Cigna Medicare Advantage 2021 Review

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Cigna is the seventh-largest provider of Medicare Advantage [1], offering plans in almost half of U.S. states. Cigna also offers Medicare drug plans that can be purchased as a stand-alone plan.

Although most of Cigna’s Medicare Advantage members are in highly rated plans, the company’s offerings don’t always get top marks from third-party rating agencies.

Here’s what you should know about Cigna Medicare Advantage.

Cigna Medicare Advantage pros and cons

Cigna’s offerings have advantages and disadvantages.

Pros

  • Member satisfaction: Cigna HealthSpring, a Cigna subsidiary, came in third out of nine Medicare Advantage providers in terms of member satisfaction in J.D. Power’s most recent Medicare Advantage study.

  • Low-cost options: A full three-quarters of Cigna’s Medicare Advantage offerings are $0-premium plans.

  • Drug plans widely available: Cigna offers six stand-alone prescription drug plans that are available in all states and Washington, D.C.

  • Breadth of benefits: Cigna offers a number of helpful member benefits, such as 24/7 telehealth, meal delivery and transportation to and from health facilities.

Cons

  • Limited plan types: Although Cigna does have PPO plans, a majority of the company’s Medicare Advantage plans are HMOs, which require members to get most of their care from in-network providers.

  • Limited availability: Cigna plans are available in only 23 states and Washington, D.C.

  • Third-party ratings: The National Committee for Quality Assurance doesn’t give any Cigna plan a rating higher than 3.5 out of 5 on its ratings scale.

Available Medicare Advantage plans

Cigna offers a few kinds of Medicare Advantage plans, and they vary in terms of structure, costs and benefits available. Cigna offers Medicare Advantage Prescription Drug Plans (or MAPDs) and stand-alone Prescription Drug Plans.

Plan offerings include the following types:

A health maintenance organization, or HMO, generally requires that you use a specific network of doctors and hospitals. To see a specialist, you may need to be referred by your primary physician. Out-of-network benefits can often be very limited.

Preferred provider organization, or PPO, plans provide the most freedom, allowing you to see any provider that accepts the insurance. You don’t necessarily need to choose your primary doctor. Referrals are not required to see specialists. Out-of-network healthcare is possible, but it can be more expensive than in-network.

Special needs plans, or SNPs, restrict membership to people with certain diseases or characteristics. The benefits, network, and drug formularies of members are tailored to their needs. Cigna offers three types of SNPs:

  • Chronic Condition SNP: Designed to meet the needs of members living with certain chronic conditions, such as diabetes.

  • Dual-Eligible SNP: For people who are entitled to Medicare and who also qualify for assistance from a state Medicaid program.

  • Institutional SNP: Provides specialized care to members who live in skilled nursing or assisted living facilities and need an institutional level of care.

Available Part D prescription drug plans

While many of Cigna’s Medicare Advantage plans include Part D drug coverage, the company also sells stand-alone Part D prescription drug plans. These plans are meant to accompany Medicare Part A and Part B and do not provide medical coverage.

Cigna offers drug coverage through six prescription drug plans, or PDPs, all of which have $0-copay options for certain medications if they’re bought through a qualifying mail order. Cigna’s plans are as follows:

  • Cigna Secure Rx.

  • Cigna Secure-Essential Rx.

  • Cigna Secure-Extra Rx.

  • Express Scripts Medicare – Choice.

  • Express Scripts Medicare – Saver.

  • Express Scripts Medicare – Value.

Additional benefits

Cigna Medicare Advantage offers many members access to routine vision, dental and hearing coverage. Other benefits are available for some plans. Here are a few standouts, although their availability varies by plan:

  • 24/7 telehealth: Members with minor medical issues can speak to a medical professional any time of day.

  • Over-the-counter allowance: Some plans include an OTC quarterly allowance that you can use to order items like aspirin, cold medicine and vitamins from Cigna’s OTC catalog. You can order online, by phone, or by mail. )

  • Transportation services: Some plans include a certain number of nonemergency, one-way trips to or from health facilities within 60 miles.

  • Silver&Fit Healthy Aging and Exercise Program: Some plans provide a fitness center membership or a home fitness program, depending on your needs.

  • Home-delivered meals: Some plans include the option to have meals delivered to your home after you’ve been discharged from an acute inpatient hospital stay or skilled nursing facility stay.

  • Cigna Case Management: Members with chronic conditions like diabetes or epilepsy can apply to this program, which helps them manage their condition using a team of nurses, pharmacists and health coaches, among others.

  • Medication Therapy Management Program: Members with certain conditions who take specific medications can enroll in this program that may lower the risk of medication errors and help you make the most of your treatment.

Customer service

Cigna Medicare Advantage members can contact their plan’s customer service in a few ways:

  • Call a customer service representative at 800-997-1654, available 24 hours a day, 365 days a year. (TTY/TDD dial 711 and follow the prompts. )

  • Chat with a member services representative, Monday to Friday from 9 a.m. to 8 p.m. Eastern time.

  • Contact Cigna through Twitter.

Cigna Medicare Advantage service area

Cigna offers Medicare Advantage Prescription Drug plans in 23 states and Washington, D.C., and Medicare prescription drug plans in all 50 states and Washington, D.C. Altogether, Cigna offers Medicare Advantage plans in 369 counties [2].

Overall, Cigna is the eighth-largest health insurer in the country [3], and it is the sixth-largest in terms of for-profit health plans [4]. More than half a million Medicare beneficiaries are enrolled in Cigna Medicare Advantage plans [5].

Cost

Costs for Medicare Advantage plans will depend on your plan, your geographic location and your health needs. One of the costs to consider is the plan’s premium, and Cigna offers a $0-premium plan in every market in 2021. In fact, three-quarters (76%) of Cigna’s Medicare Advantage plans are $0-premium plans [6].

For Medicare Advantage plans with a premium, the monthly consolidated premium (including Part C and Part D) ranges from $17. 90 to $139. For special needs plans, or SNPs, with a premium, monthly premiums range from $7 to $80 [7].

Even as a Medicare Advantage user, you’ll still be responsible for paying your Medicare Part B premium, which is $148. 50 in 2021, although some plans cover part or all of this cost.

Other out-of-pocket costs to consider include:

  • Whether the plan covers any part of your monthly Medicare Part B premium.

  • The plan’s yearly deductibles and any other deductibles, such as a drug deductible.

  • Copayments and/or coinsurance for each visit or service. For instance, there may be a $10 copay for seeing your primary doctor and a $45 copay for seeing a specialist.

  • The plan’s in-network and out-of-network out-of-pocket maximums.

  • Whether your medical providers are in-network or out-of-network, or how often you may go out of network for care.

  • Whether you require extra benefits, and if the plan charges for them.

To get a sense of costs, use Medicare’s Plan Finder to compare information among available plans in your area. To compare plans across multiple insurance carriers, you can choose to view only Cigna plans. You can also shop directly from Cigna’s website by entering your ZIP code.

Medicare star ratings

Average star rating: 3.9

If you want Medicare’s take on Cigna’s plans, look no further than the Centers for Medicare & Medicaid Services’ own star ratings, which rank each plan from best (5 stars) to worst (1 star). These ratings are based on the quality of care provided and customer satisfaction. Ratings may change over time.

Based on the most recent year of data, Cigna’s Medicare Advantage (Part C) plans get an average rating of 3.8, and the company’s prescription drug plans (Part D) get an average score of 3.7 [8]. Cigna’s overall plan score is 3.9. The average star rating of plans from all providers was 4. 06 [9]. Five stars for one Cigna contract: HealthSpring Florida.

Although Cigna’s average plan rating is sub-4.0, most of Cigna’s members are in highly rated plans. Of members who are in contracts with a Medicare star rating, 87% are in contracts rated 4.0 or above in 2021 [10].

Where did Cigna outperform?

To get an overall star rating, the CMS ranks contracts on 46 plan factors. (You can find definitions for each of these factors in the CMS Star Ratings Technical Notes.) Here’s where Cigna plans received average scores of 4.5 (out of 5) and above:

  • Colorectal cancer screening.

  • Adult BMI assessment.

  • Care for older adults — medication review.

  • Care for older adults — functional status assessment.

  • Care for older adults — pain assessment.

  • Osteoporosis management in women who had a fracture.

  • Diabetes care — eye exam.

  • Diabetes care — kidney disease monitoring.

  • Diabetes care — blood sugar controlled.

  • Complaints about the health plan.

  • Plan makes timely decisions about appeals.

  • Reviewing appeals decisions.

  • Call center — foreign language interpreter and TTY availability.

  • Complaints about the drug plan.

  • Medicare plan finder, or MPF, price accuracy.

Where did Cigna struggle?

In the categories below, Cigna contracts averaged a sub-3.0 score. (You can find definitions for each of these factors in the CMS Star Ratings Technical Notes. )

  • Annual flu vaccine.

  • Improving or maintaining physical health.

  • Improving or maintaining mental health.

  • Statin therapy for patients with cardiovascular disease.

  • Medication adherence for hypertension.

  • Medication adherence for cholesterol.

Third-party ratings

There are a few companies that weigh in on health plans or on the strength of the company in question, and we’ve included three here:

AM Best Financial Strength Rating: A

AM Best is a credit rating agency that specializes in the insurance industry. In March 2021, AM Best affirmed its Financial Strength Rating, or FSR, of A (Excellent) for Cigna Corporation, including its U.S. life/health subsidiaries, health maintenance organizations, and New Zealand- and Europe-based insurance companies. AM Best also affirmed the FSR of A (Excellent) for Cigna HealthSpring Companies [11].

An A rating in this category indicates that AM Best believes Cigna has an excellent ability to meet its ongoing insurance obligations.

J.D. Power Ranking: 3rd out of 9

In its 2021 Medicare Advantage Study — the seventh it’s done so far — J.D. Power measured satisfaction with Medicare Advantage plans by six factors. These were coverage and benefits, provider choice and cost, communication and billing, as well as customer service and information. On these measures, Cigna HealthSpring, a Cigna subsidiary, scored 822 points out of 1,000 and came in third out of the top nine Medicare Advantage providers [12].

NCQA Score Range: 2.5 to 3.5 out of 5

The National Committee for Quality Assurance rates health insurance plans on a 5-point scale (with 5 being best) based on clinical quality, member satisfaction and results from the NCQA’s accreditation survey.

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. 633. The NCQA rates health insurance plans on a 5-point scale. This is based on clinical quality, member satisfaction and results from the NCQA’s accreditation survey.

In its 2021 ratings of Cigna plans, the NCQA awarded ratings between 2.5 and 3.5 [13]. Cigna HealthCare in Georgia and HealthSpring in Tennessee were the two plans that received 2.5.

Compare alternatives

See how Medicare Advantage competitors stack up to Cigna.

Compare Medicare Advantage providers

Company

Percent in a 4-star plan or higher

Service area

Average Medicare star rating

Aetna

87%.

46 states and Washington, D.C.

3.7.

Blue Cross Blue Shield

59%.

44 states.

3.8.

Cigna

87%.

23 states and Washington, D.C.

3.9.

Humana

93%.

50 states, Washington, D.C., and Puerto Rico.

3.7.

Kaiser Permanente

100%.

8 states and Washington, D.C.

4.9.

UnitedHealthcare

76%.

50 states and Washington, D.C.

3.9.

WellCare

26%.

27 states.

3.4.

About Cigna

Cigna, headquartered in Bloomfield, Connecticut, was created in 1982 when the companies of Connecticut General Corporation, or CG, and the Insurance Company of North America — known as INA — merged. Cigna provides health insurance for individuals, families, and seniors. It also offers Medicare Advantage and Part D plans, Medicare Supplement insurance, and other insurances like whole life and cancer treatment. Cigna also offers insurance to businesses. In 2020, Cigna posted $160 billion in adjusted revenues.

Find the right Medicare Advantage plan

  • What are the plan’s costs? Do you understand what the plan’s premium, deductibles, copays and/or coinsurance will be? Are you able to afford them?

  • Is your doctor in-network? If you have a preferred medical provider or providers, make sure they participate in the plan’s network.

  • Are your prescriptions covered? It is important to know what your plan covers if you are on medication. What tier are your prescription drugs on, and are there any coverage rules that apply to them?

  • Is there dental coverage? Does the plan offer routine coverage for vision, dental and hearing needs?

  • Are there extras? Does the plan offer any extra benefits, such as fitness memberships, transportation benefits or meal delivery?

If you have additional questions about Medicare, visit Medicare.gov or call 800-MEDICARE (800-633-4227, TTY 877-486-2048).

ARTICLE SOURCES

Kate Ashford, https://www.nerdwallet.com/article/insurance/medicare/cigna-medicare-advantage
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