2015 Cigna-HealthSpring Advantage (HMO) H4454-012 By Cigna-HealthSpring

Cigna-HealthSpring Advantage (HMO) By Cigna-HealthSpring



Cigna-HealthSpring Advantage (HMO) is a 2015 Medicare Advantage ("Part C" or "MA Plan") plan by Cigna-HealthSpring. This plan from Cigna-HealthSpring works with Medicare to give you significant coverage beyond Part A and Part B benefits. If you decide to sign up for Cigna-HealthSpring Advantage (HMO) you still retain Original Medicare. But you will get additional Medicare Part A (Hospital Insurance) and Medicare Part B (Medical Insurance) coverage from Cigna-HealthSpring and not Original Medicare. With Medicare Advantage plans your always covered for urgently needed and emergency care and you receive all of the benefits of Original Medicare from this plan except hospice care. Original Medicare still provides you with hospice care even if you sign up for a Medicare Advantage Plan.



2015 Medicare Advantage Plan Details

Plan Name:
Cigna-HealthSpring Advantage (HMO)
Plan ID:
H4454-012
Provider: Cigna-HealthSpring
Plan Year:2015
Plan Type: Local HMO *
Monthly Premium C+D: $0.00
MOOP: $4,400


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Coverage Area for Cigna-HealthSpring Advantage (HMO)

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The Cigna-HealthSpring Advantage (HMO) H4454-012 is available to residents in Tennessee, and has a in-network Maximum Out-of-Pocket limit of $4,400 MOOP. This means that if you get sick or need a high cost procedure your co-pays are capped. If you enroll in Cigna-HealthSpring Advantage (HMO) plan you will stop paying co-pays for the rest of the year once you pay out of pocket $4,400 This is a very nice safety net. This plan does not provide additional Medicare prescription drug (Part-D) coverage.

Cigna-HealthSpring Advantage (HMO) is a Local HMO *. With a health maintenance organization (HMO) you will be required to receive most of your health care from an in-network provider. Health maintenance organizations require that you select a primary care physician (PCP). Your PCP will serve as your personal doctor to provide all of your basic healthcare services. If you need special care for a physician specialist, your primary care physician will make the arrangements and tell you where you can go in the network. You will need your PCPs okay, called a referral. Without getting a referral or services received from out-of-network providers are not typically covered by the plan.





Ratings for Cigna-HealthSpring Advantage (HMO) H4454

2015 Overall Rating
Part C Summary Rating
Part D Summary Rating
Staying Healthy: Screenings, Tests, Vaccines
Managing Chronic (Long Term) Conditions
Member Experience with Health Plan
Complaints and Changes in Plans Performance
Health Plan Customer Service
Drug Plan Customer Service
Complaints and Changes in the Drug Plan
Member Experience with the Drug Plan
Drug Safety and Accuracy of Drug Pricing


Member Experience with Health Plan

Total Experience Rating
Getting Needed Care
Timely Care and Appointments
Customer Service
Health Care Quality
Rating of Health Plan
Care Coordination


Member Complaints and Changes in Cigna-HealthSpring Advantage (HMO) Plans Performance

Total Rating
Members Leaving the Plan
Complaints about Health Plan
Health Plan Quality Improvement


Health Plan Customer Service Rating for Cigna-HealthSpring Advantage (HMO)

Total Customer Service Rating
Timely Decisions About Appeals
Reviewing Appeals Decisions


Staying Healthy, Screening, Testing, & Vaccines

Total Preventative Rating
Breast Cancer Screening
Colorectal Cancel Screening
Cardiovascular Screening
Diabetes Care
Annual Flu Vaccine
Improving Physical
Improving Mental Health
Monitoring Physical Activity
Adult BMI Assessment


Ratings For Managing Chronic And Long Term Care

Total Rating
SNP Care Management
Medication Review
Functional Status Assessment
Pain Screening
Osteoporosis Management
Diabetes Care - Eye Exam
Diabetes Care - Kidney Disease
Diabetes Care - Blood Sugar
Diabetes Care - Cholesterol
Controlling Blood Pressure
Rheumatoid Arthritis
Improving Bladder Control
Reducing Risk of Falling
Plan - Cause Readmissions


Ratings For Member Experience with the Drug Plan

Total Rating
Rating of Drug Plan
Getting Needed Prescription Drugs


Drug Safety and Accuracy of Drug Pricing

Total Rating
MPF Price Accuracy
High Risk Medication
Diabetes Treatment
Drug Adherence for Diabetes Medications
Drug Adherence for Hypertension (RAS antagonists)
Drug Adherence for Cholesterol (Statins)


Ratings For Member Complaints and Changes in the Drug Plans Performance

Total Rating
Complaints about the Drug Plan
Members Choosing to Leave the Plan
Drug Plan Quality Improvement


Cigna-HealthSpring Advantage (HMO) Drug Plan Customer Service ratings

Total Rating
Appeals Auto Forward
Appeals Upheld


Source: CMS.
Plans as of September 2, 2014.

Star Rating as of Oct 3, 2014.

For More Information on Ratings Please See the CMS Tech Notes Here.

Notes: Data are subject to change. All contracts for 2015 have been finalized. For 2015, enhanced alternative plans may offer additional cost sharing reductions in the gap on a sub-set of the formulary drugs, beyond the standard Part D benefit

Includes 2015 approved contracts/plans. Employer sponsored 800 series plans and plans under sanction are excluded.


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