Cigna Medicare Plans — Advantage, Medigap, and Part D

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Almost 55% of Medicare beneficiaries are now enrolled in a Medicare Advantage plan, reflecting a growing preference for private coverage over Original Medicare. This shift underlines the importance of understanding what different providers offer.

Given these trends, Cigna offers a variety of Medicare options, including Medicare Advantage plans (some of which include Part D), standalone Part D prescription drug plans (PDPs), and Medigap (Medicare Supplement) policies. However, since benefits and costs vary by ZIP code and change annually, selecting the right plan can be challenging.

In this guide, we offer a clear overview of Cigna’s 2025 Medicare offerings, along with helpful comparisons to support your decision-making process.

What Cigna Medicare Advantage Includes

Core Coverage

Cigna Medicare Advantage plans offer everything that Original Medicare offers, including Parts A (hospital), B (medical), and generally Part D for prescription drugs. Some plans also offer extras such as dental, vision, hearing, fitness programs, or allowances for over-the-counter (OTC) items, depending on your ZIP code and plan type.

However, research shows that having dental, vision, or hearing benefits in an MA plan does not guarantee that enrollees have better access to these services.

Plan Types

Cigna has multiple MA plan structures, such as HMO, which usually has limited coverage to in-network providers and may require a referral. PPO offers more flexibility for a higher cost for out-of-network participation, and Special Needs Plans (SNPs), designed for specific populations such as people with chronic conditions, those eligible for both Medicare and Medicaid, or residents of long-term care facilities.

Since provider networks and rules differ, it’s important to confirm whether your doctors and/or hospital participate in the plan(s) you are considering.

Key Takeaway

Cigna MA includes core Medicare and potential extras. However, your actual experience depends on plan design and what’s available locally.

2025 Drug-Cost Changes That Affect Cigna Plans

Part D $2,000 Cap

Beginning in 2025, Medicare enrollees with Part D coverage will pay a maximum of $2,000 out-of-pocket every year, including deductibles, copays, and coinsurance. The cap applies to both standalone PDPs and MA-PDs and provides major relief. Moreover, some enrollees can even save upwards of $1,000 a year.

Payment Smoothing

Similarly, the Medicare Prescription Payment Plan will allow beneficiaries to spread their drug copayment over a monthly payment plan, as opposed to paying all at once at the pharmacy counter. While it does not reduce the overall payment, it does improve the cash flow by spreading payments over time.

Deductibles And Formulary Notes

For 2025, the maximum Part D deductible is $590, but some plans waive the deductible. This makes it essential to carefully examine the plan’s formularies and tiers, drug tier placement as they can significantly affect the costs.

Key Takeaway

Drug costs in 2025 are more predictable thanks to the new cap and smoothing feature. However, formularies, tiers, and pharmacy networks still determine your actual expenses.

Costs and Networks — What to Watch

Premiums, Copays, and MOOP

Under some Cigna Medicare Advantage designs, some plans offer a $0 premium in addition to what you are already paying for Part B, depending on your ZIP code and plan type.

However, you will owe copays, coinsurance, and potentially a deductible. Plan cost summaries show that the average in-network annual out-of-pocket maximum (MOOP) for Part A/B services in 2025 will be around $5,320, which is significantly lower than fee-for-service Medicare’s unlimited exposure.

Providers and Referrals

Cigna’s MA plans are offered as HMOs and PPOs. HMOs generally require recipients to use in-network care and require referrals, while PPOs offer limited out-of-network access but at higher costs.

A national study indicated that, compared to traditional Medicare with Medigap coverage, MA enrollees incurred 18-24% lower monthly out-of-pocket health costs, which are largely due to provider network management and the cost-control strategies used in Medicare Advantage..

Key Takeaway

Affordability depends on how your premiums, copays, and out-of-pocket maximum (MOOP) add up, along with whether your doctors and hospitals are in the plan’s network.

Cigna Part D (PDP) vs. Drug Coverage Inside MA-PD

PDP vs. MA-PD basics

If you have Original Medicare or use a Medigap plan, you can add a standalone Part D option (PDP) for your prescriptions. MA-PDs, as an example, explicitly integrate drug coverage into the Medicare Advantage plan rather than going standalone, which packages your benefits and coordinates your rules under a single structure.

Formularies and tiers

Cigna’s list of covered drugs (formulary) organizes medications into tiers that affect how much you pay. Some may also require prior authorizations or step therapy, which can create delays in getting medicines. Cigna’s up-to-date July–August 2024 formularies list these details so you can confirm which drugs are covered and what rules apply.

Pharmacies and costs

The cost of your prescription is usually influenced by whether you use an in-network or preferred pharmacies that provide lower cost-sharing. The pharmacy you select can really impact your out-of-pocket spending. In fact, a recent review found that higher cost-sharing consistently relates to lower medication adherence across conditions.

Key Takeaway

MA-PDs simplify coverage, whereas PDPs offer flexibility. Yet, the actual costs are driven by formulary structure, cost-sharing rules, and pharmacy access.

When Medigap + Part D Might Fit Better

Medigap (Plan G/Plan N) basics

Medigap Plan G and Medigap Plan N provide predictable costs for medical expenses by covering many of the out-of-pocket costs left by Medicare Parts A and B, though premiums are typically higher. Both options have access to a provider anywhere in the U.S. without a network.

Combining Medigap with a Cigna PDP

Medigap doesn’t cover prescription drugs, so you’ll need to pair it with a standalone Cigna Part D plan. However, starting in 2025, these Part D plans will introduce a $2,000 out-of-pocket cap, helping you avoid high drug costs.

Trade-offs versus MA

Selecting Medigap + Part D means that you are going to pay a higher premium but will receive more flexibility and cost stability. Medicare Advantage (MA) plans might offer lower premiums, but once you join, you agree to receive care only from chosen health network providers. However, most MA plans (especially HMO plans) require prior authorization before receiving services.

Key Takeaway

For individuals who prioritize nationwide provider access and predictable costs, Medigap plus Part D may be a better long-term fit than a local MA plan.

Smarter Medicare Decisions in 2025

Medicare choices in 2025 provide a balancing act of coverage, cost, and convenience. Be sure to also review the ANOC and check your providers to avoid surprises in the new plan year. If you find the process overwhelming, Medicare Sharks can help you objectively compare plans in a structured way and help you make a more confident decision and move forward.