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 Southern Illinois. 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 $8600.00 (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 $8600.00 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 for your prescriptions, 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 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 a range of benefits with varying costs. Inpatient hospital stays have a copay, but many outpatient services, preventive services, and primary care visits have either no copay or a low copay. The plan also covers hearing, vision, and dental services, including eye exams, eyewear, and dental care. Additionally, the plan offers coverage for ambulance services, emergency services, and home health services, with copays or coinsurance depending on the specific service.
Inpatient Hospital See details
Inpatient Hospital benefits are covered, including acute and psychiatric care. For days 1-6, there is a $380 copay, and for days 7-90, there is no copay.
Outpatient Services See details
Outpatient Services include coverage for all outpatient hospital services with a copay between $0 and $350, and observation services with a $350 copay. Ambulatory Surgical Center (ASC) Services have no copay, while Outpatient Substance Abuse Services, Individual Sessions, and Group Sessions all have a $40 copay. Outpatient Blood Services are also covered, with a waived three-pint deductible.
Partial Hospitalization See details
Cigna True Choice Medicare (PPO) covers partial hospitalization with an $85 copay, and prior authorization is required.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by Cigna True Choice Medicare (PPO). Ground ambulance services have a $230 copay, while air ambulance services have a 20% coinsurance, and transportation services to health-related locations are not covered.
Emergency Services See details
Emergency Services, Urgently Needed Services, Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation are covered. Emergency Services and Worldwide Emergency Coverage have a $120 copay, while Urgently Needed Services has a $30 copay; all 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 $40 copay, and specialist services with a $40 copay. The plan also covers physical therapy and speech-language pathology services with a $40 copay, additional telehealth benefits with a $0-$40 copay, and opioid treatment program services with a $40 copay. Routine chiropractic care, individual and group sessions for mental health and 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 preventive services, annual physical exams, health education, kidney disease education, and other preventive services like glaucoma screenings and diabetes self-management training, with no copay. 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. Fitting/evaluation for hearing aids is covered. Prescription hearing aids are partially covered, with a copay between $399 and $1800 for all types of prescription hearing aids, but not for inner, outer, or over-the-ear hearing aids. OTC hearing aids 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-$40, and eyewear with a combined maximum benefit of $200 every year. Contact lenses, eyeglass lenses, and eyeglass frames are covered, with 1 pair covered per year.
Dental Services See details
Dental services are covered, with a $40 copay for Medicare Dental Services, and a maximum plan benefit of $1150 per year for other dental services. This plan covers 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.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, with prior authorization required. Medicare Part B Insulin Drugs have a $35 copay and a coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered by the Cigna True Choice Medicare (PPO) plan, but prior authorization is required. You will pay a 20% coinsurance for these services.
Medical Equipment See details
Medical Equipment benefits under the Cigna True Choice Medicare (PPO) plan include Durable Medical Equipment (DME) with 20% coinsurance, Prosthetics/Medical Supplies with 20% coinsurance, and Diabetic Therapeutic Shoes/Inserts with 20% coinsurance, but do not include Durable Medical Equipment for use outside the home or Diabetic Supplies.
Diagnostic and Radiological Services See details
The Cigna True Choice Medicare (PPO) plan covers diagnostic and radiological services. Diagnostic Procedures/Tests have a copay between $0 and $50, while Lab Services have no copay. Diagnostic Radiological Services have a copay of up to $250, Therapeutic Radiological Services have a copay of $60, and Outpatient X-Ray Services have a $10 copay.
Home Health Services See details
Home Health Services are covered by the Cigna True Choice Medicare (PPO) plan with no copay or coinsurance. However, Additional Hours of Care and Personal Care Services are not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered, but specific services including Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, and SET for PAD Services are not covered. Prior authorization is required, and the copay details are available.
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 a $10 copay, and for days 21-100, the copay is $214.
Other Services See details
Other Services include an over-the-counter (OTC) items benefit with a maximum plan benefit coverage amount of $35.00 every three months, and a meal benefit. 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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