HealthSpring TotalCare Plus (HMO D-SNP)
Available to residents of Flagler County, FL for 2026. Contract H5410, plan 031, segment 0.
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- Plan health benefits
- Benefits in plain text
- Rx cost-sharing for all pharmacies and tiers
- Other plans in Flagler County
- Plan website
- Browse the HealthSpring TotalCare Plus (HMO D-SNP) formulary
Renewed for 2026. CMS carries this plan forward from 2025.
Plan details
| Monthly premium (Part C + D) | $4.80 |
|---|---|
| — medical (Part C) part | $0.00 |
| — drug (Part D) part | $4.80? |
| Drug premium in CMS's quarterly plan file | $0.00The CMS Landscape file above lists $4.80 for the drug part; the two CMS files differ for this plan. |
| Monthly premium with full Extra Help (LIS) | $0.00? |
| Part B premium reduction (giveback) | None |
| Health plan deductible (in-network) | None |
| In-network out-of-pocket maximum | $1,500.00? |
| Drug deductible | $615.00Tier 1 exempt |
| Drug out-of-pocket threshold | $2,100.00 |
| Plan type | HMO D-SNP? |
| Special needs plan | Dual-eligible SNP |
| Contract / plan | H5410-031-0 |
| Offered by | Cigna HealthCare |
| Parent organization | Health Care Service Corporation |
| Formulary drugs | 3,659 |
| Formulary exception tier | 4? |
| Pharmacy search | www.cigna.com/medicare |
| Member services | (855)265-6004TTY 711 |
CMS star ratings
- Overall
- 3.5 out of 5 stars for Overall
- Health plan (Part C)
- 3.5 out of 5 stars for Health plan (Part C)
- Drug plan (Part D)
- 3.5 out of 5 stars for Drug plan (Part D)
Published per contract — every plan under contract H5410 shares this rating.
Plan health benefits
| Service | In-network |
|---|---|
| Doctor visits | |
| Primary care doctor | $0 copay |
| Specialist | $0 copay(authorization and referral required) |
| Other health care professional | $0 copay(authorization and referral required) |
| Additional telehealth services | $0 copay(authorization and referral required) |
| Preventive care | |
| Medicare-covered preventive services | $0 copay |
| Annual physical exam | $0 copay |
| Kidney disease education | $0 copay(referral required) |
| Glaucoma screening | $0 copay(referral required) |
| Diabetes self-management training | $0 copay(referral required) |
| Diagnostic tests, labs and imaging | |
| Diagnostic tests and procedures | $0 copay(authorization and referral required) |
| Lab services | $0–$50 copay(authorization and referral required) |
| Diagnostic radiology (e.g. MRI, CT) | $0 copay(authorization and referral required) |
| Therapeutic radiology | $0 copay(authorization and referral required) |
| Outpatient x-rays | $0 copay(authorization and referral required) |
| Emergency and urgent care | |
| Emergency room | $0 copay |
| Urgent care | $0 copay |
| Worldwide emergency coverage | $135 copay · $50,000 plan limit |
| Worldwide urgent care | $135 copay · $50,000 plan limit |
| Worldwide emergency transportation | $135 copay |
| Hospital care | |
| Inpatient hospital stay | $0 per stay(authorization and referral required) |
| Outpatient hospital services | $0 copay(authorization and referral required) |
| Outpatient observation | $0 copay(authorization and referral required) |
| Ambulatory surgical center | $0 copay(authorization and referral required) |
| Outpatient blood services | $0 copay |
| Skilled nursing and home health | |
| Skilled nursing facility | $0 per day for days 1–100(authorization required) |
| Home health care | $0 copay(authorization required) |
| Kidney dialysis | $0 copay(authorization and referral required) |
| Rehabilitation | |
| Occupational therapy | $0 copay(authorization and referral required) |
| Physical therapy and speech-language therapy | $0 copay(authorization and referral required) |
| Cardiac rehabilitation | $0 copay(authorization and referral required) |
| Pulmonary rehabilitation | $0 copay(authorization and referral required) |
| Mental health and substance use | |
| Inpatient psychiatric hospital stay | $0 per stay(authorization required) |
| Outpatient mental health, individual session | $0 copay(authorization required) |
| Outpatient mental health, group session | $0 copay(authorization required) |
| Psychiatrist, individual session | $0 copay(authorization required) |
| Psychiatrist, group session | $0 copay(authorization required) |
| Partial hospitalization | $0 copay(authorization required) |
| Intensive outpatient program | $0 copay(authorization required) |
| Outpatient substance use, individual session | $0 copay(authorization required) |
| Outpatient substance use, group session | $0 copay(authorization required) |
| Opioid treatment program | $0 copay(authorization required) |
| Ambulance and transportation | |
| Ground ambulance | $0 copay(authorization required) |
| Air ambulance | 20% coinsurance(authorization required) |
| Transportation to plan-approved locations | $0 copay(authorization required) |
| Medical equipment and supplies | |
| Durable medical equipment (e.g. wheelchairs, oxygen) | $0 copay(authorization required) |
| Prosthetics (e.g. braces, artificial limbs) | $0 copay(authorization required) |
| Medical supplies | $0 copay(authorization required) |
| Diabetes supplies | $0 copay(authorization required) |
| Diabetic therapeutic shoes or inserts | $0 copay(authorization required) |
| Chiropractic, acupuncture and foot care | |
| Chiropractic (Medicare-covered) | $0 copay(authorization and referral required) |
| Routine chiropractic care | Not covered |
| Acupuncture | Not covered |
| Foot exams and treatment (Medicare-covered) | $0 copay(referral required) |
| Routine foot care | Not covered |
| Dental? | |
| Medicare-covered dental services | $0 copay(authorization required) |
| Preventive dental plan limit | $2,500 plan limit every year |
| Oral exams | $0 copay |
| Cleanings | $0 copay |
| Fluoride treatment | $0 copay |
| Dental x-rays | $0 copay |
| Other diagnostic dental services | $0 copay |
| Other preventive dental services | $0 copay |
| Restorative services (fillings, crowns) | $0 copay |
| Endodontics (root canals) | $0 copay |
| Periodontics (gum disease) | $0 copay |
| Dentures and other removable prosthodontics | $0 copay |
| Maxillofacial prosthetics | $0 copay |
| Implants | $0 copay |
| Bridges and other fixed prosthodontics | $0 copay |
| Oral and maxillofacial surgery | $0 copay |
| Orthodontics | $0 copay |
| Adjunctive general services | $0 copay |
| Vision? | |
| Eye exam (Medicare-covered) | $0 copay |
| Routine eye exam | $0 copay(limits apply) |
| Eyewear after cataract surgery (Medicare-covered) | $0 copay(limits apply) |
| Eyewear plan limit | $325 plan limit every year |
| Contact lenses | $0 copay(limits apply) |
| Eyeglasses (frames and lenses) | $0 copay(limits apply) |
| Eyeglass lenses | $0 copay(limits apply) |
| Eyeglass frames | $0 copay(limits apply) |
| Eyewear upgrades | $0 copay(limits apply) |
| Hearing? | |
| Hearing exam (Medicare-covered) | $0 copay(referral required) |
| Routine hearing exam | $0 copay(referral required, limits apply) |
| Hearing aid fitting and evaluation | $0 copay(referral required, limits apply) |
| Hearing aids (all types) | $399–$1,800 copay(limits apply) |
| Hearing aids, inner ear | Not covered |
| Hearing aids, outer ear | Not covered |
| Hearing aids, over the ear | Not covered |
| Medicare Part B drugs | |
| Part B insulin | 0%–20% coinsurance(authorization required, step therapy may apply) |
| Chemotherapy and radiation drugs | 0%–20% coinsurance(authorization required, step therapy may apply) |
| Other Part B drugs | 0%–20% coinsurance(authorization required, step therapy may apply) |
| Other extra benefits? | |
| Over-the-counter (OTC) allowance | $125 allowance every three months |
| Meals after a hospital stay or for a chronic condition | $0 copay |
| Fitness benefit | $0 copay |
| Health education | Not covered |
| Nutritional / dietary benefit | Not covered |
| Extra smoking and tobacco cessation counseling | Not covered |
| Enhanced disease management | Not covered |
| Telemonitoring | Not covered |
| Remote access technologies (web/phone, nurse line) | Not covered |
| Home and bathroom safety devices | Not covered |
| Counseling services | Not covered |
| In-home safety assessment | Not covered |
| Personal emergency response system (PERS) | Not covered |
| Medical nutrition therapy | Not covered |
| Post-discharge in-home medication reconciliation | Not covered |
| Re-admission prevention | Not covered |
| Wigs for hair loss from chemotherapy | Not covered |
| Weight management programs | Not covered |
| Alternative therapies | Not covered |
| Therapeutic massage | Not covered |
| Adult day health services | Not covered |
| Home-based palliative care | Not covered |
| In-home support services | Not covered |
| Support for caregivers | Not covered |
In-network cost-sharing as the plan filed it with CMS (CMS plan benefit package (PBP) files, CY2026). A range means the cost depends on the service or setting. Rows the filing does not state are left out rather than guessed. Contact the plan for the full Evidence of Coverage.
Drug tiers — preferred pharmacy, initial coverage
| Tier | Cost-sharing |
|---|---|
| Tier 1 | $0.00 |
| Tier 2 | $20.00 |
| Tier 3 | 23% |
| Tier 4 | 24% |
| Tier 5 | 25% |
Rx cost-sharing by coverage phase
| Tier | 30-day supply | 90-day supply | ||||
|---|---|---|---|---|---|---|
| Preferred | Standard | Mail Order | Preferred | Standard | Mail Order | |
| Initial deductible phase | ||||||
| Tier 1: Preferred Generic | $0.00 | $19.00 | $0.00 | $0.00 | $57.00 | $0.00 |
| Initial coverage phase | ||||||
| Tier 1: Preferred Generic | $0.00 | $19.00 | $0.00 | $0.00 | $57.00 | $0.00 |
| Tier 2: Generic | $20.00 | $20.00 | $20.00 | $60.00 | $60.00 | $0.00 |
| Tier 3: Preferred Brand | 23% | 23% | 23% | 23% | 23% | 23% |
| Tier 4: Non-Preferred Drug | 24% | 25% | 24% | 24% | 25% | 24% |
| Tier 5: Specialty Tier | 25% | 25% | 25% | n/a | n/a | n/a |
| Catastrophic coverage phase | ||||||
| Tier 1: Preferred Generic | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 |
| Tier 2: Generic | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 |
| Tier 3: Preferred Brand | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 |
| Tier 4: Non-Preferred Drug | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 |
| Tier 5: Specialty Tier | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 |
Also available in 4 other FL counties
Benefits in plain text
HealthSpring TotalCare Plus (HMO D-SNP) (H5410-031-0) is a 2026 HMO D-SNP Medicare Advantage plan offered by Cigna HealthCare, available to residents of Flagler County, FL.
The monthly premium is $4.80 (Part C and Part D together).
With full Extra Help (the Low-Income Subsidy), the total monthly premium is $0.00.
There is no in-network deductible for health services.
Its in-network out-of-pocket maximum is $1,500.00.
The drug deductible is $615.00. Tier 1 exempt.
It is a special needs plan (Dual-eligible SNP).
The plan's formulary lists 3,659 drugs.
At a preferred pharmacy in the initial coverage phase, a 30-day supply costs tier 1: $0.00; tier 2: $20.00; tier 3: 23%; tier 4: 24%; tier 5: 25%.
CMS gives the plan's contract (H5410) an overall rating of 3.5 out of 5 stars.
Email a copy of the plan benefit details
Plan facts come from the CMS quarterly prescription drug plan public use files; the premium split, Extra Help premium, MOOP and plan type from the CMS Landscape file; the Part B giveback and health benefits from the CMS plan benefit package (PBP) files.