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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 Hudson Valley. 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 $37.00. 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:
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 depending on the drug tier and pharmacy. For example, preferred generic drugs have a $5 copay at preferred pharmacies. After your total drug costs reach $2,000, you enter the catastrophic coverage phase, where you'll pay nothing for your Part D covered drugs. This plan's premium may be reduced if you qualify for the low-income subsidy.
Additional Benefits
The Cigna True Choice Plus Medicare (PPO) plan offers a range of benefits, including inpatient hospital stays with a copay, and outpatient services with varying copays. Emergency, urgently needed, and worldwide emergency services are covered with a copay, and primary care physician services are available with copays for specialist visits and other services. The plan also includes preventive services with no copay, hearing and vision services, and dental coverage. Additional benefits include home infusion, dialysis, medical equipment, diagnostic and radiological services, home health services, cardiac rehabilitation services, and skilled nursing facility coverage. The plan also covers Over-the-Counter (OTC) Items, but excludes certain services like acupuncture and private duty nursing.
Inpatient Hospital See details
Inpatient Hospital coverage includes a $250 copay for days 1-6, and no copay for days 7-90 for both Inpatient Hospital-Acute and Inpatient Hospital Psychiatric. 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, observation services, ambulatory surgical center services, outpatient substance abuse services, and outpatient blood services, are covered. Outpatient hospital services have a copay between $0 and $375, observation services have a $375 copay, individual and group outpatient substance abuse sessions have a $35 copay, and ambulatory surgical center services have no copay.
Partial Hospitalization See details
Partial Hospitalization is covered by the Cigna True Choice Plus Medicare (PPO) plan. This benefit requires prior authorization and has a copay of $80.
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 $265 copay, while air ambulance services have a 20% coinsurance. Transportation services to plan-approved or any 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 $110 copay, and Urgently Needed Services have a $45 copay, but 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 $35 copay, physician specialist services with a $35 copay, other health care professional services with a $0-$35 copay, physical therapy and speech-language pathology services with a $35 copay, additional telehealth benefits with a $0-$35 copay, and opioid treatment program services with a $35 copay. Routine chiropractic care, individual and group mental health specialty sessions, individual and group psychiatric sessions, and podiatry services are not covered.
Preventive Services See details
The Cigna True Choice Plus Medicare (PPO) plan covers various preventive services including Medicare-covered services with no copay, annual physical exams, health education, kidney disease education services, 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, 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. The plan also covers fitness benefits.
Hearing Services See details
Hearing Services include routine hearing exams with a $30 copay, and fitting/evaluation for hearing aids, both covered once per year. Prescription hearing aids (all types) are covered with a copay between $399 and $1800 twice per year, while prescription hearing aids for the inner, outer, and over the ear are not covered, and OTC hearing aids are not covered.
Vision Services See details
Vision services include eye exams with a copay of $0-$35, and eyewear benefits including contact lenses, eyeglasses (lenses and frames), eyeglass lenses, eyeglass frames, and upgrades. Eyewear has a combined maximum plan benefit of $200 every year.
Dental Services See details
Dental Services includes coverage for Medicare Dental Services with a $35 copay and other dental services, with a maximum benefit of $3,100 per year. 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 and fixed), maxillofacial prosthetics, implant services, oral and maxillofacial surgery, and orthodontics are all covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, but require prior authorization. For Medicare Part B Insulin Drugs, there is a $35 copay and coinsurance between 0-20%. For Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs, there is coinsurance between 0-20%.
Dialysis Services See details
Dialysis Services are covered by the Cigna True Choice Plus Medicare (PPO) plan, but require prior authorization. The coinsurance for dialysis services is 20%.
Medical Equipment See details
The Cigna True Choice Plus Medicare (PPO) plan covers Durable Medical Equipment (DME) with 20% coinsurance and no copay, and Prosthetic Devices and Medical Supplies also with 20% coinsurance and no copay. Diabetic Therapeutic Shoes/Inserts are covered with 20% coinsurance and no copay, but Durable Medical Equipment for use outside the home and Diabetic Supplies are not covered.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered, including lab services with no copay, and outpatient X-ray services with a $30 copay. Diagnostic Radiological Services have a copay of at most $300, and Therapeutic Radiological Services have a coinsurance of at most 20%.
Home Health Services See details
Home Health Services are covered 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 specific services, including Intensive Cardiac Rehabilitation, Pulmonary Rehabilitation, and SET for PAD Services, are not covered. Prior authorization is required for the covered services.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) benefits are covered by Cigna True Choice Plus Medicare (PPO) with prior authorization required. You will have no copay for days 1-20, and a $214 copay for days 21-100. Additional days beyond Medicare-covered for SNF and non-Medicare-covered stays for SNF are not covered.
Other Services See details
The Cigna True Choice Plus Medicare (PPO) plan covers Over-the-Counter (OTC) Items with a maximum benefit of $125.00 every three months, including Nicotine Replacement Therapy 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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