A non-government entity
Cigna True Choice Medicare (PPO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Cigna True Choice Medicare (PPO). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Cigna True Choice Medicare (PPO) in 2025, please refer to our full plan details page.
Cigna True Choice Medicare (PPO) is a PPO plan offered by The Cigna Group available for enrollment in 2025 to people living in Denver. This plan received an overall rating of 3 out of 5 stars in 2025.
It's important to know that Cigna True Choice Medicare (PPO) is a Medicare Advantage (MA) Plan with drug coverage. That means that this plan covers both medical services and prescription drugs.
Key Plan Facts
Below are a few key facts and commonly-asked questions about Cigna True Choice Medicare (PPO).
Plan Costs:
The cost of a Medicare Advantage Plan is made up of four main parts.
- First, the monthly premium — the amount you pay every month.
- Second, the deductible — the amount you pay out of pocket for covered services before the plan starts paying.
- Third, the copayments and coinsurance — the amounts you pay out of pocket for covered services, usually after meeting the deductible (if applicable). Copays are fixed dollar amounts; coinsurance is a percentage of the cost.
- Fourth, the Out-of-Pocket Maximum — the maximum amount you could have to pay out of pocket in a year. This may be different for in-network and out-of-network services.
For Cigna True Choice Medicare (PPO), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $0.00. This is the amount you must pay every month.
This plan does not come with a Part B Premium reduction. You must continue to pay your Part B premium.
Deductibles
This plan has a $400.00 health deductible. This means, every calendar year, you pay this amount towards covered services before your insurance coverage kicks in.
This plan has no drug deductible. Your prescription medication coverage will start immediately.
Out-of-Pocket Maximums
This plan has a combined Maximum Out-Of-Pocket cost of $8950.00 (in-network or out-of-network combined). You will pay copays, coinsurance, and deductibles toward this amount. Once your total out-of-pocket costs reach $8950.00 for covered services, the plan will pay 100% of covered costs for the rest of the year.
The plan may have separate out-pocket-maximums for in-network and out-of-network services. See our full plan details page for more information.
You can see below for the coinsurance and specific copayments for in the Additional Benefits section below, or refer to our Plan Details page for more details.
Common Services:
Doctor Visits:
Specialist Visits:
Emergency Room:
Urgent Care:
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Drug Coverage
The Cigna True Choice Medicare (PPO) plan has a $0 deductible for prescription drugs. In the initial coverage phase, you'll pay a copay depending on the drug tier and the pharmacy you use. For example, preferred generic drugs have a $4 copay at preferred pharmacies. Once your total drug costs reach $2,000, you enter the catastrophic coverage phase where you pay nothing for covered drugs.
Additional Benefits
The Cigna True Choice Medicare (PPO) plan offers comprehensive coverage with a variety of benefits. Inpatient hospital stays have a copay of $285 for days 1-5, and no copay for days 6-90. Outpatient services and emergency services have varying copays, and the plan covers primary care, preventive services, hearing, vision, and dental services with copays ranging from $0 to $30. The plan includes coverage for ambulance services, with a $150 copay for ground and 20% coinsurance for air, and covers home health services with no copay. Additional benefits include coverage for medical equipment, diagnostic and radiological services, and other services such as acupuncture and over-the-counter items. However, certain services like routine chiropractic care, personal care services, and additional hours of care are not covered.
Inpatient Hospital See details
Inpatient Hospital benefits, including acute and psychiatric, are covered with prior authorization. For days 1-5, there is a $285 copay, and for days 6-90, there is no copay.
Outpatient Services See details
Outpatient Services include coverage for Outpatient Hospital Services with a copay between $0 and $285, Observation Services with a $285 copay, Ambulatory Surgical Center (ASC) Services with no copay, and Outpatient Substance Abuse Services with a $30 copay for both individual and group sessions. The plan also covers Outpatient Blood Services.
Partial Hospitalization See details
Partial Hospitalization is covered by Cigna True Choice Medicare (PPO), with a $105 copay. Prior authorization is required for this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by the Cigna True Choice Medicare (PPO) plan, with prior authorization required for all ambulance services. Ground ambulance services have a $150 copay, while air ambulance services have a 20% coinsurance. Transportation services to health-related locations are not covered.
Emergency Services See details
Emergency Services, including Worldwide Emergency Services, have a copay of $125, and Urgently Needed Services have a $30 copay, with no coinsurance for any of these services. Worldwide Emergency Services has a maximum plan benefit coverage of $50,000.
Primary Care See details
The Cigna True Choice Medicare (PPO) plan covers primary care physician services, chiropractic services with a $20 copay, occupational therapy with a $30 copay, physician specialist services with a $30 copay, and physical therapy/speech-language pathology services with a $30 copay. This plan also covers other health care professional services with a copay between $0 and $30, and opioid treatment program services with a $30 copay, and offers additional telehealth benefits with a copay between $0 and $30. Routine chiropractic care, individual and group sessions for mental health specialty services, individual and group sessions for psychiatric services, and podiatry services are not covered.
Preventive Services See details
The Cigna True Choice Medicare (PPO) plan covers preventive services, including Medicare-covered services with no copay, annual physical exams, health education, support for caregivers, and fitness benefits. Additional preventive services, such as in-home safety assessments, personal emergency response systems, medical nutrition therapy, and others, are not covered.
Hearing Services See details
Hearing Services are covered by the Cigna True Choice Medicare (PPO) plan, including Routine Hearing Exams with a $30 copay, and Fitting/Evaluation for Hearing Aids with no copay. Prescription Hearing Aids (all types) are covered with a copay between $399 and $1800, but Prescription Hearing Aids - Inner Ear, Outer Ear, and Over the Ear are not covered, and neither are OTC Hearing Aids.
Vision Services See details
Vision Services are covered under the Cigna True Choice Medicare (PPO) plan, including routine eye exams with a copay between $0 and $30, once per year. Eyewear is also covered, but contact lenses, eyeglasses (lenses and frames), eyeglass lenses, eyeglass frames, and upgrades are not covered.
Dental Services See details
The Cigna True Choice Medicare (PPO) plan covers dental services, including oral exams, dental x-rays, and other diagnostic and preventive services, with a $30 copay for Medicare dental services, and a maximum plan benefit of $1600 per year. Orthodontic services are covered under Diagnostic and Preventive Dental (16b).
Home Infusion bundled Services See details
Home Infusion bundled Services are covered and require prior authorization. For Medicare Part B Insulin Drugs, there is a $35 copay and a coinsurance between 0% and 20%. Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs are covered with a coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered under the Cigna True Choice Medicare (PPO) plan and require prior authorization. You are responsible for a 20% coinsurance.
Medical Equipment See details
Medical Equipment is covered by Cigna True Choice Medicare (PPO). Durable Medical Equipment (DME) has a 15% coinsurance, and Prosthetic Devices and Medical Supplies have a 15% coinsurance, but Durable Medical Equipment for use outside the home and Diabetic Supplies are not covered.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered under the Cigna True Choice Medicare (PPO) plan. Diagnostic Procedures/Tests have a copay between $0 and $25, and Lab Services have no copay; Diagnostic Radiological Services have a copay of at most $200, Therapeutic Radiological Services have a coinsurance of at least 20%, and Outpatient X-Ray Services have a $15 copay.
Home Health Services See details
Home Health Services are covered by the Cigna True Choice Medicare (PPO) plan with no copay and no coinsurance, but additional hours of care and personal care services are not covered. Prior authorization is required for this benefit.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered, but not in practice. The plan does not cover Medicare-covered Intensive Cardiac Rehabilitation Services, Medicare-covered Pulmonary Rehabilitation Services, Medicare-covered Supervised Exercise Therapy (SET) for Symptomatic Peripheral Artery Disease (PAD) Services, or Additional Cardiac Rehabilitation Services. Prior authorization is required.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the Cigna True Choice Medicare (PPO) plan, but require prior authorization. For days 1-20, there is no copay, and for days 21-100, the copay is $214 per day; additional days beyond Medicare coverage and non-Medicare-covered stays are not covered.
Other Services See details
Other Services include acupuncture, over-the-counter (OTC) items, and a meal benefit. Acupuncture is covered with a maximum plan benefit coverage amount of $300.00 every year. OTC items are covered up to $40.00 every three months. The plan also provides a meal benefit for chronic illness or a medical condition that requires the enrollee to remain at home for a period of time. However, Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services, Private Duty Nursing Services, Case Management (Long Term Care), Institution for Mental Disease Services for Individuals 65 or Older, Services in an Intermediate Care Facility for Individuals with Intellectual Disabilities, Case Management, Tobacco Cessation Counseling for Pregnant Women, Freestanding Birth Center Services, Respiratory Care Services, Family Planning Services, Nursing Home Services, Home and Community Based Services, Personal Care Services, and Self-Directed Personal Assistance Services are not covered.
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