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 South Carolina. 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 $350.00 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 $9550.00 (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 $9550.00 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 Medicare (PPO)
Need help deciding? Talk with one of our licensed insurance specialists 1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
Drug Coverage
The Cigna True Choice Medicare (PPO) plan has a $0 deductible for prescription drugs. In the initial coverage phase, you will pay a copay for your prescriptions depending on the drug tier and the pharmacy you use. For example, preferred generic drugs have a $5 copay at preferred pharmacies. Once your total drug costs reach $2000, you enter the catastrophic coverage phase, where you pay nothing for your covered drugs.
Additional Benefits
The Cigna True Choice Medicare (PPO) plan offers a variety of benefits, including inpatient and outpatient hospital care, with varying copays depending on the service. You'll also have access to primary care, preventive, hearing, vision, and dental services, each with its own cost structure, such as copays for doctor visits and exams, and coinsurance for some services. Additional benefits include ambulance, emergency services, and home health services, as well as coverage for medical equipment and various therapies.
Inpatient Hospital See details
The Cigna True Choice Medicare (PPO) plan covers inpatient hospital stays, including acute and psychiatric care, with prior authorization required. For Inpatient Hospital-Acute, you'll pay a $215 copay for days 1-7, and no copay for days 8-90, while Inpatient Hospital-Psychiatric has a $595 copay for days 1-3, and no copay for days 4-90; additional days and upgrades for both acute and psychiatric care are not covered.
Outpatient Services See details
Outpatient Services are covered by the Cigna True Choice Medicare (PPO) plan, including outpatient hospital services with a copay between $0 and $315, and observation services with a $315 copay. Ambulatory Surgical Center (ASC) Services have no copay, and outpatient substance abuse services have a $25 copay for both individual and group sessions. Outpatient blood services are also covered.
Partial Hospitalization See details
Partial Hospitalization is covered by the Cigna True Choice Medicare (PPO) plan, but requires prior authorization. You will have a $105 copay for this service.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by the Cigna True Choice Medicare (PPO) plan. Ground Ambulance Services have a copay of $255.00, and 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, 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 $25 copay), physician specialist services (with a $25 copay), other health care professional services (with a copay between $0 and $25), physical therapy and speech-language pathology services (with a $25 copay), additional telehealth benefits (with a copay between $0 and $25), and opioid treatment program services (with a copay between $25 and $25). This plan does not cover routine chiropractic care, individual or group sessions for mental health specialty services, individual or group sessions for psychiatric services, or podiatry services.
Preventive Services See details
The Cigna True Choice Medicare (PPO) plan covers preventive services including Medicare-covered services, annual physical exams, health education, kidney disease education, and other preventive services with no copay or coinsurance. Some additional preventive services, such as in-home safety assessments, personal emergency response systems, medical nutrition therapy, and others, are not covered.
Hearing Services See details
Hearing Services include routine hearing exams with a $25 copay, and coverage for the fitting/evaluation for hearing aids, limited to one visit per year. Prescription hearing aids (all types) are covered with a copay between $399 and $1800, but prescription hearing aids for the inner ear, outer ear, and over the ear are not covered, and OTC hearing aids are not covered.
Vision Services See details
The Cigna True Choice Medicare (PPO) plan covers vision services, including eye exams with a copay of $0-$25, and eyewear. Eyewear includes contact lenses, eyeglasses (lenses and frames), eyeglass lenses, eyeglass frames, and upgrades. Eyewear has a combined maximum benefit of $250 per year.
Dental Services See details
Dental Services are covered, including Medicare Dental Services with a $25 copay. Other dental services are covered, up to a maximum of $1300 per year, including 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 & fixed), maxillofacial prosthetics, implant services, oral and maxillofacial surgery, and orthodontics.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, but require prior authorization. For Medicare Part B Insulin Drugs, you will pay a $35 copay, with a coinsurance between 0% and 20%. For Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs, you will pay a coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered by the Cigna True Choice Medicare (PPO) plan. You will pay 20% coinsurance for these services, and prior authorization is required.
Medical Equipment See details
The Cigna True Choice Medicare (PPO) plan covers Durable Medical Equipment with a 20% coinsurance and no copay, Prosthetic Devices and Medical Supplies with a 20% coinsurance and no copay, and Diabetic Therapeutic Shoes/Inserts with a 20% coinsurance and no copay; however, 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 Diagnostic Procedures/Tests, Lab Services, Diagnostic Radiological Services, Therapeutic Radiological Services, and Outpatient X-Ray Services. Diagnostic Procedures/Tests have a copay between $0 and $95, Lab Services have no copay, Diagnostic Radiological Services have a copay up to $195, Therapeutic Radiological Services have a copay of $60, and Outpatient X-Ray Services have no 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 covered, but the plan does not cover any of the sub-services, including Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, and SET for PAD Services. Prior authorization is required for this benefit.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the Cigna True Choice Medicare (PPO) plan, but require prior authorization. For days 1-20, there is a $10 copay; for days 21-60, the copay is $214; and for days 61-100, there is no copay.
Other Services See details
The Cigna True Choice Medicare (PPO) plan does not cover acupuncture, over-the-counter items, 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. The plan does cover a meal benefit for a chronic illness or a medical condition that requires the enrollee to remain at home for a period of time.
Get Personalized Help from a licensed insurance agent
1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
*/SMID: MULTIPLAN_HCIHNMEDADVRX25_HCI_M
MedicareAdvantageRX.com is owned and operated by Dog Media Solutions LLC.
This is a promotional communication.
Every year, Medicare evaluates plans based on a 5-star rating system.
Part B premium reduction is not available with all plans. Availability varies by carrier and location. Actual Part B premium reduction could be lower. Deductibles, copays and coinsurance may apply.
* Benefit(s) mentioned may be part of a special supplemental program for chronically ill members with one of the following conditions: Diabetes mellitus, Cardiovascular disorders, Chronic and disabling mental health conditions, Chronic lung disorders, Chronic heart failure. This is not a complete list of qualifying conditions. Having a qualifying condition alone does not mean you will receive the benefit(s). Other requirements may apply.
Enrollment in Medicare/Medicare Advantage may be limited to certain times of the year unless you qualify for a Special Enrollment Period
We do not offer every plan available in your area. Currently, we represent 18 organizations, which offer 52,101 products in your area. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all of your options.
We represent Medicare Advantage HMO, PPO and PFFS organizations and stand-alone PDP prescription drug plans that are contracted with Medicare. Enrollment depends on the plan's contract renewal.
Not all plans offer all of these benefits. Benefits may vary by carrier and location. Limitations and exclusions may apply.
Please contact Medicare.gov ,1-800-MEDICARE , or your local State Health Insurance Program (SHIP) to get information on all of your options.
Medicare has neither approved nor endorsed any information on this site.
Speak with a licensed insurance agent: 1-877-649-2073 / TTY 711 | 8am - 11pm ET | 7 days a week
© 2023 Dog Media Solutions LLC. All rights reserved