2022 Cigna Fundamental Medicare (PPO)

Cigna Fundamental Medicare (PPO) H7787-002 is a 2022 Medicare Advantage Plan or Part-C by Cigna available to residents in Texas. This plan does not provide additional prescription drug (Part-D) coverage. The Cigna Fundamental Medicare (PPO) has a monthly premium of $0 and has an in-network maximum out-of-pocket limit of $5,700 (MOOP). This means that if you get sick or need a high cost procedure the co-pays are capped once you pay $5,700 out-of-pocket. This can be a extremely nice safety net.

Cigna Fundamental Medicare (PPO) is a Local PPO *. A preferred provider organization (PPO) is a Medicare plan that has created contracts with a network of "preferred" providers for you to choose from at reduced rates. You do not need to select a primary care physician and you do not need referrals to see other providers in the network. Offering you a little more flexibility overall. You can get medical attention from a provider outside of the network but you will have to pay the difference between the out-of-network bill and the PPOs discounted rate.

Cigna works with Medicare to provide significant coverage beyond Part A and Part B benefits. If you decide to sign up for Cigna Fundamental Medicare (PPO) you still retain Original Medicare. But you will get additional Part A (Hospital Insurance) and Part B (Medical Insurance) coverage from Cigna and not Original Medicare. With Medicare Advantage you are always covered for urgently needed and emergency care. Plus you receive all the benefits of Original Medicare from Cigna except hospice care. Original Medicare still provides you with hospice care even if you sign up for Medicare Advantage.

Ready to Enroll?

Click Here

Or Call
1-855-778-4180
Mon-Fri 8am-8pm EST
Sat 8am-8pm EST

2022 Cigna Medicare Advantage Plan Costs

2021 Cigna Fundamental Medicare (PPO) Summary of Benefits

*This will be updated with 2022 data when available.

---

Additional Benefits

No

---

Comprehensive Dental

Diagnostic services	Not covered
Endodontics	Not covered
Extractions	50% coinsurance (Out-of-Network)
Extractions	$35-75 copay
Non-routine services	Not covered
Periodontics	$10-55 copay
Periodontics	50% coinsurance (Out-of-Network)
Prosthodontics, other oral/maxillofacial surgery, other services	50% coinsurance (Out-of-Network)
Prosthodontics, other oral/maxillofacial surgery, other services	$0-195 copay
Restorative services	50% coinsurance (Out-of-Network)
Restorative services	$10-195 copay

---

Deductible

$750 annual deductible

---

Diagnostic Tests and Procedures

Diagnostic radiology services (e.g., MRI)	$0-150 copay
Diagnostic radiology services (e.g., MRI)	50% coinsurance (Out-of-Network)
Diagnostic tests and procedures	50% coinsurance (Out-of-Network)
Diagnostic tests and procedures	$0-150 copay
Lab services	$0 copay
Lab services	0-50% coinsurance (Out-of-Network)
Outpatient x-rays	50% coinsurance (Out-of-Network)
Outpatient x-rays	$0 copay

---

Doctor Visits

Primary	$10 copay per visit
Primary	50% coinsurance per visit (Out-of-Network)
Specialist	$30 copay per visit
Specialist	50% coinsurance per visit (Out-of-Network)

---

Emergency care/Urgent Care

Emergency	$90 copay per visit (always covered)
Urgent care	$30 copay per visit (always covered)

---

Foot Care (podiatry services)

Foot exams and treatment	$30 copay
Foot exams and treatment	50% coinsurance (Out-of-Network)
Routine foot care	Not covered

---

Ground Ambulance

$200 copay (Out-of-Network)
$200 copay

---

Hearing

Fitting/evaluation	$0 copay
Fitting/evaluation	50% coinsurance (Out-of-Network)
Hearing aids - inner ear	$0 copay
Hearing aids - inner ear	$0 copay (Out-of-Network)
Hearing aids - outer ear	$0 copay
Hearing aids - outer ear	$0 copay (Out-of-Network)
Hearing aids - over the ear	$0 copay (Out-of-Network)
Hearing aids - over the ear	$0 copay
Hearing exam	50% coinsurance (Out-of-Network)
Hearing exam	$10-30 copay

---

Inpatient Hospital Coverage

$255 per day for days 1 through 5 $0 per day for days 6 through 90
20% per stay (Out-of-Network)

---

Medical Equipment/Supplies

Diabetes supplies	0-20% coinsurance per item
Diabetes supplies	50% coinsurance per item (Out-of-Network)
Durable medical equipment (e.g., wheelchairs, oxygen)	20% coinsurance per item
Durable medical equipment (e.g., wheelchairs, oxygen)	50% coinsurance per item (Out-of-Network)
Prosthetics (e.g., braces, artificial limbs)	20% coinsurance per item
Prosthetics (e.g., braces, artificial limbs)	50% coinsurance per item (Out-of-Network)

---

Medicare Part B Drugs

Chemotherapy	20% coinsurance (Out-of-Network)
Chemotherapy	20% coinsurance
Other Part B drugs	20% coinsurance
Other Part B drugs	20% coinsurance (Out-of-Network)

---

Mental Health Services

Inpatient hospital - psychiatric	20% per stay (Out-of-Network)
Inpatient hospital - psychiatric	$255 per day for days 1 through 5 $0 per day for days 6 through 90
Outpatient group therapy visit	$0 copay
Outpatient group therapy visit	50% coinsurance (Out-of-Network)
Outpatient group therapy visit with a psychiatrist	$0 copay
Outpatient group therapy visit with a psychiatrist	50% coinsurance (Out-of-Network)
Outpatient individual therapy visit	$0 copay
Outpatient individual therapy visit	50% coinsurance (Out-of-Network)
Outpatient individual therapy visit with a psychiatrist	50% coinsurance (Out-of-Network)
Outpatient individual therapy visit with a psychiatrist	$0 copay

---

MOOP

$8,700 In and Out-of-network $5,700 In-network

---

Option

Yes, contact plan for further details

---

Optional supplemental benefits

No

---

Outpatient Hospital Coverage

50% coinsurance per visit (Out-of-Network)
$0-195 copay per visit

---

Preventive Care

$0 copay (Out-of-Network)
$0 copay

---

Preventive Dental

Cleaning	$0 copay
Cleaning	50% coinsurance (Out-of-Network)
Dental x-ray(s)	$0 copay
Dental x-ray(s)	50% coinsurance (Out-of-Network)
Fluoride treatment	Not covered
Oral exam	50% coinsurance (Out-of-Network)
Oral exam	$0 copay

---

Rehabilitation Services

Occupational therapy visit	$30 copay
Occupational therapy visit	50% coinsurance (Out-of-Network)
Physical therapy and speech and language therapy visit	50% coinsurance (Out-of-Network)
Physical therapy and speech and language therapy visit	$30 copay

---

Skilled Nursing Facility

45% per stay (Out-of-Network)
$0 per day for days 1 through 20 $184 per day for days 21 through 100

---

Transportation

Not covered

---

Vision

Contact lenses	$0 copay (Out-of-Network)
Contact lenses	$0 copay
Eyeglass frames	$0 copay
Eyeglass frames	$0 copay (Out-of-Network)
Eyeglass lenses	$0 copay
Eyeglass lenses	$0 copay (Out-of-Network)
Eyeglasses (frames and lenses)	$0 copay (Out-of-Network)
Eyeglasses (frames and lenses)	$0 copay
Other	Not covered
Routine eye exam	$0 copay
Routine eye exam	0-50% coinsurance (Out-of-Network)
Upgrades	$0 copay
Upgrades	$0 copay (Out-of-Network)

---

Wellness Programs (e.g. fitness nursing hotline)

Covered

CMS Star Ratings for Cigna Fundamental Medicare (PPO) H7787

Staying Healthy, Screening, Testing, & Vaccines

Managing Chronic And Long Term Care for Older Adults

Member Experience with Health Plan

Member Complaints and Changes in Cigna Fundamental Medicare (PPO) Plans Performance

Health Plan Customer Service Rating for Cigna Fundamental Medicare (PPO)

Cigna Fundamental Medicare (PPO) Drug Plan Customer Service Ratings

Ratings For Member Complaints and Changes in the Drug Plans Performance

Member Experience with the Drug Plan

Drug Safety and Accuracy of Drug Pricing

Ready to Enroll?

Click Here

Or Call
1-855-778-4180
Mon-Fri 8am-8pm EST
Sat 8am-8pm EST

Coverage Area for Cigna Fundamental Medicare (PPO)

(Click county to compare all available Advantage plans)

Go to top

Source: CMS.
Data as of September 1, 2021.
Notes: Data are subject to change as contracts are finalized. For 2022, enhanced alternative may offer additional cost sharing reductions in the gap on a sub-set of the formulary drugs, beyond the standard Part-D benefit. Includes 2022 approved contracts. Employer sponsored 800 series and plans under sanction are excluded.