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 Texas. 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 $425.00 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 $14000.00 (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 $14000.00 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 a $0 deductible for prescription drugs. During the initial coverage phase, you'll pay a copay ranging from $4 to $100 depending on the drug tier and pharmacy. Once your total drug costs reach $2,000, you enter the catastrophic coverage phase, where you pay nothing for Part D covered drugs. Those who qualify for the low-income subsidy may have their premiums reduced.
Additional Benefits
The Cigna True Choice Medicare (PPO) plan offers comprehensive coverage, including inpatient and outpatient hospital services with varying copays. This plan also includes coverage for a range of services like primary care, preventive services, hearing, vision, and dental, with specific copays and annual maximums for certain benefits. Emergency, ambulance, and home health services are covered, and some services require prior authorization.
Inpatient Hospital See details
Inpatient Hospital benefits are covered, with a copay of $235 per day for days 1-7, and no copay for days 8-90. Additional days for Inpatient Hospital-Acute are covered, but Non-Medicare-covered stays and upgrades for Inpatient Hospital-Acute are not covered. Inpatient Hospital Psychiatric benefits are covered, with a copay of $235 per day for days 1-6, and no copay for days 7-90; however, additional days and non-Medicare covered stays for Inpatient Hospital Psychiatric are not covered.
Outpatient Services See details
Outpatient Services, including all outpatient hospital services, are covered under the Cigna True Choice Medicare (PPO) plan. Outpatient Hospital Services have a copay between $0 and $325, Observation Services have a $325 copay, and Ambulatory Surgical Center (ASC) Services have no copay. Outpatient Substance Abuse Services, including individual and group sessions, have a copay of $35. Outpatient Blood Services are covered, with a three-pint deductible waived.
Partial Hospitalization See details
Partial Hospitalization is covered under the Cigna True Choice Medicare (PPO) plan, but requires prior authorization. You will have an $80 copay for this service.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by the Cigna True Choice Medicare (PPO) plan, including both ground and air ambulance services. Ground ambulance services have a $240 copay, while air ambulance services have a 20% coinsurance, but 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 Medicare (PPO) plan. Emergency Services and Worldwide Emergency Coverage have a $110 copay, while Urgently Needed Services have a $30 copay; there is no coinsurance for any of these services. Worldwide Emergency Services have a maximum plan benefit coverage of $50,000.
Primary Care See details
The Cigna True Choice Medicare (PPO) plan covers primary care physician services, chiropractic services (with a $15 copay), occupational therapy (with a $35 copay), physician specialist services (with a $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). Mental health specialty services, psychiatric services, and podiatry services are partially covered, with individual and group sessions for mental health and psychiatric services 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 services, glaucoma screenings, diabetes self-management training, barium enemas, digital rectal exams, EKG following Welcome Visit, and a fitness benefit. 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 are covered by the Cigna True Choice Medicare (PPO) plan. Hearing exams have a $25 copay, and prescription hearing aids (all types) have a copay between $399 and $1800; however, Prescription Hearing Aids - Inner Ear, Prescription Hearing Aids - Outer Ear, Prescription Hearing Aids - Over the Ear and 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, including contact lenses, eyeglasses (lenses and frames), eyeglass lenses, and eyeglass frames, are covered with a combined maximum benefit of $250 per year.
Dental Services See details
Dental Services are covered by Cigna True Choice Medicare (PPO), with a $35 copay for Medicare Dental Services and a maximum plan benefit of $950 per year for other dental 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 also covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, and require prior authorization. For Medicare Part B Insulin Drugs, you pay a $35 copay with 0-20% coinsurance, and for Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs, you pay 0-20% coinsurance.
Dialysis Services See details
Dialysis Services are covered under the Cigna True Choice Medicare (PPO) plan, but require prior authorization. You are responsible for 20% coinsurance.
Medical Equipment See details
Medical equipment is covered, with a 20% coinsurance for Durable Medical Equipment (DME), Prosthetic Devices, and Medical Supplies. Diabetic Therapeutic Shoes/Inserts are covered with a 20% coinsurance, but Diabetic Supplies are not covered, and Durable Medical Equipment for use outside the home is not covered.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered by the Cigna True Choice Medicare (PPO) plan. Diagnostic Procedures/Tests have a copay between $0 and $100, Lab Services have no copay, Diagnostic Radiological Services have a copay up to $175, Therapeutic Radiological Services have a copay of $60, and Outpatient X-Ray Services have a $15 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. This benefit requires authorization.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered, but the plan does not cover any of the sub-services, including 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. Prior authorization is required.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by Cigna True Choice Medicare (PPO) with prior authorization required. For days 1-20, there is no copay, and for days 21-100, the copay is $214 per day; additional days beyond Medicare-covered SNF stays and non-Medicare-covered SNF stays are not covered.
Other Services See details
The Cigna True Choice Medicare (PPO) plan's "Other Services" benefit covers over-the-counter items with a maximum benefit of $20 every three months, and meal benefits for chronic illnesses or conditions requiring you to stay at home. Acupuncture, Dual Eligible SNPs with Highly Integrated Services, and several other services are not covered.
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