Cigna Medicare Formulary

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When shopping for health insurance, it’s expected that you’ll examine which benefits are covered when visiting a doctor’s office or hospital. But what about telemedicine services you receive from home?

Are you a current Cigna Medicare plan member and looking to find out how your plan covers a drug? Are you shopping for Medicare prescription drug coverage and want to find a plan that covers your drugs? Either way, using a plan’s drug formulary (list of drugs covered by the plan) can help you ensure you know how your drugs are covered and at what cost.

You can download official and up-to-date Cigna Medicare plan formulary documents from the Cigna Member Resources and Services page. 

In this guide, we outline how to use the Cigna Medicare drug formulary and how you can explore your own plan’s drug coverage.

You can also compare Medicare Advantage (Medicare Part C) plans online, including how much they cost and what drugs they cover. You may be able to find a Cigna Medicare Advantage plan where you live that covers all of your Medicare Part A and Part B benefits as well as your prescriptions.

Where Can Cigna Plan Members Find the Cigna Formulary?

You can download your Cigna plan formulary, and you should also be able to view your plan’s formulary from your myCigna account or mobile app.

Where Can Non-Cigna Members Find the Cigna Formulary?

If you are not enrolled in a Cigna Medicare plan, you can call and speak with a licensed insurance agent who can help you compare formularies for Cigna plans where you live.

You can also view an online comprehensive Cigna drug formulary. Note that this list includes all drugs that may be covered by Cigna plans, but each individual plan may not cover all drugs on this list. 

• Page 28 features a table of contents with drugs categorized by treatment type.
  
  
• Page 79 features an index with all drugs listed alphabetically.
  
  
• Pages 5-27 show the copayment amount for each drug tier for each Cigna plan arranged by state and county. 

What Is an Insurance Formulary?

Medicare plans that include coverage of prescription drugs use what’s called a “formulary” as part of the benefit terms. A formulary is a list of drugs that are covered by the plan.  

Formularies are typically categorized by “tiers,” with each tier representing a different classification of drugs. For example, one tier might include drugs that are relatively inexpensive and commonly prescribed while another tier features drugs that are more expensive and more rarely used.

Each tier often comes with its own copayment or coinsurance amount and tiers can even have their own deductibles and other coverage terms.

Which Drugs Are Included On A Formulary?

Medicare Advantage and Medicare Part D plans must cover all FDA-approved drugs in the following categories:

• HIV/AIDS treatment
• Antidepressants
• Antipsychotic medications
• Anti-convulsive treatments for seizure disorders
• Immunosuppressant drugs
• Anti-cancer drugs that are not covered by Medicare Part B
• Most vaccines that are not covered by Medicare Part B 

What Type Of Medications Are Not Covered On A Formulary?

Certain types of drugs are not allowed to be included on a formulary or covered by a Medicare drug plan. These include drugs used for:

• Weight loss or weight gain
• Cosmetic purposes, including hair growth
• Fertility
• Sexual performance or erectile dysfunction 

Over-the-counter drugs are not allowed to be included on a formulary. However, many Medicare Advantage and Medicare Part D plans feature discounts for over-the-counter medications and other health items, including many Cigna plans. 

How Can I Find Out How Much My Prescription Will Cost?

Cigna Medicare Advantage and Medicare Part D plans use the tier system to outline the copayment amount of every covered drug. When your doctor prescribes you a medication, check the formulary to see which tier the drug belongs to and the corresponding copayment amount. 

Depending on the tier of the drug and the coverage of your plan, you may have to first satisfy an annual drug deductible before any copayments apply. 

If you are a Cigna member, you may use your myCigna account or mobile app to check the expected price of a drug using the “Price a Medication” feature.

How Much Do Cigna Medicare Drug Plans Cost?

Below is the weighted average premium, deductible and copayment or coinsurance for each of Cigna Medicare Part D plan in 2024.

Cigna Saver Rx

Monthly premium: $19

• Preferred generics = $0
• Generics = $6
• Preferred brands = 18%
• Non-preferred = 49%
• Specialty = 25%

Cigna Secure Rx

Monthly premium: $47

Copayments/coinsurance:

• Preferred generics = $0
• Generics = $3
• Preferred brands = 16%
• Non-preferred = 43%
• Specialty = 25%

Cigna Extra Rx

Monthly premium: $85

Copayments/coinsurance:

• Preferred generics = $3
• Generics = $12
• Preferred brands = 20%
• Non-preferred = 50%
• Specialty = 31%

How Can I Compare Cigna Medicare Drug Coverage to Other Plans?

Medicare beneficiaries in most locations have their choice of dozens of plans offered by numerous different insurance carriers. Each plan from every company will come with its own drug formulary, premiums and coverage amounts, so it’s important to compare plans before enrolling to ensure that you find the best policy for your needs. 

If you need help sorting through plan formularies and understanding the benefits of each plan, connect with a licensed insurance agent or compare plans online.