Cigna HealthCare (now Health Spring) structures its 2026 Medicare Advantage coverage around three network models with different provider access rules. Federal mandates require behavioral health cost-sharing parity with Original Medicare, insulin price caps without deductibles and automatic Medicare Prescription Payment Plan renewals.
- HMO: Network restrictions define HMO coverage. HMO plans require members to select a primary care doctor who manages all healthcare services and issues referrals. Plans cover no out-of-network care except emergencies. This structure works through centralized coordination where one physician directs all specialist visits.
- HMO-POS: HMO-POS plans combine features from both HMO and PPO structures. Plans require primary care coordination for network specialists who need referrals. Members can see out-of-network providers for certain services though costs increase. HMO-POS plans provide greater flexibility compared to standard HMO coverage while keeping care coordination.
- PPO: Provider freedom distinguishes PPO plans from other structures. No primary care physician selection or referral requirements exist. Members can visit any Medicare-accepting provider, with in-network care costing less than out-of-network visits. Members control provider choices without coordination mandates.




