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 Kansas City. 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 $150.00 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 $8000.00 (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 $8000.00 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 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. Once your total drug costs reach $2,000, you enter the catastrophic coverage phase, where you pay nothing for covered Part D drugs. If you qualify for the low-income subsidy, your Part D costs are $0.
Additional Benefits
The Cigna True Choice Medicare (PPO) plan offers comprehensive coverage, including inpatient and outpatient services, with varying copays. Emergency, primary care, preventive, hearing, vision, and dental services are also covered, with specific copays or coinsurance amounts depending on the service. Additionally, this plan includes coverage for home health services and dialysis services. This plan also offers coverage for ambulance services, diagnostic and radiological services, and skilled nursing facility services with specific cost-sharing requirements. However, certain services like cardiac rehabilitation and some "other services" are not covered.
Inpatient Hospital See details
Inpatient Hospital coverage includes both Inpatient Hospital-Acute and Inpatient Hospital Psychiatric services, both requiring prior authorization. For Inpatient Hospital-Acute, you pay a $365 copay for days 1-6, and no copay for days 7-90; additional days are covered. Inpatient Hospital Psychiatric has the same cost sharing as Inpatient Hospital-Acute. Non-Medicare-covered stays and upgrades are not covered.
Outpatient Services See details
Outpatient Services include all outpatient hospital services, with copays ranging from $0 to $395, and observation services with a $395 copay. Ambulatory Surgical Center (ASC) Services have no copay, and Outpatient Substance Abuse services, including individual and group sessions, have a copay of $35. Outpatient Blood Services are also covered, including services not usually covered by Medicare plans.
Partial Hospitalization See details
Cigna True Choice Medicare (PPO) covers partial hospitalization with a $70 copay. Prior authorization is required for coverage.
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 $275 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, including Urgently Needed Services, are covered by Cigna True Choice Medicare (PPO), with a $125 copay for Emergency Services and a $55 copay for Urgently Needed Services, and no coinsurance. Worldwide Emergency Services are also covered, with a $125 copay for Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation, and 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 $15 copay, occupational therapy services with a $35 copay, specialist services with a $35 copay, physical therapy and speech-language pathology services with a $35 copay, and other health care professional services with a copay between $0 and $35. This plan does not cover routine chiropractic care, individual or group sessions for mental health specialty services, podiatry services, or individual or group sessions for psychiatric services.
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. Fitness benefits are also covered, including physical and memory fitness, but 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 $25 copay. Prescription hearing aids are covered with a copay between $399 and $1800, while inner ear, outer ear, and over-the-ear prescription hearing aids are not covered.
Vision Services See details
Vision services include eye exams with a copay between $0 and $35. Eyewear has a combined maximum benefit of $350 per year for both in-network and out-of-network services. Contact lenses, eyeglasses (lenses and frames), eyeglass lenses, eyeglass frames, and upgrades are also covered.
Dental Services See details
Dental Services, offered by Cigna True Choice Medicare (PPO), includes coverage for Medicare Dental Services with a $35 copay, as well as other dental services with a $1,150 maximum benefit per year. 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 and fixed), maxillofacial prosthetics, implant services, oral and maxillofacial surgery, and orthodontics are all covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered by the Cigna True Choice Medicare (PPO) plan, with prior authorization required. Medicare Part B Insulin Drugs have a $35 copay and coinsurance between 0% and 20%. Other Medicare Part B drugs have coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered under the Cigna True Choice Medicare (PPO) plan. You will pay 20% coinsurance.
Medical Equipment See details
Medical equipment benefits are covered by the Cigna True Choice Medicare (PPO) plan, with a 20% coinsurance for Durable Medical Equipment (DME), Prosthetic Devices, and Medical Supplies, and no copay. 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 by the Cigna True Choice Medicare (PPO) plan. Diagnostic Procedures/Tests have a copay between $0 and $200, while Lab Services have no copay. Diagnostic Radiological Services have a copay between $0 and $200, and Therapeutic Radiological Services have a 20% coinsurance. Outpatient X-Ray Services have a $15 copay.
Home Health Services See details
Home Health Services are covered by Cigna True Choice Medicare (PPO), 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. Prior authorization is required for this benefit.
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, the copay is $10, and for days 21-100, the copay is $214. Additional days beyond Medicare-covered and non-Medicare-covered stays for SNF are not covered.
Other Services See details
Other Services under the Cigna True Choice Medicare (PPO) plan are partially covered, with acupuncture, over-the-counter items, 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 not covered. The plan does cover a Meal Benefit for a chronic illness or medical condition that requires the enrollee to remain at home for a period of time.
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