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 Connecticut. 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 $250.00 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 $9550.00 (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 $9550.00 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 your prescriptions. The copay 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. Once your total drug costs reach $2,000, you enter the catastrophic coverage phase where you pay nothing for Part D covered drugs.
Additional Benefits
The Cigna True Choice Medicare (PPO) plan offers a range of benefits with varying cost-sharing. Inpatient hospital stays have a copay, while outpatient services have copays depending on the service. Emergency and primary care services are covered, with copays applying to many services. The plan also provides coverage for preventive, hearing, vision, and dental services. Additional benefits include home health, skilled nursing, and medical equipment coverage. However, some services like acupuncture, private duty nursing, and certain types of therapy are not covered by this plan.
Inpatient Hospital See details
Inpatient Hospital services, including Acute and Psychiatric, are covered. For Inpatient Hospital-Acute, you will pay a $340 copay for days 1-6, and no copay for days 7-90. For Inpatient Hospital Psychiatric, you will pay a $340 copay for days 1-5, and no copay for days 6-90.
Outpatient Services See details
Outpatient Services include coverage for Outpatient Hospital Services with a copay between $0 and $340, Observation Services with a $340 copay, Ambulatory Surgical Center (ASC) Services with no copay, Individual and Group Sessions for Outpatient Substance Abuse with a $35 copay, and Outpatient Blood Services.
Partial Hospitalization See details
Partial Hospitalization is covered under the Cigna True Choice Medicare (PPO) plan. This benefit requires prior authorization and has a copay of $80.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by Cigna True Choice Medicare (PPO). Ground ambulance services have a $265 copay, and air ambulance services have a 20% coinsurance; however, transportation services to any health-related location are not covered.
Emergency Services See details
Emergency Services under the Cigna True Choice Medicare (PPO) plan include a $125 copay, while urgently needed services have a $55 copay; both have no coinsurance. Worldwide emergency services, including Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation, each have a $125 copay and no coinsurance, with a maximum plan benefit 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, physician specialist services with a $35 copay, physical therapy and speech-language pathology services with a $35 copay, other health care professional services with a copay between $0 and $35, and opioid treatment program services with a $35 copay. The plan also covers additional telehealth benefits with a copay between $0 and $35. 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 a variety of preventive services, including Medicare-covered services, annual physical exams, health education, kidney disease education, glaucoma screening, diabetes self-management training, barium enemas, digital rectal exams, and EKGs following a welcome visit. The plan also covers support for caregivers of enrollees and fitness benefits, but 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, additional sessions of smoking and tobacco cessation counseling, enhanced disease management, telemonitoring services, remote access technologies, home and bathroom safety devices and modifications, or counseling services.
Hearing Services See details
Hearing services include coverage for hearing exams with a $25 copay. Prescription hearing aids (all types) are covered with a copay between $399 and $1800, but prescription hearing aids for the inner ear, outer ear, and over the ear are not covered. Fitting/evaluation for hearing aids and routine hearing exams are covered.
Vision Services See details
Vision services include eye exams with a copay of $0-$35, and eyewear benefits, including contact lenses, eyeglasses (lenses and frames), eyeglass lenses, and eyeglass frames, with a combined maximum plan benefit coverage of $200 per year. Routine eye exams are covered once per year.
Dental Services See details
Dental services are covered, including Medicare dental services with a $35 copay. The plan has a maximum benefit of $2500 per year for both in-network and out-of-network services. Various other dental services, such as oral exams, dental x-rays, and orthodontics are 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. Insulin has a $35 copay and a coinsurance between 0% and 20%, while Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs have a coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered by the Cigna True Choice Medicare (PPO) plan, but require prior authorization. You will pay 20% coinsurance for these services.
Medical Equipment See details
Medical equipment is covered under the Cigna True Choice Medicare (PPO) plan, including Durable Medical Equipment with 20% coinsurance and Prosthetic Devices with a 20% coinsurance. Durable Medical Equipment for use outside the home and Diabetic Supplies are not covered, and Diabetic Therapeutic Shoes/Inserts have a 20% coinsurance.
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 $40, while Lab Services have no copay. Diagnostic Radiological Services have a copay of up to $150, Therapeutic Radiological Services have a $60 copay, 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, though authorization is required. Additional Hours of Care and Personal Care Services are not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered with prior authorization, but specific services like Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, and SET for PAD Services are not covered. There is a copay for some services, but the exact amount is not specified in the provided information.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the Cigna True Choice Medicare (PPO) plan, with prior authorization required. For days 1-20, there is no copay, and for days 21-100, the copay is $214 per day; additional days beyond Medicare-covered for SNF and non-Medicare-covered stays are not covered.
Other Services See details
The Cigna True Choice Medicare (PPO) plan does not cover 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, or Self-Directed Personal Assistance Services. Over-the-counter items are covered with a maximum benefit of $65 every three months. A meal benefit is also covered for chronic illnesses or medical conditions that require the enrollee to remain at home.
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