Understanding HMO Plans
HMO plans operate within a designated network of healthcare professionals. To receive specialist care, a referral from a primary care physician (PCP) is required.
Cigna Medicare Advantage HMO plans may offer numerous benefits, such as:
- Coverage for vision
- Coverage for dental
- Coverage for hearing care
Keep in mind that services, including Medicaid services, must be obtained from in-network providers to be covered under an HMO plan, which typically includes hospital insurance.
For those seeking more flexibility, a Health Maintenance Organization-Point of Service (HMO-POS) plan may be an ideal choice.
HMO-POS plans to enable beneficiaries to access services outside of the network for specific circumstances, such as certain out-of-network care, but at a higher cost. This offers a balance between the structure of an HMO and the freedom to seek care beyond the plan’s network.
The Flexibility of PPO Plans
PPO plans offer a network of healthcare professionals, allowing members to see both in-network and out-of-network providers without requiring referrals for specialist visits.
Cigna Medicare Advantage PPO plans are known for their flexibility and may provide low copays.
Keep in mind that seeking care from out-of-network providers may result in higher coinsurance or copay amounts.
While Cigna’s PPO plans have a distinct network of healthcare providers, comparing Medicare Advantage plans to evaluate coverage and costs across different providers is necessary. Quality of care is maintained for both in-network and out-of-network providers under Cigna Medicare Advantage PPO plans, but it’s essential to review specific plan details for any disclosures, exclusions, and limitations that may apply.
Specialized Care with SNPs
Special Needs Plans (SNPs) are HMO plans designed to meet the specific needs of individuals with disabilities and/or certain diseases. Cigna SNP may provide:
- Prescription coverage
- Additional benefits
These plans are beneficial for customers with unique requirements, such as medical or financial needs, as benefits vary to cater to individual needs.
Cigna SNP coverage is tailored to those with chronic or disabling conditions, with specific qualifying medical conditions differing depending on the plan. Generally, these plans encompass diseases and healthcare needs that necessitate specialized care, such as:
- Cancer
- Chronic heart failure
- Chronic lung disorders
- Diabetes
- End-stage renal disease
- HIV/AIDS
- Neurological disorders
- Stroke
These are just a few examples of the conditions covered by Cigna SNP plans.