A non-government entity
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 $500.00 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 $5600.00 (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 $5600.00 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:
Sign up for Cigna True Choice Access Medicare (PPO)
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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'll pay a copay for each prescription depending on the drug tier and pharmacy. 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 will pay nothing for your Part D covered drugs. If you qualify for the low-income subsidy, your Part D costs will be $0.
Additional Benefits
The Cigna True Choice Access Medicare (PPO) plan offers a range of benefits with varying cost-sharing. This plan includes coverage for inpatient and outpatient hospital services, primary care, preventive services, hearing, vision, and dental. The plan has copays for certain services, such as primary care visits, specialist visits, and hearing exams, while other services, like preventive services and outpatient blood services, have no copay. The plan also covers emergency services, ambulance services, and home health services.
Inpatient Hospital See details
Inpatient Hospital services are covered, with a copay of $295 for days 1-8 and no copay for days 9-90 for Inpatient Hospital-Acute; Inpatient Hospital Psychiatric has a copay of $285 for days 1-8 and no copay for days 9-90. Additional Days for Inpatient Hospital-Acute are covered, while Non-Medicare-covered Stay and Upgrades for Inpatient Hospital-Acute are not covered, and Additional Days and Non-Medicare-covered Stay for Inpatient Hospital Psychiatric are not covered.
Outpatient Services See details
Outpatient Services includes coverage for outpatient hospital services with a copay ranging from $0 to $275, observation services with a $290 copay, ambulatory surgical center (ASC) services with no copay, outpatient substance abuse services with a $35 copay for both individual and group sessions, and outpatient blood services. Outpatient blood services include an enhanced benefit where three pints are deductible waived.
Partial Hospitalization See details
Partial Hospitalization is covered under the Cigna True Choice Access Medicare (PPO) plan, but requires prior authorization. You will have a $105 copay for this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered under the Cigna True Choice Access Medicare (PPO) plan. Ground ambulance services have a $265 copay, while air ambulance services have a 20% coinsurance; however, 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 under the Cigna True Choice Access Medicare (PPO) plan. Emergency Services and Worldwide Emergency Coverage have a $125 copay, while Urgently Needed Services has a $55 copay; all three have no coinsurance. Worldwide Urgent Coverage and Worldwide Emergency Transportation also have a $125 copay and no coinsurance. Worldwide Emergency Services have a maximum plan benefit coverage of $50,000.
Primary Care See details
The Cigna True Choice Access Medicare (PPO) plan's primary care benefit covers primary care physician services, chiropractic services, occupational therapy services, physician specialist services, other health care professionals, psychiatric services, physical therapy, speech-language pathology services, additional telehealth benefits, and opioid treatment program services. Chiropractic services have a $15 copay. Occupational therapy services, physician specialist services, physical therapy, and speech-language pathology services have a $35 copay. Other health care professional services have a copay between $0 and $35. Additional telehealth benefits have a copay between $0 and $35. Opioid treatment program services have a $35 copay. Individual and group sessions for mental health and psychiatric services are not covered, and routine chiropractic care is not covered.
Preventive Services See details
Preventive Services include coverage for Medicare-covered services with no copay, an annual physical exam, health education, kidney disease education services, glaucoma screenings, diabetes self-management training, barium enemas, digital rectal exams, EKG following a Welcome Visit, and fitness benefits. However, 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, 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 include routine hearing exams with a $20 copay, and fitting/evaluation for hearing aids, each covered once per year. Prescription hearing aids are 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
Vision Services includes eye exams with a copay of $0-$35, along with coverage for eyewear, including contact lenses, eyeglasses (lenses and frames), eyeglass lenses, eyeglass frames, and upgrades. Eyewear has a combined maximum plan benefit coverage of $250 every year.
Dental Services See details
Dental services are covered. Medicare dental services have a $35 copay and require prior authorization, and other dental services are covered with a $1,200 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 also covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, with prior authorization required. For Medicare Part B Insulin Drugs, there is a $35 copay and a coinsurance between 0% and 20%. The plan also covers Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs, with a coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered under the Cigna True Choice Access Medicare (PPO) plan, but require prior authorization. The coinsurance for these services is 20%.
Medical Equipment See details
Medical Equipment benefits include coverage for Durable Medical Equipment (DME) with 20% coinsurance and Prosthetic Devices, and Medical Supplies. Diabetic Equipment is also covered, but 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 partially covered. Lab Services have no copay, while Diagnostic Radiological Services have a copay up to $125, and Therapeutic Radiological Services have a copay up to $80. Outpatient X-Ray Services have no copay.
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. Authorization is required for this benefit.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered by the Cigna True Choice Access Medicare (PPO) plan. Prior authorization is required for this benefit, but the plan does not cover any of the listed services.
Skilled Nursing Facility (SNF) See details
The Cigna True Choice Access Medicare (PPO) plan covers Skilled Nursing Facility (SNF) services, but prior authorization is required. For days 1-20, there is no copay, and for days 21-100, the copay is $214.
Other Services See details
Under Other Services, 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. Over-the-Counter (OTC) Items are covered with a $50 benefit every three months. The plan also covers a meal benefit for chronic illnesses and medical conditions.
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