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 Central Arizona. 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 $475.00 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 $9350.00 (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 $9350.00 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'll pay a copay for your prescriptions depending on the drug tier and pharmacy you use. For example, preferred generic drugs have a $5 copay at preferred pharmacies. Once 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 also offers a premium reduction if you qualify for the low-income subsidy, also known as "Extra Help".
Additional Benefits
The Cigna True Choice Medicare (PPO) plan offers a range of benefits with varying costs. This plan includes coverage for inpatient hospital stays with a copay, outpatient services with copays, and emergency services with a $125 copay. It also covers preventive services with no copay, vision and dental services, and home health services with no copay. The plan also covers hearing services with a copay, and offers coverage for ambulance and transportation services, as well as diagnostic and radiological services. Other benefits include coverage for home infusion and dialysis services with coinsurance, as well as medical equipment with coinsurance. This plan covers other services like acupuncture, and over-the-counter items.
Inpatient Hospital See details
Inpatient Hospital benefits are covered, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric services. For Inpatient Hospital-Acute, you will pay a $295 copay for days 1-6, and no copay for days 7-90. For Inpatient Hospital Psychiatric, you will pay a $295 copay for days 1-6, and no copay for days 7-90. Additional days for Inpatient Hospital-Acute are covered, while non-Medicare-covered stays and upgrades for Inpatient Hospital-Acute are not covered, and additional days and non-Medicare-covered stays for Inpatient Hospital Psychiatric are not covered.
Outpatient Services See details
The Cigna True Choice Medicare (PPO) plan covers outpatient services, including outpatient hospital services with a copay between $0 and $275, observation services with a $275 copay, and ambulatory surgical center (ASC) services with no copay. Outpatient substance abuse services have a copay of $30 for both individual and group sessions. Outpatient blood services are also covered.
Partial Hospitalization See details
Partial Hospitalization is covered by the Cigna True Choice Medicare (PPO) plan. This benefit requires prior authorization and has a copay of $105.
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 $250 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, and Worldwide Emergency Services are covered. Emergency Services and Worldwide Emergency Coverage have a $125 copay, Urgently Needed Services has a $30 copay, and all services have no coinsurance.
Primary Care See details
The Cigna True Choice Medicare (PPO) plan covers Primary Care Physician Services with no copay, Chiropractic Services with a $20 copay, Occupational Therapy Services with a $30 copay, Physician Specialist Services with a $30 copay, Podiatry Services with a $30 copay, Physical Therapy and Speech-Language Pathology Services with a $30 copay, and Additional Telehealth Benefits with a copay between $0 and $30. However, routine chiropractic care, individual and group sessions for mental health specialty services, and individual and group sessions for psychiatric services are not covered.
Preventive Services See details
The Cigna True Choice Medicare (PPO) plan covers preventive services, including an annual physical exam, with no copay. Additional preventive services, such as health education, support for caregivers, and fitness benefits are also covered. 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 by the Cigna True Choice Medicare (PPO) plan, including routine hearing exams with a $30 copay. Fitting/Evaluation for Hearing Aids are covered once per year. Prescription Hearing Aids (all types) are covered with a copay between $399 and $1800, but Prescription Hearing Aids - Inner Ear, Outer Ear, and Over the Ear are not covered. 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-$30, and eyewear, which includes contact lenses and eyeglass lenses and frames, with a combined maximum benefit of $225 every year. Routine eye exams are limited to one per year.
Dental Services See details
Dental Services are covered under the Cigna True Choice Medicare (PPO) plan, with a $30 copay for Medicare Dental Services; other services include 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), Maxillofacial Prosthetics, Implant Services, Prosthodontics (fixed), Oral and Maxillofacial Surgery and Orthodontics, all of which have no copay and no coinsurance. There is a maximum plan benefit coverage of $1,700 every year for both in-network and out-of-network services.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, with prior authorization required. For Medicare Part B Insulin Drugs, you will pay a $35 copay, with a coinsurance between 0% and 20%. For Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs, the coinsurance ranges from 0% to 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 benefits are covered by the Cigna True Choice Medicare (PPO) plan, including Durable Medical Equipment (DME) with 20% coinsurance and Prosthetics/Medical Supplies with 20% coinsurance. Durable Medical Equipment for use outside the home and Diabetic Supplies are not covered, while Diabetic Therapeutic Shoes/Inserts are covered with 20% coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered, including all diagnostic services, diagnostic procedures/tests with a copay between $0 and $50, and lab services with no copay. Radiological services are also covered, including diagnostic radiological services with a maximum copay of $150, therapeutic radiological services with at least 20% coinsurance, and outpatient X-ray services with a $20 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, but prior authorization is required. 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. Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, and SET for PAD Services are also not covered.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the Cigna True Choice Medicare (PPO) plan, requiring prior authorization. For days 1-20, there is no copay, and for days 21-100, the copay is $214 per day; additional days beyond Medicare-covered and non-Medicare-covered stays are not covered.
Other Services See details
The Cigna True Choice Medicare (PPO) plan covers acupuncture with a maximum benefit coverage amount of $300 per year. The plan also covers over-the-counter (OTC) items, including Nicotine Replacement Therapy (NRT) and Naloxone, up to $50 every three months, and offers a meal benefit for chronic illnesses or conditions requiring home confinement. However, 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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