A non-government entity
Cigna True Choice DE Medicare (PPO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Cigna True Choice DE 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 DE Medicare (PPO) in 2025, please refer to our full plan details page.
Cigna True Choice DE Medicare (PPO) is a PPO plan offered by The Cigna Group available for enrollment in 2025 to people living in Delaware. This plan received an overall rating of 3 out of 5 stars in 2025.
It's important to know that Cigna True Choice DE 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 DE 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 DE 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 $11000.00 (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 $11000.00 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 DE Medicare (PPO) plan has a $0 deductible for prescription drugs. In the initial coverage phase, you'll pay a copay for your prescriptions depending on the drug tier and whether you use a preferred or standard pharmacy. For example, preferred generic drugs have a $4 copay, while preferred brand drugs have a $100 copay. Once your total drug costs reach $2,000, you enter the catastrophic coverage phase and pay nothing for your Part D covered drugs. This plan also offers a premium reduction for those who qualify for the low-income subsidy.
Additional Benefits
The Cigna True Choice DE Medicare (PPO) plan offers a variety of benefits. This plan covers inpatient hospital stays with a copay, as well as outpatient services, emergency services, and primary care services. Additional benefits include preventive, hearing, vision, and dental services, with varying copays and coverage limits. The plan also covers home health services, skilled nursing facilities, and other services like acupuncture and over-the-counter items.
Inpatient Hospital See details
Inpatient Hospital coverage includes both Inpatient Hospital-Acute and Inpatient Hospital Psychiatric services, with a copay of $255 for days 1-5 and no copay for days 6-90 for Inpatient Hospital-Acute, and a copay of $230 for days 1-5 and no copay for days 6-90 for Inpatient Hospital Psychiatric. Additional days, non-Medicare covered stays, and upgrades for both services are not covered.
Outpatient Services See details
Outpatient Services include coverage for outpatient hospital services with a copay between $0 and $350, observation services with a $350 copay, ambulatory surgical center services with no copay, and outpatient substance abuse services with a $35 copay for individual and group sessions. Outpatient blood services are also covered.
Partial Hospitalization See details
Partial Hospitalization is covered by the Cigna True Choice DE Medicare (PPO) plan, and requires prior authorization. You will have an $80 copay for this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered, with prior authorization required for all ambulance services. Ground ambulance services have a $235 copay, while air ambulance services have 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 the Cigna True Choice DE Medicare (PPO) plan. Emergency Services and Worldwide Emergency Coverage have a $110 copay, while Urgently Needed Services have a $45 copay, and 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, Chiropractic Services, Occupational Therapy Services, Physician Specialist Services, Mental Health Specialty Services, Other Health Care Professional, Psychiatric Services, Physical Therapy and Speech-Language Pathology Services, Additional Telehealth Benefits, and Opioid Treatment Program Services are covered. Chiropractic Services have a $15 copay, Occupational Therapy Services have a $35 copay, Physician Specialist Services have a $35 copay, and Physical Therapy and Speech-Language Pathology Services have a $35 copay. Mental Health Specialty Services and Psychiatric Services do not cover individual or group sessions, and Podiatry Services are not covered.
Preventive Services See details
The Cigna True Choice DE Medicare (PPO) plan covers preventive services, including Medicare-covered services, annual physical exams, health education, kidney disease education, and other preventive services like glaucoma screenings and diabetes self-management training. However, services such as in-home safety assessments and weight management programs are not covered.
Hearing Services See details
Hearing Services include routine hearing exams with a $35 copay. Prescription hearing aids are covered with a copay between $399 and $1800, and are limited to 2 per year, but inner ear, outer ear, and over the ear prescription hearing aids are not covered.
Vision Services See details
Vision services are covered, including eye exams with a copay of $0-$35. Eyewear is covered, with a combined maximum benefit of $150 every year, and contact lenses are covered, with no copay.
Dental Services See details
The Cigna True Choice DE Medicare (PPO) plan covers dental services, including oral exams with a $35 copay, 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. The plan has a maximum benefit of $1550 per year for both in-network and out-of-network services.
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 a coinsurance between 0-20%, while Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs have a coinsurance between 0-20%.
Dialysis Services See details
Dialysis Services are covered by the Cigna True Choice DE Medicare (PPO) plan, but require prior authorization. You will pay 20% coinsurance for these services.
Medical Equipment See details
Medical Equipment, including Durable Medical Equipment (DME) and Prosthetics/Medical Supplies, is covered by the Cigna True Choice DE Medicare (PPO) plan. DME has a 20% coinsurance with no copay, while Prosthetic Devices and Medical Supplies have a 20% coinsurance and no copay. Durable Medical Equipment for use outside the home and Diabetic Supplies are not covered, but Diabetic Therapeutic Shoes/Inserts are covered with a 20% coinsurance and no copay.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered, including diagnostic procedures and tests with a copay between $0 and $50, and lab services with 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 $35 copay.
Home Health Services See details
Home Health Services are covered under the Cigna True Choice DE Medicare (PPO) plan with no copay and no coinsurance. However, 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 DE Medicare (PPO) plan. This includes 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.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the Cigna True Choice DE Medicare (PPO) plan, but require prior authorization. For days 1-20, there is no copay, and for days 21-100, the copay is $214.
Other Services See details
The Cigna True Choice DE Medicare (PPO) plan covers acupuncture with a maximum benefit coverage amount of $300 per year. The plan also covers over-the-counter (OTC) items with a maximum benefit coverage amount of $50 every three months, including nicotine replacement therapy and Naloxone. The plan provides a meal benefit for chronic illnesses and medical conditions requiring the enrollee to stay at home. However, Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services, Private Duty Nursing Services, and other services are not covered.
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