A non-government entity
Cigna True Choice Plus Medicare (PPO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Cigna True Choice Plus 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 Plus Medicare (PPO) in 2025, please refer to our full plan details page.
Cigna True Choice Plus Medicare (PPO) is a PPO plan offered by The Cigna Group available for enrollment in 2025 to people living in Northwest Pennsylvania. This plan received an overall rating of 3 out of 5 stars in 2025.
It's important to know that Cigna True Choice Plus 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 Plus 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 Plus Medicare (PPO), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $26.00. 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 $125.00 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 $10100.00 (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 $10100.00 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 Plus Medicare (PPO)
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Drug Coverage
The Cigna True Choice Plus Medicare (PPO) plan has an enhanced alternative drug benefit. There is no deductible for prescription drugs. During the initial coverage phase, you will pay a copay depending on the drug tier and pharmacy type, with costs ranging from $4 to $100 for a 30-day supply. Once your total drug costs reach $2000, you enter the catastrophic coverage phase where you pay nothing for covered drugs.
Additional Benefits
The Cigna True Choice Plus Medicare (PPO) plan offers a range of benefits with varying costs. Inpatient hospital stays have a $175 copay for the first five days, then no copay for the next 85 days. Outpatient services have copays ranging from $0 to $250. The plan covers emergency services with a $125 copay and primary care physician services with a $15 copay, and covers hearing and vision services. This plan also provides coverage for ambulance services, with a $275 copay for ground transport and 20% coinsurance for air transport. Other benefits include home health services with no copay, dental services with a $25 copay, and prescription hearing aids with copays between $399 and $1800. The plan also offers an OTC benefit with a maximum coverage of $125 every three months.
Inpatient Hospital See details
Inpatient Hospital benefits, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric, are covered. For days 1-5, there is a $175 copay, and for days 6-90, there is no copay; there is no coinsurance. Additional days and non-Medicare-covered stays for both Inpatient Hospital-Acute and Inpatient Hospital Psychiatric are not covered.
Outpatient Services See details
Outpatient Services, including all outpatient hospital services, are covered by the Cigna True Choice Plus Medicare (PPO) plan. Outpatient hospital services have a copay between $0 and $250, observation services have a $250 copay, and Ambulatory Surgical Center (ASC) services have no copay. Outpatient substance abuse services have a $25 copay for both individual and group sessions, and outpatient blood services are also covered.
Partial Hospitalization See details
Partial Hospitalization is covered under the Cigna True Choice Plus Medicare (PPO) plan, with a copay of $85. Prior authorization is required.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered under the Cigna True Choice Plus Medicare (PPO) plan. Ground ambulance services have a $275 copay, and air ambulance services have 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 has a $55 copay, and there is no coinsurance for any of these services.
Primary Care See details
The Cigna True Choice Plus Medicare (PPO) plan covers primary care physician services, chiropractic services with a $15 copay, occupational therapy services with a $25 copay, physician specialist services with a $25 copay, and physical therapy and speech-language pathology services with a $25 copay. Mental health and psychiatric services individual and group sessions, and podiatry services are not covered, and telehealth services have a copay between $0 and $25.
Preventive Services See details
The Cigna True Choice Plus Medicare (PPO) plan covers preventive services, including Medicare-covered services with no copay, annual physical exams, health education, kidney disease education, glaucoma screenings, diabetes self-management training, barium enemas, digital rectal exams, and EKGs following a Welcome Visit. 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. Fitness benefits are covered.
Hearing Services See details
Hearing services include routine hearing exams with a $25 copay, and fitting/evaluation for hearing aids with no copay. Prescription hearing aids are partially covered, with a copay between $399 and $1800 for all types, but inner ear, outer ear, and over the ear hearing aids are not covered, and OTC hearing aids are not covered.
Vision Services See details
Vision Services include coverage for eye exams with a copay between $0 and $25, routine eye exams, eyewear, contact lenses, eyeglasses (lenses and frames), eyeglass lenses, eyeglass frames, and upgrades. Eyewear has a combined maximum benefit of $250 per year.
Dental Services See details
Dental Services are covered by the Cigna True Choice Plus Medicare (PPO) plan. For Medicare Dental Services, there is a $25 copay and prior authorization is required; other dental services have a maximum plan benefit of $2800 per year.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered by Cigna True Choice Plus Medicare (PPO), including Insulin and other Part B drugs. For Medicare Part B Insulin Drugs, there is a $35 copay and a coinsurance between 0% and 20%; for Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs, there is a coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered under the Cigna True Choice Plus Medicare (PPO) plan, but require prior authorization. You will pay 20% coinsurance.
Medical Equipment See details
The Cigna True Choice Plus Medicare (PPO) plan covers Durable Medical Equipment (DME) with a 20% coinsurance, and Prosthetics/Medical Supplies with a 20% coinsurance. Durable Medical Equipment for use outside the home and Diabetic Supplies are not covered, while Diabetic Therapeutic Shoes/Inserts are covered with a 20% coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered by the Cigna True Choice Plus Medicare (PPO) plan, with a copay for all diagnostic services and outpatient radiological services. Diagnostic Procedures/Tests have a copay between $0 and $50, while Lab Services have no copay. Diagnostic Radiological Services have a copay up to $225, Therapeutic Radiological Services have a $60 copay, and Outpatient X-Ray Services have a $30 copay.
Home Health Services See details
Home Health Services are covered by the Cigna True Choice Plus 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 Plus Medicare (PPO) plan. The plan does not cover Medicare-covered Intensive Cardiac Rehabilitation Services, Medicare-covered Pulmonary Rehabilitation Services, Medicare-covered Supervised Exercise Therapy (SET) for Symptomatic Peripheral Artery Disease (PAD) Services, or Additional Cardiac Rehabilitation Services.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the Cigna True Choice Plus Medicare (PPO) plan, with a $0 copay for days 1-20, and a $214 copay for days 21-100. Additional days beyond Medicare-covered SNF stays and non-Medicare-covered SNF stays are not covered.
Other Services See details
The Cigna True Choice Plus Medicare (PPO) plan's Other Services benefit covers over-the-counter (OTC) items, with a maximum benefit coverage amount of $125.00 every three months, and includes Nicotine Replacement Therapy (NRT) and Naloxone coverage. 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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