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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 North New Jersey. 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 $38.00. 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 $12000.00 (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 $12000.00 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. The plan has a $0 deductible. 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. After your total drug costs reach $2000, you enter the catastrophic coverage phase and pay nothing for covered drugs.
Additional Benefits
The Cigna True Choice Plus Medicare (PPO) plan offers comprehensive coverage, including inpatient and outpatient hospital services, with varying copays. This plan also includes coverage for primary care, preventive services, hearing, vision, and dental services, each with specific copays and coverage limits. Additionally, the plan provides benefits for emergency services, ambulance services, and home health services, as well as coverage for home infusion, dialysis, and medical equipment.
Inpatient Hospital See details
Inpatient Hospital benefits, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric, are covered, with a copay of $365 for days 1-4 and no copay for days 5-90 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 for Inpatient Hospital-Acute, Non-Medicare-covered Stay for Inpatient Hospital-Acute, Upgrades for Inpatient Hospital-Acute, Additional Days for Inpatient Hospital Psychiatric, and Non-Medicare-covered Stay for Inpatient Hospital Psychiatric are not covered.
Outpatient Services See details
Outpatient Services are covered, including outpatient hospital services with a copay between $0 and $365, observation services with a $365 copay, ambulatory surgical center services with no copay, and outpatient substance abuse services with a $10 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 Plus Medicare (PPO) plan, but requires prior authorization. You will have an $80 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, with prior authorization required for all ambulance services. Ground ambulance services have a $265 copay, while air ambulance services have a 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 under the Cigna True Choice Plus Medicare (PPO) plan. Emergency Services and Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation have a $110 copay with no coinsurance, and Urgently Needed Services has a $45 copay with no coinsurance. The copay for Emergency Services and Urgently Needed Services is waived if admitted to the hospital within 24 hours.
Primary Care See details
Primary Care benefits include coverage for Primary Care Physician Services, Chiropractic Services with a $15 copay, Occupational Therapy Services with a $10 copay, Physician Specialist Services with a $10 copay, Other Health Care Professional services with a copay between $0 and $10, Physical Therapy and Speech-Language Pathology Services with a $10 copay, Additional Telehealth Benefits with a copay between $0 and $10, and Opioid Treatment Program Services with a $10 copay. Routine Chiropractic Care, Individual and Group Sessions for Mental Health and Psychiatric Services, and Podiatry Services are not covered.
Preventive Services See details
The Cigna True Choice Plus Medicare (PPO) plan covers preventive services, including an annual physical exam, health education, kidney disease education services, glaucoma screening, diabetes self-management training, barium enemas, digital rectal exams, and EKG following a welcome visit. However, this plan does not cover in-home safety assessments, personal emergency response systems, medical nutrition therapy, post-discharge in-home medication reconciliation, readmission 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, or counseling services.
Hearing Services See details
Hearing services with the Cigna True Choice Plus Medicare (PPO) plan include hearing exams with a $10 copay, routine hearing exams (1 per year), and fitting/evaluation for hearing aids (1 per year). Prescription hearing aids are partially covered, with a copay between $399 and $1800 depending on the type of hearing aid. OTC hearing aids, and prescription hearing aids for the inner ear, outer ear, and over the ear are not covered.
Vision Services See details
The Cigna True Choice Plus Medicare (PPO) plan covers vision services, including routine eye exams with a copay of $0-$10. Eyewear is covered with a combined maximum benefit of $300 every year, and contact lenses are also covered.
Dental Services See details
Dental Services are covered, with a $2,200 annual maximum benefit. Medicare dental services have a $10 copay, while 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 covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered under the Cigna True Choice Plus Medicare (PPO) plan. Medicare Part B Insulin Drugs have a $35 copay and a coinsurance between 0% and 20%, while Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs have a coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered by the Cigna True Choice Plus Medicare (PPO) plan, but require prior authorization. You will pay 20% coinsurance for these services.
Medical Equipment See details
The Cigna True Choice Plus Medicare (PPO) plan covers Durable Medical Equipment (DME) with a 20% coinsurance and requires prior authorization, but does not cover DME for use outside the home. Prosthetics/Medical Supplies - Non-Medicare benefits are covered with coinsurance for Medicare-covered prosthetic devices and medical supplies, and Diabetic Therapeutic Shoes/Inserts are covered with a 20% coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services, including diagnostic procedures and tests, lab services, and radiological services, are covered by the Cigna True Choice Plus Medicare (PPO) plan. Lab services have no copay, while diagnostic procedures and tests have a copay up to $100. Diagnostic radiological services have a copay up to $175, therapeutic radiological services have a $60 copay, and outpatient X-ray services have a $40 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. This benefit requires authorization.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered by the Cigna True Choice Plus Medicare (PPO) plan, but are not covered in practice. Prior authorization is required.
Skilled Nursing Facility (SNF) See details
The Cigna True Choice Plus Medicare (PPO) plan covers Skilled Nursing Facility (SNF) services with 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 Plus Medicare (PPO) plan covers Over-the-Counter (OTC) Items with a maximum benefit coverage amount of $95.00 every three months, including Nicotine Replacement Therapy (NRT) and Naloxone coverage. Acupuncture, Dual Eligible SNPs, 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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