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 New York City. 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 $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 $9000.00 (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 $9000.00 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 Medicare (PPO)
Need help deciding? Talk with one of our licensed insurance specialists 1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
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, which varies depending on the drug tier and pharmacy type, and then you enter the next coverage phase once your total drug costs reach $2,000. Once you reach the catastrophic coverage phase, you will pay nothing for your Part D covered drugs. This plan may also reduce your premium if you qualify for the low-income subsidy (LIS).
Additional Benefits
The Cigna True Choice Medicare (PPO) plan offers a wide range of benefits. The plan covers inpatient hospital stays with copays, outpatient services with varying copays, and partial hospitalization with an $80 copay. Emergency, urgent, and worldwide emergency services are covered with copays, and primary care visits have copays between $0 and $40. Preventive services are covered, and hearing and vision services are included with copays and maximum benefit amounts. Dental services are covered with a $40 copay and a maximum annual benefit. Other covered services include ambulance, home infusion, dialysis, medical equipment with coinsurance, diagnostic services with copays and coinsurance, home health services with no copay, and skilled nursing facility (SNF) services with copays.
Inpatient Hospital See details
Inpatient Hospital coverage includes a copay of $210 for days 1-7, and no copay for days 8-90 for Inpatient Hospital-Acute, and a copay of $335 for days 1-6, and no copay for days 7-90 for Inpatient Hospital Psychiatric. Additional days, non-Medicare covered stays, and upgrades for Inpatient Hospital-Acute and Inpatient Hospital Psychiatric are not covered.
Outpatient Services See details
Outpatient Services include coverage for all outpatient hospital services, with copays ranging from $0 to $300, and observation services with a $300 copay. Ambulatory Surgical Center (ASC) Services have no copay, and outpatient substance abuse services include individual and group sessions, each with a copay of $40. Outpatient blood services are also covered with a waived three-pint deductible.
Partial Hospitalization See details
Partial hospitalization is covered by Cigna True Choice Medicare (PPO) with prior authorization. You will pay an $80 copay for this service.
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 $265 copay, while Air Ambulance Services have a 20% coinsurance; however, 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 by Cigna True Choice Medicare (PPO). Emergency Services and Worldwide Emergency Coverage have a $110 copay, while Urgently Needed Services has a $45 copay; there is no coinsurance for any of these services. Worldwide Emergency Services has a maximum plan benefit coverage of $50,000.
Primary Care See details
Primary Care Physician Services, Occupational Therapy Services, Physical Therapy and Speech-Language Pathology Services, Chiropractic Services, Physician Specialist Services, Other Health Care Professional, Psychiatric Services, Additional Telehealth Benefits, and Opioid Treatment Program Services are covered. Chiropractic Services have a $15 copay, and Routine Chiropractic Care is not covered. Occupational Therapy Services and Physical Therapy and Speech-Language Pathology Services have a $35 copay, and there is a $40 copay for Physician Specialist Services. Other Health Care Professional and Additional Telehealth Benefits have a copay that ranges from $0 to $40, and Opioid Treatment Program Services has a $40 copay. Mental Health Specialty Services, Podiatry Services, Individual Sessions for Psychiatric Services, and Group Sessions for Psychiatric Services are not covered.
Preventive Services See details
The Cigna True Choice Medicare (PPO) plan covers preventive services, including Medicare-covered services, annual physical exams, kidney disease education services, and other preventive services. The plan 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, 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, additional sessions of smoking cessation, fitness benefits, enhanced disease management, telemonitoring services, remote access technologies, home and bathroom safety devices, and counseling services.
Hearing Services See details
Hearing Services are covered, including routine hearing exams with a $30 copay. Fitting/Evaluation for Hearing Aids are covered, and Prescription Hearing Aids (all types) are covered with a copay between $399 and $1800. Prescription Hearing Aids - Inner Ear, Prescription Hearing Aids - Outer Ear, Prescription Hearing Aids - Over the Ear, and OTC Hearing Aids are not covered.
Vision Services See details
Vision services include eye exams with a copay of $0-$40, and eyewear, including contact lenses, eyeglasses (lenses and frames), eyeglass lenses, eyeglass frames, and upgrades. Eyewear has a combined maximum benefit of $100 per year for both in and out-of-network services. Contact lenses are unlimited, while eyeglasses (lenses and frames), eyeglass lenses, and eyeglass frames are limited to one per year.
Dental Services See details
Dental Services are covered, with a $40 copay for Medicare Dental Services. There is a $1700 maximum plan benefit coverage amount for both in-network and out-of-network services, per year.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, and require prior authorization. For Medicare Part B Insulin Drugs, there is a $35 copay and coinsurance between 0% and 20%. For Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs, there is 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. The plan has a coinsurance of 20% for these services.
Medical Equipment See details
Medical Equipment coverage under the Cigna True Choice Medicare (PPO) plan includes Durable Medical Equipment (DME) with a 20% coinsurance, Prosthetics/Medical Supplies with a 20% coinsurance, and Diabetic Therapeutic Shoes/Inserts with a 20% coinsurance; Durable Medical Equipment for use outside the home and Diabetic Supplies are not covered.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services, including diagnostic procedures/tests, lab services, and outpatient X-ray services, are covered. Diagnostic Procedures/Tests have a copay between $0 and $40, Lab Services have no copay, and Diagnostic Radiological Services have a copay up to $300. Therapeutic Radiological Services have a coinsurance of at least 20%, and Outpatient X-Ray Services have a $30 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 additional hours of care and personal care services are not covered. Prior authorization is required for this benefit.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered by the Cigna True Choice Medicare (PPO) plan, but the specific services listed, including Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, and SET for PAD Services, are not covered. Prior authorization is required.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the Cigna True Choice Medicare (PPO) plan. For days 1-20, there is no copay, and for days 21-100, the copay is $214.
Other Services See details
The "Other Services" benefit in the Cigna True Choice Medicare (PPO) plan includes coverage for Over-the-Counter (OTC) items with a maximum benefit of $50 every three months, and meal benefits. 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.
Get Personalized Help from a licensed insurance agent
1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
*/SMID: MULTIPLAN_HCIHNMEDADVRX25_HCI_M
MedicareAdvantageRX.com is owned and operated by Dog Media Solutions LLC.
This is a promotional communication.
Every year, Medicare evaluates plans based on a 5-star rating system.
Part B premium reduction is not available with all plans. Availability varies by carrier and location. Actual Part B premium reduction could be lower. Deductibles, copays and coinsurance may apply.
* Benefit(s) mentioned may be part of a special supplemental program for chronically ill members with one of the following conditions: Diabetes mellitus, Cardiovascular disorders, Chronic and disabling mental health conditions, Chronic lung disorders, Chronic heart failure. This is not a complete list of qualifying conditions. Having a qualifying condition alone does not mean you will receive the benefit(s). Other requirements may apply.
Enrollment in Medicare/Medicare Advantage may be limited to certain times of the year unless you qualify for a Special Enrollment Period
We do not offer every plan available in your area. Currently, we represent 18 organizations, which offer 52,101 products in your area. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all of your options.
We represent Medicare Advantage HMO, PPO and PFFS organizations and stand-alone PDP prescription drug plans that are contracted with Medicare. Enrollment depends on the plan's contract renewal.
Not all plans offer all of these benefits. Benefits may vary by carrier and location. Limitations and exclusions may apply.
Please contact Medicare.gov ,1-800-MEDICARE , or your local State Health Insurance Program (SHIP) to get information on all of your options.
Medicare has neither approved nor endorsed any information on this site.
Speak with a licensed insurance agent: 1-877-649-2073 / TTY 711 | 8am - 11pm ET | 7 days a week
© 2023 Dog Media Solutions LLC. All rights reserved