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 South Carolina. 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 $22.00. 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 does not have a health deductible. Your insurance coverage on covered health services will start immediately.
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 $6200.00 (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 $6200.00 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 a $0 deductible for prescription drugs. In the initial coverage phase, you'll pay a copay for your prescriptions, which varies based on the drug tier and pharmacy type. For example, preferred generic drugs have a $4 copay at preferred pharmacies. Once your total drug costs reach $2000, you enter the catastrophic coverage phase where you pay nothing for your Part D covered drugs. Please note that this summary does not include all details about the plan's drug coverage, and you should review the plan's formulary for specific drugs.
Additional Benefits
The Cigna True Choice Plus Medicare (PPO) plan offers a range of benefits with varying costs. Inpatient hospital stays have copays, with psychiatric stays having different copays. Outpatient services have copays depending on the service. Emergency services have a copay, while primary care, hearing, and vision services have copays. This plan also covers services like ambulance, home health, and dialysis with copays or coinsurance. Dental, medical equipment, and diagnostic services are also included, with different copays, coinsurance, and annual maximums. Some services require prior authorization.
Inpatient Hospital See details
Inpatient Hospital services are covered, with a copay of $290 for days 1-6 and no copay for days 7-90 for Inpatient Hospital-Acute, and a copay of $595 for days 1-3, and no copay for days 4-90 for Inpatient Hospital Psychiatric; however, additional days and non-Medicare covered stays for Inpatient Hospital Psychiatric are not covered. Additional days for Inpatient Hospital-Acute are covered.
Outpatient Services See details
Outpatient Services are covered by the Cigna True Choice Plus Medicare (PPO) plan, which includes all outpatient hospital services, observation services, ambulatory surgical center services, outpatient substance abuse services, and outpatient blood services. Outpatient hospital services have a copay between $0 and $275, observation services have a $275 copay, and ambulatory surgical center services have no copay. Individual and group sessions for outpatient substance abuse have a copay of $25, and outpatient blood services have a waived three-pint deductible.
Partial Hospitalization See details
Partial Hospitalization is covered by the Cigna True Choice Plus Medicare (PPO) plan, but requires prior authorization. You will have a $130 copay for this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by the Cigna True Choice Plus Medicare (PPO) plan. Ground ambulance services have a $270 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 by the Cigna True Choice Plus Medicare (PPO) plan. Emergency Services and Worldwide Emergency Coverage have a $140 copay, while Urgently Needed Services have a $65 copay; all have no coinsurance. Worldwide Emergency Services has a maximum plan benefit of $50,000.
Primary Care See details
The Cigna True Choice Plus Medicare (PPO) plan covers primary care physician services, chiropractic services with a $20 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. The plan also covers telehealth benefits with a copay between $0 and $25, and opioid treatment program services with a $25 copay. However, routine chiropractic care, individual and group sessions for mental health specialty services, individual and group sessions for psychiatric services, and podiatry services are not covered.
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, and additional services like health education and fitness benefits. 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 include routine hearing exams with a $25 copay, and fitting/evaluation for hearing aids with no copay. Prescription hearing aids are covered with a copay between $399 and $1800 depending on the type of hearing aid, while OTC hearing aids, and prescription hearing aids for the inner, outer, and over the ear are not covered.
Vision Services See details
Vision services include eye exams with a copay of $0-$10, and eyewear with a combined maximum benefit of $150 every year. Eyeglasses (lenses and frames), eyeglass lenses, and eyeglass frames are limited to one per year, and contact lenses and upgrades are also covered.
Dental Services See details
Dental services are covered under the Cigna True Choice Plus Medicare (PPO) plan. Medicare dental services require prior authorization and have a $25 copay, and other dental services are covered up to a maximum of $350 per year.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, and require prior authorization. Medicare Part B Insulin Drugs have a $35 copay and 0-20% coinsurance. Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs have 0-20% coinsurance.
Dialysis Services See details
Dialysis Services are covered by the Cigna True Choice Plus Medicare (PPO) plan. You will pay 20% coinsurance for this service.
Medical Equipment See details
Medical equipment benefits under the Cigna True Choice Plus Medicare (PPO) plan include Durable Medical Equipment (DME) with a 20% coinsurance and Prosthetics/Medical Supplies, which has a 20% coinsurance for Medicare-covered supplies, but excludes coverage for Durable Medical Equipment for use outside the home. Diabetic Therapeutic Shoes/Inserts have a 20% coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered, with some services requiring prior authorization. Diagnostic Procedures/Tests have a copay between $0 and $95, while Lab Services have no copay. Diagnostic Radiological Services have a copay up to $225, Therapeutic Radiological Services have a copay up to $60, and Outpatient X-Ray Services have no 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 covered, but 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, and Additional Cardiac Rehabilitation Services. Prior authorization is required for this benefit.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the Cigna True Choice Plus Medicare (PPO) plan, but require prior authorization. For days 1-20, there is a $20 copay; for days 21-60, the copay is $214; and for days 61-100, there is no copay. Additional days beyond Medicare-covered and non-Medicare-covered stays for SNF are not covered.
Other Services See details
Other Services include a meal benefit, but acupuncture, over-the-counter items, 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. The meal benefit is provided for a chronic illness or medical condition that requires the enrollee to remain at home.
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