Cigna offers Medicare plans, but it is not the same as Medicare itself

Cigna is a private insurance company that sells Medicare Advantage plans and prescription drug coverage to people who are already enrolled in Medicare. Cigna does not run Medicare — that is the federal program administered by the Centers for Medicare & Medicaid Services (CMS). Think of it this way: Medicare is the foundation. Cigna is one of many private insurers that builds on top of it and sells you a different way to use your Medicare benefits.

If you are asking whether Cigna is a legitimate Medicare option, the answer is yes. Cigna is approved by CMS to sell Medicare Advantage plans (also called Part C) in most states. But "legitimate" and "right for you" are different questions. Cigna plans vary by location, cost, and what doctors and hospitals they cover. You need to know what Cigna actually offers in your area before you decide.

Key Takeaways

  • Cigna sells Medicare Advantage plans and Part D prescription drug plans, but does not operate Medicare itself — CMS does.
  • Cigna Medicare Advantage plans are available in most states but not all, and coverage varies by county and plan type.
  • You must be enrolled in Medicare Part A and Part B before you can join a Cigna Medicare plan.
  • Cigna plans have networks — you pay less if you use doctors and hospitals in their network, and more or nothing if you go out of network.
  • You can switch to or away from Cigna during the Annual Enrollment Period (October 15 to December 7 each year) or if you may have access to for a Special Enrollment Period.

What Cigna Medicare plans actually cover

Cigna offers two main types of Medicare plans. The first is Medicare Advantage (Part C), which is an all-in-one alternative to Original Medicare. With a Cigna Medicare Advantage plan, Cigna becomes your insurer. You still have Medicare Part A and Part B, but Cigna manages your benefits, sets your copays and deductibles, and controls which doctors and hospitals you can see without paying extra.

The second type is Part D prescription drug coverage, which you can add to Original Medicare or to a Medicare Advantage plan. Cigna Part D plans cover medications on a formulary — a list of drugs the plan will pay for. Different Cigna Part D plans cover different drugs, and the copay you pay depends on which tier the drug is on.

Medicare Advantage plans sold by Cigna often include extras that Original Medicare does not: dental, vision, hearing, or fitness benefits. But these extras come with trade-offs. You will have a network of doctors and hospitals. You may need referrals to see specialists. You may have to use mail order for some prescriptions. Read the plan details for your county before you enroll.

How to find Cigna Medicare plans in your area

Cigna does not sell Medicare plans everywhere. Availability depends on your state and county. The easiest way to see what Cigna offers near you is to visit Medicare.gov and use the plan finder tool. Enter your zip code, and the tool will show you every Medicare Advantage and Part D plan available in your area, including Cigna plans.

When you search, you will see the plan name, monthly premium, deductible, copays for doctor visits and hospital stays, and which pharmacies and doctors are in the network. You can compare Cigna plans side by side with plans from other insurers like Humana, UnitedHealthcare, or Aetna. The plan finder also shows you whether your current doctors are in each plan's network — this matters, because switching plans can mean switching doctors.

If you do not have internet access or prefer to talk to someone, you can call 1-800-MEDICARE (1-800-633-4227). A representative can tell you which Cigna plans are available in your zip code and answer questions about coverage and costs.

Costs: premiums, deductibles, and copays

Cigna Medicare Advantage plans have a monthly premium, which is what you pay to Cigna each month. Some Cigna plans have a $0 premium, meaning you pay nothing monthly — you only pay when you use care. Other plans charge $50 to $200 or more per month. The premium depends on the plan type and your location.

In addition to the premium, you will pay out-of-pocket costs when you receive care. These include deductibles (the amount you pay before the plan starts paying), copays (a fixed amount per visit or service), and coinsurance (a percentage of the cost). A Cigna plan might have a $0 deductible for doctor visits but a $250 deductible for hospital stays. Copays for a primary care visit might be $10, and a specialist visit might be $40.

All Cigna Medicare Advantage plans have an out-of-pocket maximum — a yearly cap on what you pay. Once you hit that cap, Cigna pays 100% of covered services for the rest of the year. The out-of-pocket maximum varies by plan but is set by federal law: in 2024, it cannot exceed $7,550 for in-network care.

If you choose a Cigna Part D plan without a Medicare Advantage plan, you pay a separate premium for the drug coverage. Part D premiums vary widely depending on which drugs you take and which plan you choose.

Network restrictions and how they affect your care

Cigna Medicare Advantage plans use a network model. This means Cigna has contracts with certain doctors, hospitals, and pharmacies. When you see a doctor in the network, you pay your copay and that is it. When you see a doctor outside the network, you pay more — sometimes much more — or Cigna may not cover the visit at all.

Some Cigna Medicare Advantage plans are HMO plans, which means you must use in-network doctors and hospitals except in emergencies. Other Cigna plans are PPO plans, which give you more flexibility to see out-of-network doctors, but you will pay higher copays or coinsurance. A few Cigna plans are PFFS (Private Fee-for-Service) plans, which work differently — Cigna pays a set amount for each service, and you can see any doctor who accepts the plan.

Before you enroll in a Cigna plan, check whether your current doctors are in the network. Use the plan finder on Medicare.gov or call Cigna directly at the number on their website. If your doctor is not in the network and you want to keep seeing them, you may need to choose a different plan or switch back to Original Medicare.

When you can enroll in or switch Cigna plans

You can join a Cigna Medicare plan during the Annual Enrollment Period, which runs from October 15 to December 7 each year. Any changes you make during this window take effect on January 1 of the following year. This is the main time to enroll, switch plans, or drop coverage.

You may also be able to switch plans if you may have access to for a Special Enrollment Period. This is a shorter window outside the annual period. You may have access to if you move to a new county, lose your current coverage, or have certain life changes like losing a job or becoming a U.S. citizen. Special Enrollment Periods usually last 2 months from the date of the may have access to event.

If you are new to Medicare — turning 65 or becoming may be able to access due to disability or end-stage renal disease — you have an Initial Enrollment Period that lasts 7 months. This period is centered on your birthday month (for age 65) or the month you become may be able to access. During this window, you can enroll in a Cigna plan without waiting for the annual period.

How Cigna compares to other Medicare insurers

Cigna is one of several large insurers selling Medicare plans. Others include Humana, UnitedHealthcare, Aetna, and regional plans. All of them are approved by CMS and offer similar types of plans — Medicare Advantage and Part D. The differences are in the specific plans they offer, the networks they use, the premiums they charge, and the extra benefits they include.

Cigna plans in your area may have lower premiums than Humana plans, or better dental coverage, or a larger network of doctors. Or they may not. This is why comparing plans on Medicare.gov is essential. You cannot assume that Cigna is better or worse than another insurer without looking at what each one actually offers in your zip code.

One thing to know: switching between insurers is common and free. If you enroll in a Cigna plan this year and decide next year that you prefer Humana or want to go back to Original Medicare, you can switch during the next Annual Enrollment Period. There is no penalty for switching.

Frequently Asked Questions

Do I have to use Cigna if I want Medicare?

No. Cigna is optional. You can stay on Original Medicare (Part A and Part B) your whole life and never use Cigna. Original Medicare is run by the federal government and has no network restrictions — you can see any doctor who accepts Medicare. Cigna is one choice among many, and it is only for people who want a different structure.

Can I use my Cigna Medicare plan if I travel out of state?

It depends on the plan type. Most Cigna Medicare Advantage HMO plans only cover care in-network within your state or a specific region. If you travel, you may have limited or no coverage. Some Cigna PPO plans offer out-of-state coverage, but you will pay higher copays. Check your plan documents or call Cigna before you travel.

What happens if I drop my Cigna plan mid-year?

You cannot drop a Cigna Medicare Advantage plan in the middle of the year unless you may have access to for a Special Enrollment Period. If you try to leave without a may have access to reason, you will be locked in until the next Annual Enrollment Period. The exception is if you move out of the plan's service area or lose coverage — those are may have access to events.

Does Cigna Medicare cover prescription drugs?

Some Cigna Medicare Advantage plans include prescription drug coverage built in. Others do not. If your Cigna plan does not include drug coverage, you must enroll in a separate Part D plan — either from Cigna or another insurer. If you do not enroll in any drug coverage when you are first may be able to access, you may pay a penalty later.

How do I contact Cigna if I have questions about my plan?

You can find Cigna's customer service number on your insurance card or on Medicare.gov. Cigna also has a website where you can log in to your account, view your coverage, and find in-network doctors. If you do not have a Cigna plan yet, you can call 1-800-MEDICARE to ask questions before you enroll.