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Cigna True Choice Access Medicare (PPO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Cigna True Choice Access 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 Access Medicare (PPO) in 2025, please refer to our full plan details page.
Cigna True Choice Access Medicare (PPO) is a PPO plan offered by The Cigna Group available for enrollment in 2025 to people living in Alabama/South Mississippi. This plan received an overall rating of 3 out of 5 stars in 2025.
It's important to know that Cigna True Choice Access 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 Access 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 Access 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 $285.00 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 $5800.00 (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 $5800.00 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 Access Medicare (PPO) plan has a $0 deductible for prescription drugs. During the initial coverage phase, you will pay a copay depending on the drug tier and pharmacy type. For example, preferred generic drugs have a $4 copay at preferred pharmacies and $20 at standard pharmacies. After your total drug costs reach $2,000, you enter the catastrophic coverage phase, where you pay nothing for your Part D covered drugs. This plan's premium may be reduced if you qualify for the low-income subsidy.
Additional Benefits
The Cigna True Choice Access Medicare (PPO) plan offers a variety of benefits, including coverage for inpatient and outpatient services, with varying copays. Emergency services and ambulance services are covered, along with primary care services with copays ranging from $15 to $35. Preventive services, hearing, vision, and dental services are also included, with specific copays and annual maximums. Additional benefits of this plan include coverage for home health services with no copay, and medical equipment such as DME and Diabetic Therapeutic Shoes/Inserts with no copay. The plan also offers a $40 OTC benefit every three months, and a meal benefit for those with chronic illnesses. However, some services like cardiac rehabilitation, and additional hours of care are not covered.
Inpatient Hospital See details
Inpatient Hospital services are covered, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric. For days 1-7, there is a $295 copay, and days 8-90 have no copay. Additional days for Inpatient Hospital-Acute are covered, but Non-Medicare-covered stay and upgrades for Inpatient Hospital-Acute, and all Inpatient Hospital Psychiatric additional days are not covered.
Outpatient Services See details
Outpatient Services with the Cigna True Choice Access Medicare (PPO) plan include coverage for all outpatient hospital services, with copays ranging from $0 to $275, and also covers observation services with a $290 copay. The plan also covers Ambulatory Surgical Center (ASC) services with no copay, and covers outpatient substance abuse services with a copay of $35 for individual and group sessions. Outpatient Blood Services are also covered.
Partial Hospitalization See details
Partial Hospitalization is covered with a $105 copay. Prior authorization is required.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered, including ground ambulance services with a $275 copay and air ambulance services with 20% coinsurance. 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. Emergency Services and Worldwide Emergency Coverage have a $125 copay, while Urgently Needed Services have a $55 copay, and all services have no coinsurance. Worldwide Emergency Services has a maximum plan benefit of $50,000.
Primary Care See details
Primary Care benefits include coverage for 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. Chiropractic Services have a $15 copay, Physician Specialist Services have a $35 copay, Occupational Therapy Services have a $35 copay, Physical Therapy and Speech-Language Pathology Services have a $35 copay, while Routine Chiropractic Care, Individual Sessions for Mental Health Specialty Services, Group Sessions for Mental Health Specialty Services, Individual Sessions for Psychiatric Services, and Group Sessions for Psychiatric Services are not covered. Additional Telehealth Benefits have a copay that ranges from $0 to $35.
Preventive Services See details
Preventive Services include coverage for Medicare-covered preventive services, annual physical exams, health education, kidney disease education services, glaucoma screening, diabetes self-management training, barium enemas, digital rectal exams, EKG following Welcome Visit, and a fitness benefit, all with no copay. In-Home Safety Assessment, Personal Emergency Response System (PERS), Medical Nutrition Therapy (MNT), 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 Benefit, 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 are not covered.
Hearing Services See details
Hearing services with the Cigna True Choice Access Medicare (PPO) plan include hearing exams for a $20 copay, routine hearing exams (1 per year), and fitting/evaluation for hearing aids (1 per year). Prescription hearing aids (all types) are covered with a copay between $399 and $1800, but prescription hearing aids for the inner, outer, and over the ear are not covered, and OTC hearing aids are also not covered.
Vision Services See details
Vision services include eye exams with a copay between $0-$30, and eyewear benefits that include contact lenses, eyeglasses (lenses and frames), eyeglass lenses, and eyeglass frames with a combined maximum plan benefit of $250 every year. Routine eye exams are covered once per year.
Dental Services See details
The Cigna True Choice Access Medicare (PPO) plan covers dental services, including 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. The plan has a $35 copay for Medicare dental services, and a maximum benefit of $1,050 per year for both in-network and out-of-network services.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered by the Cigna True Choice Access Medicare (PPO) plan, but require prior authorization. The plan's cost sharing includes a $35 copay for Medicare Part B Insulin Drugs, with a coinsurance between 0% and 20% for Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs.
Dialysis Services See details
Dialysis Services are covered under the Cigna True Choice Access Medicare (PPO) plan, but require prior authorization. The coinsurance for Dialysis Services is 20%.
Medical Equipment See details
Medical Equipment is covered under the Cigna True Choice Access Medicare (PPO) plan, with no copay for Durable Medical Equipment (DME), Prosthetics/Medical Supplies, and Diabetic Therapeutic Shoes/Inserts; however, there is a 20% coinsurance for DME, Prosthetics/Medical Supplies, and Diabetic Therapeutic Shoes/Inserts, and Durable Medical Equipment for use outside the home and Diabetic Supplies are not covered.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services includes coverage for lab services with no copay, diagnostic radiological services with a copay up to $125, therapeutic radiological services with a copay up to $80, and outpatient X-ray services with no copay. Diagnostic Procedures/Tests are not covered.
Home Health Services See details
Home Health Services are covered by the Cigna True Choice Access Medicare (PPO) plan with no copay and no coinsurance, but additional hours of care and personal care services are not covered. This benefit requires authorization.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered by the Cigna True Choice Access 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 under the Cigna True Choice Access Medicare (PPO) plan, but require prior authorization. For days 1-20, there is no copay, and for days 21-100, the copay is $214. Additional days beyond Medicare-covered for SNF and non-Medicare-covered stays for SNF are not covered.
Other Services See details
The Cigna True Choice Access Medicare (PPO) plan does not cover acupuncture, 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. The plan covers Over-the-Counter (OTC) Items with a maximum benefit of $40.00 every three months, and it covers a Meal Benefit for a chronic illness or a medical condition that requires the enrollee to remain at home.
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