Cigna and Senior Care Coverage

Overview of Cigna Insurance Plans for Seniors

Cigna has three types of health insurance plans for Medicare beneficiaries: Medicare Advantage, Medigap, and Part D. Here is a more comprehensive breakdown of Cigna’s options:

• Medicare Advantage (Part C): By law, Medicare Advantage plans must cover everything Original Medicare (Parts A and B) covers. Part C plans also typically  include “extras” like prescription drugs (Part D), dental coverage, hearing aids, and more. Many of Cigna’s Health Maintenance (HMO) plans and Preferred Provider Organization (PPO) plans have low or no monthly premiums. You may still need to pay the Part B premium each month.
• Medicare Supplement Health Insurance (Medigap): Cigna’s Medigap plans help pay for out-of-pocket costs that Original Medicare does not cover, including premiums, deductibles, and copays. Cigna Medigap offers discounts for Medigap customers who live within the same household and for those who apply online.
• Part D (Prescription Drug): Cigna offers stand-alone Part D coverage to those on Original Medicare. Part D plans through Cigna (including those included in a Medicare Advantage plan) offer benefits like low copays, a network of more than 63,000 pharmacies nationwide, and drug coverage for over 3,000 medications.

It is important to note that Original Medicare and private Medicare options do not cover long-term (custodial) care. From senior living facilities to comprehensive home health care, many older adults sign up for long-term care insurance (LTCI) plans to help pay for a wide range of long-term care  Unfortunately, Cigna does not offer LTCI plans. They do, however, have plans that include short-term options, including skilled nursing facility care, for up to 100 days.

Does Cigna Cover Nursing Homes and Skilled Nursing Care?

The need for long-term nursing home care is very common among older adults. It may come as a surprise that Original Medicare doesn’t offer much in the way of nursing home coverage.

Even though nursing homes are places where seniors can access round-the-clock medical care, Medicare defines most nursing home care as custodial care. Custodial care refers to non-medical activities of daily living, like bathing, eating, and sleeping. Medicare doesn’t cover custodial care if that’s the only care required.

Medicare Part A may, however, cover the cost of skilled medical care that is provided to you during a nursing home stay, or within your own home (home health care) if you meet specific criteria.1 Consequently, Cigna Medicare Advantage plans only cover the same degree of nursing home care.

Medicare Part A coverage, provided through Cigna’s Part C plans, can cover inpatient care at a skilled nursing facility (SNF).2 This coverage only applies under specific circumstances. Typically, this entails care under a skilled care plan written by a doctor or provided by medically certified personnel in a state-licensed skilled nursing center. The care is usually for a specified period of time.

Long-term care insurance is the best option to help with nursing home costs. As we’ve mentioned, Cigna does not offer these plans. If you need to stay at a skilled nursing facility for more than 100 days, you may want to find a long-term care plan from another carrier to cover additional days. Medicare Part A will only pay for skilled nursing care for the first 100 days of care (assuming you meet the aforementioned requirements).

In contrast, some insurance carriers, like UnitedHealthcare, offer a Part C PPO SNP (special needs plan) specifically for people living in nursing homes in certain states. This plan is designed to cover the type of medical care given in nursing homes. It doesn’t cover custodial care services, but may be beneficial for seniors living in long-term care facilities.

Does Cigna Cover Home Care?

Many older adults want to live in the comfort of their own homes with the one-on-one assistance of a professional caregiver. Because personal care such as meal preparations, housekeeping, bathing, grooming, and dressing are not covered by Medicare or Medicaid, much of the care required to remain at home is paid for out of pocket.

Skilled care, such as that provided by a home health care agency, is generally covered by Medicare, including Medicare Advantage plans offered through Cigna. Home health care may include nursing care, physical therapy, occupational therapy, and speech therapy. For even greater home care coverage, you may want to consider a LTCI from another carrier.

Does Cigna Cover Hospice Care?

Hospice care, also referred to as end-of-life care, is provided when a person is believed to have less than six months to live. At the time that hospice care begins, a person has chosen to stop pursuing curative treatments – treatments that help you live longer. Cigna offers coverage options for end-of-life care. Many of the costs associated with hospice care are covered through Cigna’s Medicare Advantage plans.

Here are some of the hospices services you might be eligible for with Cigna:

• Basic medical care with a focus on pain and symptom control
•  Access to a hospice team member 24/7
• Counseling and social support to help you and your family with psychological, emotional, and spiritual issues
• Volunteer support, such as meal preparations or errands
• Respite care for caregivers, family, or others who help take care of you3

Does Cigna Cover Assisted Living?

None of Cigna’s Medicare plans cover assisted living. LTCI does cover a portion of assisted living costs. The exact amount that these plans cover varies from one plan and carrier to another. If you’re interested in LTCI, we’d recommend considering other private carriers who offer these plans.

How Do I Enroll in a Cigna Medicare Plan for Senior Care?

You can start shopping for Cigna Medicare plans on Cigna’s website. You will need to input your ZIP code to see which plans are available in your area. From there, you can either enroll online or call a licensed Cigna agent. Cigna agents are available by phone Monday through Friday, from 8 a.m. to 8 p.m. ET. Whether you sign up online or over the phone, Cigna makes it easy to find the best plan for you, understand the benefits and costs, and enroll.

How Cigna Compares to Other Insurance Carriers

Want to compare your options? Below is a ballpark of how some popular Medicare insurance companies compare to Cigna. All information listed is based on our team’s research, but remember that costs, plans, and availability may vary based on your location.

*Availability varies by zip code; eligibility requirements for Medigap plans may also vary

For a closer look at these carriers and their offerings, check out our resources below:

• Aetna Medicare Advantage review
• Aetna Medigap review
• Humana Medicare Advantage review
• Humana Medigap review
• Humana senior care coverage guide
• UnitedHealthcare Medicare Advantage review
• UnitedHealthcare Medigap review
• UnitedHealthcare senior care coverage guide

What Other Options Exist to Pay for Senior Care?

If Cigna’s plans do not cover the kind of senior care you need, LTCI is a great way to pay for additional services, including:

• Assistance with daily hygiene and at-home care
• Community-based services
• Assisted living facilities
• Residential care facilities
• Skilled nursing facilities
• Special care units
• Continuing-care communities

In addition to LTCI, people pay for senior care in a variety of ways, including:

• Private pay, including personal savings and retirement accounts
• Social Security income
• Reverse mortgages
• Home care loans
• Life insurance policy conversions