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 Northeast Ohio. 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 $50.00 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 $13300.00 (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 $13300.00 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 will pay a copay for each prescription, which varies depending on the drug tier and the pharmacy you use. For example, preferred generic drugs have a $4 copay at preferred pharmacies, while standard generic drugs have a $45 copay. After your total drug costs reach $2000, 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 varying costs. Inpatient hospital stays have a $350 copay for the first 5 days, with no copay thereafter. Outpatient services have copays ranging from $0 to $350. The plan includes coverage for primary care with copays, as well as hearing and vision services. Dental services are covered with a $40 copay for Medicare dental services, and a $1500 annual maximum benefit for other services. Emergency services, home health, and preventive services are also covered.
Inpatient Hospital See details
Inpatient Hospital benefits, including Acute and Psychiatric, are covered under the Cigna True Choice Medicare (PPO) plan. For days 1-5, there is a $350 copay, and for days 6-90, there is no copay; there is no coinsurance.
Outpatient Services See details
Outpatient Services, including all outpatient hospital services, are covered by the Cigna True Choice Medicare (PPO) plan. Outpatient Hospital Services have a copay between $0 and $350, and Observation Services have a $350 copay. Ambulatory Surgical Center (ASC) Services have no copay, and Outpatient Substance Abuse Services have a $40 copay for both individual and group sessions. Outpatient Blood Services are also covered.
Partial Hospitalization See details
Partial Hospitalization is covered under the Cigna True Choice Medicare (PPO) plan, but requires prior authorization. You will have an $80 copay for this service.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by the Cigna True Choice Medicare (PPO) plan. Ground Ambulance Services have a $230 copay, while Air Ambulance Services have a 20% coinsurance; however, Transportation Services to any health-related location are not covered.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered under the Cigna True Choice Medicare (PPO) plan. Emergency Services and Worldwide Emergency Coverage have a $110 copay, while Urgently Needed Services have a $45 copay; all services have no coinsurance.
Primary Care See details
The Cigna True Choice Medicare (PPO) plan covers Primary Care Physician Services, Chiropractic Services (with a $15 copay), Occupational Therapy Services (with a $35 copay), Physician Specialist Services (with a $40 copay), Other Health Care Professional (with a $0-$40 copay), Physical Therapy and Speech-Language Pathology Services (with a $35 copay), Additional Telehealth Benefits (with a $0-$40 copay), and Opioid Treatment Program Services (with a $40 copay). However, 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 zero dollar services, annual physical exams, health education, kidney disease education services, and other preventive services such as glaucoma screenings, diabetes self-management training, barium enemas, digital rectal exams, and EKGs following a Welcome Visit. The plan does not cover in-home safety assessments, personal emergency response systems, medical nutrition therapy, post-discharge in-home medication reconciliation, re-admission prevention, wigs for hair loss related to chemotherapy, weight management programs, alternative therapies, therapeutic massage, adult day health services, nutritional/dietary benefits, home-based palliative care, in-home support services, support for caregivers of enrollees, additional sessions of smoking and tobacco cessation counseling, enhanced disease management, telemonitoring services, remote access technologies, home and bathroom safety devices and modifications, and counseling services.
Hearing Services See details
Hearing Services are covered by the Cigna True Choice Medicare (PPO) plan, including routine hearing exams with a $25 copay. Prescription hearing aids are covered with a copay between $399 and $1800, while the plan does not cover OTC hearing aids, and some prescription hearing aid sub-services are not covered.
Vision Services See details
The Cigna True Choice Medicare (PPO) plan covers vision services including routine eye exams with a copay of $0-$30. Eyewear benefits are covered up to a combined maximum of $300 per year for both in-network and out-of-network services, and include contact lenses, eyeglasses (lenses and frames), eyeglass lenses, and eyeglass frames. Upgrades are also covered.
Dental Services See details
Dental Services are covered, with a $40 copay for Medicare Dental Services. Other services include Oral Exams, Dental X-Rays, Other Diagnostic Dental Services, Prophylaxis (Cleaning), Fluoride Treatment, Other Preventive Dental Services, Restorative Services, Adjunctive General Services, Endodontics, Periodontics, Prosthodontics (removable), Maxillofacial Prosthetics, Implant Services, Prosthodontics (fixed), Oral and Maxillofacial Surgery, and Orthodontics, all of which have no copay or coinsurance, and a maximum plan benefit of $1500 per year.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered by the Cigna True Choice Medicare (PPO) plan and require prior authorization. This includes benefits for Medicare Part B Insulin Drugs with a $35 copay and coinsurance between 0-20%, Medicare Part B Chemotherapy/Radiation Drugs with coinsurance between 0-20%, and Other Medicare Part B Drugs with coinsurance between 0-20%.
Dialysis Services See details
Dialysis Services are covered by the Cigna True Choice Medicare (PPO) plan. You will pay 20% coinsurance for these services.
Medical Equipment See details
Medical equipment benefits are covered, with a 20% coinsurance for Durable Medical Equipment (DME), Prosthetic Devices, and Medical Supplies, and no copay. Diabetic Therapeutic Shoes/Inserts are covered with a 20% coinsurance, while Durable Medical Equipment for use outside the home and Diabetic Supplies are not covered.
Diagnostic and Radiological Services See details
The Cigna True Choice Medicare (PPO) plan covers diagnostic and radiological services, including diagnostic procedures and tests with a copay between $0 and $50, and lab services with no copay. Diagnostic radiological services have a maximum copay of $150, therapeutic radiological services have a $60 copay, and outpatient X-rays have a $60 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. Additional Hours of Care and Personal Care Services are not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered by the Cigna True Choice Medicare (PPO) plan. This includes Medicare-covered Intensive Cardiac Rehabilitation Services, Medicare-covered Pulmonary Rehabilitation Services, Medicare-covered Supervised Exercise Therapy (SET) for Symptomatic Peripheral Artery Disease (PAD) Services, and Additional Cardiac Rehabilitation Services.
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.
Other Services See details
The Cigna True Choice Medicare (PPO) plan covers acupuncture with no copay, up to $300 per year, and offers Over-the-Counter (OTC) items with a maximum benefit of $55 every three months, including nicotine replacement therapy and Naloxone. The plan also covers a meal benefit for chronic or medical conditions requiring the enrollee to remain at home, but does not cover Dual Eligible SNPs with Highly Integrated Services, Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services, Private Duty Nursing Services, and other services.
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