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 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 $39.00. 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 $11300.00 (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 $11300.00 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 Plus Medicare (PPO) plan has an enhanced alternative drug benefit. This plan has no deductible for prescription drugs. In the initial coverage phase, you'll pay a copay for your prescriptions, with costs varying based on the drug tier and pharmacy. For example, preferred generic drugs have a $4 copay at preferred pharmacies. Once your total drug costs reach $2,000, 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. For inpatient hospital stays, you'll pay a copay, and outpatient services have copays depending on the service. This plan also covers services like primary care with a $10 copay, preventive services with no copay, hearing and vision services, and dental services up to a $2,500 annual maximum. Additionally, there are also benefits for home infusion, home health, and skilled nursing facilities.
Inpatient Hospital See details
Inpatient Hospital benefits are covered under the Cigna True Choice Plus Medicare (PPO) plan, with a copay of $340 for days 1-4 and no copay for days 5-90 for Inpatient Hospital-Acute. Inpatient Hospital Psychiatric has a copay of $250 for days 1-6 and no copay for days 7-90. 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 are covered by the Cigna True Choice Plus Medicare (PPO) plan. Outpatient Hospital Services have a copay between $0 and $340, Observation Services have a $340 copay, Ambulatory Surgical Center (ASC) Services have no copay, Outpatient Substance Abuse Services have a $10 copay for both individual and group sessions, and Outpatient Blood Services are covered.
Partial Hospitalization See details
Partial Hospitalization is covered by the Cigna True Choice Plus Medicare (PPO) plan with prior authorization required. The copay for this benefit is $80.
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 $260 copay, while Air Ambulance Services have a 20% coinsurance, and transportation services 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, Worldwide Urgent Coverage, and Worldwide Emergency Transportation have a $110 copay, while Urgently Needed Services has a $45 copay; all services have no coinsurance.
Primary Care See details
The Cigna True Choice Plus Medicare (PPO) plan covers primary care services, chiropractic services (with a $15 copay), occupational therapy (with a $10 copay), physician specialist services (with a $10 copay), physical therapy and speech-language pathology services (with a $10 copay), other health care professional services (with a copay between $0 and $10), opioid treatment program services (with a copay between $10 and $10), and additional telehealth benefits (with a copay between $0 and $10). However, 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 Medicare-covered services with no copay, annual physical exams, health education, fitness benefits, 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.
Hearing Services See details
Hearing services include hearing exams with a $10 copay, and prescription hearing aids with a copay between $399 and $1800 depending on the type of hearing aid. Routine hearing exams and fitting/evaluation for hearing aids are also covered. Prescription hearing aids - inner ear, outer ear, and over the ear, as well as OTC hearing aids, are not covered.
Vision Services See details
Vision services are covered, including routine eye exams with a copay of $0-$10. Eyewear is covered with a combined maximum of $200 per year, and contact lenses, eyeglasses (lenses and frames), eyeglass lenses, eyeglass frames, and upgrades are also covered.
Dental Services See details
Dental services are covered, including Medicare dental services with a $10 copay and other dental services, up to a $2,500 maximum 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), maxillofacial prosthetics, implant services, prosthodontics (fixed), oral and maxillofacial surgery, and orthodontics are also covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, including Medicare Part B Insulin Drugs, Medicare Part B Chemotherapy/Radiation Drugs, and Other Medicare Part B Drugs. For Medicare Part B Insulin Drugs, there is a $35 copay and a coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered by the Cigna True Choice Plus Medicare (PPO) plan. You will pay 20% coinsurance for these services.
Medical Equipment See details
Medical Equipment is covered, including Durable Medical Equipment (DME) with 15% coinsurance and Prosthetics/Medical Supplies with 20% coinsurance, while Durable Medical Equipment for use outside the home is not covered. Diabetic Equipment is covered, but Diabetic Supplies are not covered; Diabetic Therapeutic Shoes/Inserts have a 20% coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered by the Cigna True Choice Plus Medicare (PPO) plan. Diagnostic Procedures/Tests have a copay between $0 and $100, Lab Services have no copay, Diagnostic Radiological Services have a copay of at most $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, 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, or Additional Cardiac Rehabilitation Services. Prior authorization is required.
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 no copay, and for days 21-100, the copay is $214. Additional days beyond Medicare-covered and non-Medicare-covered stays for SNF are not covered.
Other Services See details
Other Services includes coverage for Over-the-Counter (OTC) Items and a Meal Benefit, while acupuncture, Dual Eligible SNPs with Highly Integrated Services, and several other services are not covered. The OTC benefit provides up to $75 every three months, and the meal benefit is available for those with chronic illnesses or medical conditions that require them to stay at home.
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