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 Georgia. 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 $250.00 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 will pay a copay for each drug, which varies based on the drug tier and the pharmacy you use. For example, preferred generic drugs have an $8 copay at preferred pharmacies. Once your total drug costs reach $2000, you enter the catastrophic coverage phase. In this phase, you will pay nothing for your Part D covered drugs.
Additional Benefits
The Cigna True Choice Medicare (PPO) plan offers a range of benefits, including inpatient hospital stays, outpatient services, and emergency care. For inpatient hospital stays, you'll pay a copay, which varies depending on the type of care and the number of days. Outpatient services have copays that also vary depending on the specific service. The plan also covers preventive services with no copay, along with hearing, vision, and dental services. You'll have copays for exams and other services, and there are annual maximums for certain dental services. Other covered services include home health, ambulance, and skilled nursing facility care, with varying copays or coinsurance depending on the service.
Inpatient Hospital See details
Inpatient Hospital benefits are covered, including both Inpatient Hospital-Acute and Inpatient Hospital Psychiatric. For Inpatient Hospital-Acute, you will pay a $290 copay for days 1-8, and no copay for days 9-90. For Inpatient Hospital Psychiatric, you will pay a $595 copay for days 1-3, and no copay for days 4-90. Additional days for Inpatient Hospital-Acute are covered, with no copay. Non-Medicare-covered stays and upgrades for Inpatient Hospital-Acute, and 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 and outpatient substance abuse services, are covered. For outpatient hospital services, you may pay a copay between $0 and $295, and for observation services, the copay is $290. Ambulatory Surgical Center (ASC) Services have no copay, and individual and group sessions for outpatient substance abuse have a copay of $35.
Partial Hospitalization See details
Partial Hospitalization is covered by the Cigna True Choice Medicare (PPO) plan, but requires prior authorization. You will pay an $80 copay for this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by the Cigna True Choice Medicare (PPO) plan, with prior authorization required for all ambulance services. Ground ambulance services have a $270 copay, and air ambulance services have a 20% coinsurance, while 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. Emergency Services and Worldwide Emergency Coverage have a $110 copay, while Urgently Needed Services have a $45 copay, and there is no coinsurance for any of these services.
Primary Care See details
The Cigna True Choice Medicare (PPO) plan covers primary care physician services, chiropractic services with a $15 copay, occupational therapy services with a $35 copay, physician specialist services with a $35 copay, physical therapy and speech-language pathology services with a $35 copay, other health care professional services with a copay between $0 and $35, and opioid treatment program services with a $35 copay. The plan does not cover routine chiropractic care, individual or group mental health specialty sessions, individual or group psychiatric sessions, and podiatry services. Additional telehealth benefits are also covered with a copay between $0 and $35.
Preventive Services See details
The Cigna True Choice Medicare (PPO) plan covers preventive services, including Medicare-covered services with no copay, an annual physical exam, and other preventive services like health education, glaucoma screening, diabetes self-management training, barium enemas, digital rectal exams, and EKG following Welcome Visit. 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 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 are covered by the Cigna True Choice Medicare (PPO) plan, including routine hearing exams with a $30 copay. Fitting/evaluation for hearing aids is covered once per year, and prescription hearing aids (all types) are covered with a copay between $399 and $1800 for two hearing aids per year. Prescription hearing aids for the inner, outer, and over the ear are not covered, nor are OTC hearing aids.
Vision Services See details
Vision services include eye exams with a copay between $0 and $35, routine eye exams (1 every year), eyewear with a combined maximum benefit of $250 every year, contact lenses, eyeglasses (lenses and frames) (1 every year), eyeglass lenses (1 every year), eyeglass frames (1 every year), and upgrades.
Dental Services See details
Dental Services are covered, including Medicare Dental Services with a $35 copay, and other dental services with a $1,300 annual maximum. Specific services like oral exams, dental x-rays, and more have unlimited benefits.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, but require prior authorization. For Medicare Part B Insulin Drugs, there is a $35 copay and a coinsurance between 0% and 20%. For Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs, there is 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 is covered by Cigna True Choice Medicare (PPO), including Durable Medical Equipment (DME) with a 20% coinsurance and Prosthetics/Medical Supplies with a 20% coinsurance, but Durable Medical Equipment for use outside the home and Diabetic Supplies are not covered. Diabetic Therapeutic Shoes/Inserts are covered with a 20% coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services, including diagnostic procedures/tests, lab services, diagnostic radiological services, therapeutic radiological services, and outpatient X-ray services, are covered. Diagnostic procedures/tests have a copay between $0 and $95, while lab services and outpatient X-ray services have no copay. Diagnostic radiological services have a copay of up to $250, and therapeutic radiological services have a copay of $80.
Home Health Services See details
Home Health Services are covered by the Cigna True Choice Medicare (PPO) plan with no copay and no coinsurance. Additional hours of care and personal care services are not covered.
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, and there is a copay for some services.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services require prior authorization and are covered under the Cigna True Choice Medicare (PPO) plan. For days 1-20, there is no copay, and for days 21-100, the copay is $214 per day; additional days beyond Medicare-covered, and non-Medicare-covered stays are not covered.
Other Services See details
Other Services with the Cigna True Choice Medicare (PPO) plan includes coverage for Over-the-Counter (OTC) items, with a maximum benefit of $50 every three months, which can include Nicotine Replacement Therapy (NRT) and Naloxone. Acupuncture, meal benefits, 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 are not covered.
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