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 West Metro Atlanta. 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 $350.00 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 $10100.00 (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 $10100.00 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. During the initial coverage phase, you'll pay a copay for your prescriptions depending on the drug tier and pharmacy you use. For preferred generic drugs, you'll pay an $8 copay at preferred pharmacies and a $20 copay at standard pharmacies. Once 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, including inpatient and outpatient hospital services, with varying copays. Emergency, primary care, preventive, hearing, vision, dental, and home health services are covered, and many services have no copay. The plan also includes coverage for ambulance, partial hospitalization, home infusion, dialysis, medical equipment, and diagnostic services, often with copays or coinsurance.
Inpatient Hospital See details
Inpatient Hospital benefits are covered, with a $300 copay for days 1-6, and no copay for days 7-90 for Inpatient Hospital-Acute. Inpatient Hospital Psychiatric has a $595 copay for days 1-3, and no copay for days 4-90. Additional days and non-Medicare-covered stays for Inpatient Hospital Psychiatric and Inpatient Hospital-Acute are not covered.
Outpatient Services See details
Outpatient Services include coverage for outpatient hospital services with a copay between $0 and $375, observation services with a $300 copay, and ambulatory surgical center services with no copay. Outpatient substance abuse services are covered with a $40 copay for both individual and group sessions, and outpatient blood services are also covered.
Partial Hospitalization See details
Partial Hospitalization is covered by the Cigna True Choice Medicare (PPO) plan, but requires prior authorization. You will have a $105 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 $260 copay, while air ambulance services have a 20% coinsurance, and transportation services to any health-related location are not covered.
Emergency Services See details
Emergency Services, Urgently Needed Services, Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation are covered under the Cigna True Choice Medicare (PPO) plan. Emergency Services and Worldwide Emergency Coverage have a $125 copay, Urgently Needed Services has a $55 copay, and Worldwide Emergency Transportation and Worldwide Urgent Coverage also have a $125 copay.
Primary Care See details
Primary Care Physician Services, Chiropractic Services, Occupational Therapy Services, Physician Specialist Services, Mental Health Specialty Services, Other Health Care Professional, Psychiatric Services, Physical Therapy and Speech-Language Pathology Services, Additional Telehealth Benefits, and Opioid Treatment Program Services are covered. Chiropractic services have a $15 copay, while Occupational Therapy Services have a $40 copay. Physician Specialist Services and Physical Therapy and Speech-Language Pathology Services have a $40 copay. Other Health Care Professional services have a copay between $0 and $40, and Additional Telehealth Benefits have a copay between $0 and $40. Mental Health Specialty Services and Psychiatric Services do not cover individual or group sessions, and Podiatry Services are not covered.
Preventive Services See details
Preventive services include coverage for Medicare-covered services, annual physical exams, health education, kidney disease education services, and other preventive services like glaucoma screenings, with no copay or coinsurance. However, in-home safety assessments, personal emergency response systems, medical nutrition therapy, and several other services are not covered.
Hearing Services See details
Hearing services are covered, including hearing exams with a $30 copay. Routine hearing exams and fitting/evaluation for hearing aids are covered once per year. Prescription hearing aids are partially covered, with a copay between $399 and $1800, but inner ear, outer ear, and over the ear hearing aids are not covered. OTC hearing aids are not covered.
Vision Services See details
The Cigna True Choice Medicare (PPO) plan covers vision services, including eye exams with a copay of $0-$40. Eyewear is covered, with a combined maximum benefit of $250 every year for both in-network and out-of-network services. Contact lenses and upgrades are also covered.
Dental Services See details
Cigna True Choice Medicare (PPO) covers dental services, including oral exams with a $40 copay, dental x-rays, other diagnostic dental services, prophylaxis (cleaning), fluoride treatment, other preventive dental services, restorative services, adjunctive general services, endodontics, periodontics, prosthodontics (removable and fixed), maxillofacial prosthetics, implant services, oral and maxillofacial surgery, and orthodontics, all with no copay. A $40 copay applies to Medicare dental services. There is a $1250 maximum plan benefit coverage amount per year for both in-network and out-of-network services.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, requiring prior authorization. For Medicare Part B Insulin Drugs, there is a $35 copay and a coinsurance between 0% and 20%. For Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs, the coinsurance ranges from 0% to 20%.
Dialysis Services See details
Dialysis Services are covered by the Cigna True Choice Medicare (PPO) plan, but require prior authorization. There is a 20% coinsurance for these services.
Medical Equipment See details
The Cigna True Choice Medicare (PPO) plan covers medical equipment, including durable medical equipment with 20% coinsurance and no copay, and prosthetic devices with 20% coinsurance and no copay. The plan does not cover durable medical equipment for use outside the home and diabetic supplies, but does cover diabetic therapeutic shoes/inserts with 20% coinsurance and no copay.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered. Diagnostic Procedures/Tests have a copay between $0 and $95, while Lab Services have no copay. Diagnostic Radiological Services have a copay up to $250, Therapeutic Radiological Services have a copay of $80, and Outpatient X-Ray Services have no 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 authorization is required. Additional hours of care and personal care services are not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered, but the plan does not cover the following sub-services: Cardiac Rehabilitation Services, Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, and SET for PAD 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.
Other Services See details
The Cigna True Choice Medicare (PPO) plan's "Other Services" benefit covers Over-the-Counter (OTC) Items with a maximum benefit coverage amount of $15 every three months, including Nicotine Replacement Therapy (NRT) and Naloxone. Acupuncture, Dual Eligible SNPs with Highly Integrated Services, 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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