care services while Medicare offers coverage for the remaining 80%.

How to sign up for Part A and B Medicare With Cigna.

Most people will automatically qualify for Original Medicare services, and they will not have to sign up. These are US citizens or permanent residents with work histories who are 65 years old or more. They will be automatically enrolled by the social security administration.

If you automatically qualify for Medicare, you can start receiving health services from the following period:

  • At the beginning of the month, you will turn 65 years’ old
  • For disabled people, two years after receiving benefits from either the social security administration or railway retirement board.
  • For people with end-term diseases, the month they start receiving their benefits from social security.

If you do not qualify for social security in any of the three required ways, and you want to sign up for original Medicare services, visit the social security office nearest to you.

Cigna Medicare Advantage Plan

If you plan to stick to only the original Medicare services and benefits provided by social security, you are going to deal with a lot of out-of-pocket costs that will be financially draining. This is why private health insurance schemes are available.

Medicare Advantage is Part C Medicare that is provided by a private insurer. Cigna Medicare advantage will cover all the benefits of your Original Medicare and will cover some core healthcare that original Medicare does not offer provision for. This healthcare includes vision, dental, hearing, and drug prescription care.

Under Cigna Medicare Advantage, there are 3 plans that you can choose from. They are:

Health Maintenance Organization (HMO) plan

With this plan, you will be able to select a primary healthcare practitioner that will help you organize your care services and refer you to professionals and health providers within the Cigna network.

Preferred Provider Organization (PPO) plan

With this plan, you have the liberty of choosing any health provider or specialist that you like. Cigna provides minimal network restriction for this plan, and you will not need any referral from a primary provider to see a specialist. Under this plan, if you choose a specialist from the Cigna network, the out-of-pocket cost will be lower compared to the services of specialists outside the network.

Special Needs Plans

This plan is especially for those with a particular health complication and will require certain health care services. People who this plan is made for are those that qualify for both Medicare and Medicaid.

Cigna Medicare Advantage plans are not the same in every region of the US. However, they have health benefits and features for you such as:

  • Zero cost monthly premiums, even on the Plan B Medicare services.
  • Unlimited access to telehealth and telemedicine. This will allow you to consult a qualified doctor via telecommunication at any time of the day or during the night.
  • Enticing discounts on health and wellbeing services such as Lasik vision modification, yoga merchandises, etc.
  • Therapy management on medication for those who have various drug prescriptions.
  • Automatic membership to Sliver&Fit a US-based fitness and wellbeing program for work out and gyms nationwide.
  • Cigna benefit checkup that will cover up for expenses such as meals and housing.
  • Cigna supplemental benefits like medical transportation, to and fro the hospital

Cigna Prescription Drug Plan

This is known as Plan D, and it is another private health insurance scheme that will cover the cost of all drug prescriptions and medications.

If you don't fancy any of Cigna’s Medicare advantage plans, or you are satisfied with your original Medicare services and want only coverage for drug prescriptions, this plan is ideal for you.

Cigna Prescription Drug plan is a standalone plan, and you can pair it up with our original Medicare plan. In this case, it will cover up for the drug prescription that your Part A Medicare left out.

Just like with Medicare Advantage, Cigna prescription drug plans are location-based, so you must verify if it is available in your region before enrolling.

Benefits and features of Cigna Plan D include the following:

  • Cover the cost of more than 3000 generic and branded drugs. These drugs range from common medications drugs to specific health issue drugs.
  • Cigna has a network of over 63000 pharmacies in the US that will accept its prescription drug plan coverage and health insurance.
  • Low out-of-pocket copayments on prescribed drugs in any of the 63000 pharmacies nationwide.
  • Drug prescription mail deliveries of about 3 months’ supply.

Cigna Prescription Drug Plans

Cigna has 3 standalone prescription drug plans that you can take advantage of. They include the following:

Cigna Secure Rx Prescription Drug Plan

This plan will come with a monthly premium of $29. It will also include a copayment of $1 on specific generic drugs that you choose.

Cigna Secure Essential Rx Prescription Drug Plan

This plan comes with an average monthly premium of about $24, It also includes a $4 copayment of chosen generic drugs.

Cigna Secure Extra Rx Prescription Drug Plan

This plan comes with a monthly premium cost of $50 and a zero cost on copayment for your specific generic drugs.

Cigna Medical Supplement

Medicare supplement is also referred to as Medigap. Just as it implies, it helps you to supplement both your Part A and Part B Medicare coverage. Cigna Medicare supplements will cover your Medicare coinsurance, copayments, out-of-pocket expenses, and deductibles.

With Cigna Medicare supplement insurance, you can receive healthcare from any hospital or provider that accepts Part A and B Medicare.

Cigna Offers about 10 various Medicare supplement plans in US states. All these plans have their different benefits and features, and are standardized by the US federal government:

Cigna Medicare supplement plans include the following:

Cigna Medicare Supplement Plan A

This plan will provide coverage to both Original Medicare parts. It will also settle other costs like coinsurance, copayments, hospices care, and services under Part A Medicare, including its coinsurance and copayments. In case of blood transfusion, Cigna Medicare supplement Plan A will cover costs for the initial 3 pints of blood used.

Plan N Medicare Supplement

Cigna Plan N Medicare supplement will offer coverage for all the benefits and features of Plan A supplements. In addition to that, it will cover coinsurance costs for nursing care and services in Part A Medicare. It will also offer coverage for deductible costs and transportation in case of emergency care.

Furthermore, Cigna Plan N Medicare supplement will cover coinsurance for Part B Medicare. For copayments under part B Medicare, you will have to pay a fee of $20 for a doctor's visit, and about $50 for ER as long as it is not an inpatient health center care.

Because of the copayments of Plan N, you will be required to pay less monthly premium costs compared to some other Cigna Medicare supplement plans.

Plan G Medicare Supplement

Cigna Plan G is one of the most popular Medicare supplement plans in the USA. This plan covers all the Plan A aspects. It covers coinsurance and expenses for skilled nurse services, Part A Medicare deductible costs, Part B Medicare out of pocket charges, and any emergency expense on foreign travels to receive care.

However, one of the shortcomings of Cigna Plan G as reiterated by its members is that it does not cover Part B Medicare deductibles with an annual cost of $203 per year. But the good side is that Part B deductible is the only out-of-pocket cost that you will pay if you have Cigna Plan G. It will cover every other annual payment available.

Plan F Medicare Supplement

This is another popular Cigna Medicare plan with all-inclusive cost coverage. Cigna Plan G Medigap is the only supplement plan that will cover all the Medigap benefits that Cigna has to offer. It covers every cost that Plan G caters for, and in addition, the $203 annual deductible cost from Part B Medicare.

Unfortunately, federal legislation does not allow those that qualify for Medicare since the year 2020 to join Cigna Plan F Medicare. So if your Medicare eligibility starts from 2020 you will not be able to enroll in this plan. However, those that qualify for Medicare before 2020 can enroll for this plan as long as Cigna offers it in their region.

High Deductible Plan F Medicare Supplement

This is another Medigap Plan that Cigna only offers in certain parts of the country. The plan provides the same coverage as the normal plan F Medigap. However, members of the plan are obligated to pay a yearly deductible fee before the plan will be activated. The current deductible cost is $2370.

Once you pay the annual deductible cost, the Cigna Plan F Medicare supplement will cover all extra expenses that you will spend in a year. This highly deductible Plan F has one the lowest premiums ever seen for a Medicare supplement plan.

Medicare Ratings on Cigna Medigap Plans

Medicare makes an evaluation of private insurers' Medicare plans on a yearly basis. They make use of 5-star ratings for this evaluation.

For the latest rating, Cigna has a total of 5 stars as a Medicare company. It also has a 5-star rating for its Medicare advantage plan options and the prescription drug plan scheme. Medicare rated Cigna 4 stars in eleven of the states it offers coverage.

Cigna Medicare Providers

Cigna has a broad network of health service providers in the US. To verify if a medical practitioner, health care provider, and pharmacy store is part of Cigna's large network, check online for its directories with a list of pharmacies and providers.

Will Cigna Cover the Cost for My Medicare Vision?

Cigna has Medicare advantage plans that will cover the cost of vision coverage. This will come with benefits such as routine eye tests and diagnosis, glasses prescription and contact lenses.

Depending on the Cigna Medical advantage plan that you choose, you might be entitled to a yearly allowance that will cover the cost of glass frames, contacts, and lenses. If you are under any of the medical advantage plans that provide vision coverage, visit an optician under Cigna network services for eye care.

Will Cigna Cover the Cost of My Medicare Dental Care?

Cigna has Medicare advantage plans that will cover vision, dental, and hearing cares that original Medicare does not cater for. The benefits of dental care under Cigna plans will include routine teeth examination, denture services, teeth fillings, and x-ray analysis.

In some parts of the USA, you can get dental standalone plans from Cigna. You can choose to pair the plan with your original Medicare, or any Cigna Health insurance service.

Cigna Online Portal

If you are a member of any plan that Cigna offers, you can open an online portal via the Cigna website. The online account will enable you to check for Providers and pharmacies in the Cigna network, get financial estimates for various health care services, verify the benefits available to you, and plan how you will spend your money.

Cigna also has a mobile app that is available for iOS and Android smartphones. The app comes with a lot of features that will help you coordinate your healthiness and wellbeing.

Medicare Enrollment Periods

When you become eligible for Medicare, there will be various openings for you to enroll in the various parts of Medicare with Cigna. These openings have due dates, and once they elapse, it will be difficult for you to enroll.

The enrollment periods include the following:

Initial Enrollment Periods

A social security beneficiary or anyone that is eligible for Medicare will have an initial 7 months’ period where they can apply for Medicare. This period starts on the first day of the third month before a birthday month and will elapse on the last day of the third month after a birth month.

An example of this is if you are due to turn 65 on July 10, then you can sign up for your Original Medicare services from the first day of April, and the window will automatically close on the last day of October in that year. Only seniors that have made provisions to be automatically enrolled will not have to bother with this.

Aside from the original Medicare, you can also sign up for Medical advantage and Prescription drug plan during the Initial enrollment periods.

Eligible Medicare seniors that enroll for a Prescription drug plan outside the initial enrollment period will have to pay a fine for late enrollment.

You will be able to change your Medicare plan and coverage features during other enrollment periods.

Annual Enrollment Period

This is another enrollment window that opens every year. It will last from the 15th of October until the 7th of December. The annual enrollment period is also referred to as the Annual election period.

Various plan changes and switches can occur during this periods, and they include the following:

  • Members of Part A and B Medicare can add Cigna Part C plans.
  • Members of the Cigna Part C plan can change back to Original Medicare, Part A, and B
  • Members of Parts A or B Medicare can sign up, terminate or change to Cigna Part D Prescription Drug Plan.
  • Members of a certain Cigna Part C Plan can switch to another Cigna Part C plans.

Special Enrollment Periods

Special enrollment periods are not available to everyone eligible for Medicare. Special Enrollment Period can start and end anytime. Most times beneficiaries that qualify for Special enrollment periods will have to meet a particular criterion to activate the beginning of this period.

You may qualify for special enrollment periods through one of the following ways:

  • You lose your Medicare coverage even though you are not responsible for the situation. This can be as a result of a terminated employer-sponsored plan; hence you are left with no Medicare coverage.
  • You suffer financial casualty at the hands of fraudsters such that it leaves you with no Medicare coverage.
  • You previously have spousal coverage that you lost as a result of retirement, insurer bankruptcy, closure, unemployment, or divorce.
  • You were out of the country during the previous enrolment window and that made you unable to get coverage or change Medicare plans.
  • You missed the last enrollment window because you were in detention, incapacitated, and admitted to a hospital or reprimanded to a rehabilitation center.

The terms and conditions for special enrollment periods will be defined by Cigna health insurance.

Medicare Financial Support

Most seniors eligible for Medicare have fixed income and will require help in settling expenses that Medicare does not cover. There are various programs designed for them to get help and offset deductible, copayments, and premium costs.

Some of the programs designed for this include:

Medicaid

Medicaid is one of such resources that will come in handy for them. It is a health insurance scheme that the federal government organized for low-income seniors. Beneficiaries that need medical help and meet their state income limit will be able to enroll for Medicaid at the closest human service office to them. Medicaid will help them supplement their Medicare coverages.

Eligibility for Medicaid and Medicare means that the senior will not have to enroll in a private insurer Medigap scheme. Medicaid will fill in for all that Medigap entails.

Medicare Savings Programs

Another way low-income seniors can leverage their out-of-pocket Medicare cost is to get help with their monthly premiums. Medicare saving program is a state coordinated plan that will help low-income earners that are eligible for Medicare.

People with incomes from working can qualify for these programs and they include the following:

Qualified Medicare Beneficiary Program

This program will help beneficiaries cover the cost of deductibles, monthly premiums, and copays that come with Part A and B Medicare.

Special Low Income Medicare Beneficiary Program

This program is designed for Medicare seniors that require help with monthly Part B premiums.

Qualifying Individual Program

This will help cover the cost of Part B Medicare for seniors who are only financially capable enough for part A Medicare. Even though they qualify for Part B Medicare, they are unable to afford the coverage.

Seniors will be accepted to this plan based on first come first serve. The enrollment is on a yearly basis and preference will be given to those who applied in the previous years.

Qualify Disabled and Working individuals

This is for people that qualify for Medicare as disabled and not seniors, this program covers their Part A Medicare coverage.

 

 

About THE AUTHOR

Greg McKnight

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