A non-government entity
Cigna True Choice Medicare (PPO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Cigna True Choice 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 Medicare (PPO) in 2025, please refer to our full plan details page.
Cigna True Choice Medicare (PPO) is a PPO plan offered by The Cigna Group available for enrollment in 2025 to people living in Tennessee. This plan received an overall rating of 3 out of 5 stars in 2025.
It's important to know that Cigna True Choice 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 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 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 $200.00 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 $10000.00 (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 $10000.00 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 Medicare (PPO) plan has an enhanced alternative drug benefit with no deductible. During the initial coverage phase, you will pay a copay for your prescriptions, which varies depending on the drug tier and the pharmacy you use. For example, preferred generic drugs have a $10 copay at a preferred pharmacy, while standard generic drugs have a $47 copay. Once your total drug costs reach $2,000, you enter the catastrophic coverage phase, where you will pay nothing for your Part D covered drugs. This plan's premium may be reduced if you qualify for the low-income subsidy (LIS).
Additional Benefits
The Cigna True Choice Medicare (PPO) plan offers a range of benefits with varying cost-sharing. This plan includes coverage for inpatient and outpatient hospital services, with copays ranging from $0 to $320, as well as coverage for ambulance services with copays and coinsurance. Preventive services are covered with no copay, along with hearing and vision services, including hearing exams, eyewear, and eye exams. Dental services are also covered, along with home infusion, dialysis, and medical equipment services.
Inpatient Hospital See details
Inpatient Hospital benefits are covered by the Cigna True Choice Medicare (PPO) plan, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric services. For Inpatient Hospital-Acute, you'll pay a $305 copay for days 1-6, and no copay for days 7-90; the additional days, non-Medicare-covered stay, and upgrades are not covered. For Inpatient Hospital Psychiatric, you'll pay a $305 copay for days 1-5, and no copay for days 6-90; the additional days and non-Medicare-covered stay are not covered.
Outpatient Services See details
Outpatient Services for the Cigna True Choice Medicare (PPO) plan include coverage for all outpatient hospital services with a copay of $0-$320, observation services with a $320 copay, and ambulatory surgical center services with no copay. Outpatient substance abuse services have a $45 copay for individual and group sessions, and outpatient blood services are also covered.
Partial Hospitalization See details
Partial Hospitalization is covered by the Cigna True Choice Medicare (PPO) plan. This benefit has a copay of $105.00.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by the Cigna True Choice Medicare (PPO) plan, with all ambulance services requiring prior authorization. Ground ambulance services have a $300 copay, while air ambulance services have a 20% coinsurance; however, transportation services to any health-related location are not covered.
Emergency Services See details
Emergency Services, Urgently Needed Services, Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation are covered by the Cigna True Choice Medicare (PPO) plan. Emergency Services and Worldwide Emergency Coverage have a $125 copay, Urgently Needed Services has a $55 copay, and Worldwide Urgent Coverage and Worldwide Emergency Transportation also have a $125 copay.
Primary Care See details
The Cigna True Choice Medicare (PPO) plan covers primary care physician services, chiropractic services (with a $20 copay), occupational therapy services (with a $40 copay), physician specialist services (with a $45 copay), physical therapy and speech-language pathology services (with a $40 copay), additional telehealth benefits (with a $0-$45 copay), and opioid treatment program services (with a $45 copay). Mental health specialty services and psychiatric services are partially covered, as individual and group sessions are not covered.
Preventive Services See details
The Cigna True Choice Medicare (PPO) plan covers preventive services, including Medicare-covered services with no copay, annual physical exams, health education, kidney disease education, and other preventive services like glaucoma screenings and diabetes self-management training. However, the plan does not cover in-home safety assessments, personal emergency response systems, medical nutrition therapy, post-discharge in-home medication reconciliation, re-admission prevention, wigs for hair loss, 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 smoking cessation counseling, enhanced disease management, telemonitoring services, remote access technologies, home and bathroom safety devices, or counseling services. The fitness benefit is covered.
Hearing Services See details
Hearing Services are covered, including hearing exams, fitting/evaluation for hearing aids, and prescription hearing aids. Hearing exams have a $20 copay, and routine hearing exams and fitting/evaluation for hearing aids are each covered once per year. Prescription hearing aids have a copay between $399 and $1800, but prescription hearing aids - inner ear, outer ear, and over the ear are not covered. OTC Hearing Aids are not covered.
Vision Services See details
Vision services include eye exams with a copay of $0-$35, and routine eye exams once per year. Eyewear is covered with a combined maximum benefit of $150 per year for both in-network and out-of-network services, and includes contact lenses, eyeglasses (lenses and frames), eyeglass lenses (1 pair per year), and eyeglass frames (1 frame per year). Upgrades are also covered.
Dental Services See details
Dental services are covered under the Cigna True Choice Medicare (PPO) plan, with a $45 copay for Medicare Dental Services, and a maximum plan benefit of $1,300 per year for both in-network and out-of-network services. 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, with prior authorization required. For Medicare Part B Insulin Drugs, there is a $35 copay and a coinsurance between 0% and 20%. Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs are covered with a coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered by the Cigna True Choice Medicare (PPO) plan, but require prior authorization. The coinsurance for dialysis services is 20%.
Medical Equipment See details
Medical Equipment coverage under the Cigna True Choice Medicare (PPO) plan includes Durable Medical Equipment (DME) with 20% coinsurance, Prosthetics/Medical Supplies with 20% coinsurance, and Diabetic Therapeutic Shoes/Inserts with 20% coinsurance; however, Durable Medical Equipment for use outside the home and Diabetic Supplies are not covered. The plan has no copay for any of these services.
Diagnostic and Radiological Services See details
The Cigna True Choice Medicare (PPO) plan covers diagnostic and radiological services. Diagnostic Procedures/Tests have a copay between $0 and $150, while Lab Services have 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 $50 copay.
Home Health Services See details
Home Health Services are covered by the Cigna True Choice 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 not covered by the Cigna True Choice Medicare (PPO) plan. Prior authorization is required for this benefit.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by Cigna True Choice Medicare (PPO), but require prior authorization. For days 1-20, there is no copay, and for days 21-100, the copay is $214 per day; additional days beyond Medicare coverage and non-Medicare covered stays are not covered.
Other Services See details
Other Services, including acupuncture, over-the-counter items, meal benefits, and more, are not covered by the Cigna True Choice Medicare (PPO) plan. Authorization and referrals are not required for these services.
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