HealthSpring (formerly Cigna) vs. Anthem: 2026 Comparison

MoneyGeek compared HealthSpring and Anthem across three product lines using 2026 CMS data. Medicare Advantage pricing, star ratings and availability data comes from the 2026 CMS landscape file and CMS Quality Rating System scores for plan year 2026.

Medigap pricing reflects 2026 average monthly premiums for a non-tobacco user at ages 65 and 75. ACA data draws from the 2026 CMS Quality Rating System scores and marketplace landscape files. We analyzed plan availability, average premiums, out-of-pocket maximums, quality ratings and member experience scores across all states where each carrier operates.

Medicare Advantage is a private plan alternative to Original Medicare. Instead of paying separately for hospital coverage (Medicare Part A) and medical coverage (Medicare Part B), you enroll in one plan from a private insurer that bundles those benefits and usually adds drug coverage. Your eligibility depends on which plans operate in your specific county, not just your state.

• HealthSpring sells Medicare Advantage in 29 states. Anthem operates in 12, and nine of those 12 overlap with HealthSpring. California, Indiana and Wisconsin are the exceptions where Anthem operates without HealthSpring.
• HealthSpring states: Alabama, Arizona, Arkansas, Colorado, Connecticut, Delaware, Florida, Georgia, Illinois, Kansas, Kentucky, Maryland, Mississippi, Missouri, Nevada, New Jersey, New Mexico, New York, North Carolina, Ohio, Oklahoma, Oregon, Pennsylvania, South Carolina, Tennessee, Texas, Utah, Virginia, Washington.
• Anthem states: California, Colorado, Connecticut, Georgia, Indiana, Kentucky, Missouri, Nevada, New York, Ohio, Virginia, Wisconsin.

CMS star ratings are a federal quality score, from 1 to 5 stars. It measures how well each Medicare Advantage plan performs on clinical care, chronic condition management and member experience. Think of them as a government-issued report card for your health plan. Plans rated 4 stars or higher qualify for special enrollment periods. That means you can switch into them outside the standard October-to-December annual window, which most enrollees don't know.

HealthSpring covers over 680,000 Medicare Advantage members across its 29-state coverage area, per CMS enrollment data. Anthem's Medicare Advantage plans cover nearly 1.3 million members. A larger enrollment base gives a carrier more data to track health outcomes and more leverage to negotiate provider contract terms, which is one reason Anthem's larger member pool does not automatically translate to better star ratings: scale helps on administration but doesn't determine clinical care quality.

In February 2026, CMS issued a notice of intent to impose intermediate sanctions against Anthem's parent company Elevance. CMS found Elevance had submitted risk adjustment data corrections via USB drives rather than required electronic systems for seven years, from 2018 through 2025.

Elevance earned a reprieve in late May 2026 after completing initial compliance steps and submitting overpayment amounts to CMS. No enrollment ban went into effect, and the 1.3 million members already enrolled aren't affected. Buyers considering Anthem for 2027 should confirm the current compliance resolution status at cms.gov before the October 2026 annual enrollment period opens.

Your Medicare Advantage premium is what you pay per month on top of your Medicare Part B premium, which most enrollees pay separately. A $0-premium plan means no additional monthly cost beyond Part B. The out-of-pocket maximum (MOOP) is the most you'd pay in a calendar year before your plan covers all remaining covered costs. It caps annual costs in a high-expense year, such as a major surgery or serious illness.

Plan G is the most widely chosen Medigap option for new Medicare enrollees today. It covers nearly everything Original Medicare leaves unpaid, including hospital coinsurance, skilled nursing costs and the Part A deductible. The one gap Plan G does not fill is the Medicare Part B deductible, which is $283 in 2026. After you pay that once per year, Plan G covers the rest.

Plan F is the most comprehensive Medigap option because it also covers the Part B deductible. The trade-off: it is only available to enrollees who became Medicare-eligible before January 1, 2020. If you qualified after that date, Plan G is your most comprehensive alternative and the better comparison to start with.  

Plan N costs less per month than Plan G but adds copays of up to $20 for office visits and up to $50 for emergency room visits that don't result in hospital admission. Enrollees who rarely see doctors often pay less overall with Plan N even after those copays. Frequent users come out ahead with Plan G despite its higher base premium.

HealthSpring sells Plans A, B, C and D, which cover different combinations of Medicare gaps between basic hospital benefits and Plan G's near-comprehensive coverage. Anthem sells only Plans A, F, G and N. If you need Plan B, C or D, Anthem is not an option. HealthSpring also offers high-deductible Plans F and G, which carry lower monthly premiums but require you to pay a $2,870 deductible before coverage applies. Anthem offers no high-deductible options.

HealthSpring sells Medigap in 43 states. Maine is the one Anthem Medigap state where HealthSpring has no presence. The other 11 Anthem Medigap states fall within HealthSpring's coverage area. In 32 states, HealthSpring is the only option between these two carriers. Minnesota and Wisconsin use state-specific Medigap structures instead of standard lettered plans. Ohio is the only shared market where neither carrier offers Plan N.

Colorado, Georgia and Indiana are the only states where both carriers sell ACA plans. Everywhere else, where you live determines your options.

Plan types determine how you access care, not just what you pay:   

• HMO (Health Maintenance Organization) plans: Coverage stays in-network except emergencies. You select a primary care physician who coordinates your care and refers you to specialists.
• EPO (Exclusive Provider Organization) plans: No primary care physician requirement and no referrals needed for specialists. Coverage remains in-network only except emergencies.
• POS (Point of Service) plans: Primary care physician required with referral system, but out-of-network care available at increased cost.
• PPO (Preferred Provider Organization) plans: Maximum provider flexibility. Specialist visits require no referrals. Out-of-network care covered at reduced benefit levels.

Cigna sells HMO and EPO plans only on the ACA marketplace. If you need PPO or POS access, Cigna is not an option.