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 $475.00 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 your prescriptions. The copay amounts vary depending on the drug tier and the pharmacy you use. For preferred generic drugs, the copay is $8 at preferred pharmacies and $20 at standard pharmacies. For standard generic drugs, the copay is $47, and for preferred brand drugs, the copay is $100, regardless of the pharmacy. For non-preferred drugs, you pay 33% coinsurance.
Additional Benefits
The Cigna True Choice Medicare (PPO) plan offers a range of benefits with varying cost structures. Inpatient hospital stays have a copay, while outpatient services, primary care, and preventive services have copays ranging from $0 to $315. The plan also covers ambulance services, emergency services, hearing, vision, dental, home infusion, dialysis, medical equipment, home health, and skilled nursing facility services, with different copays, coinsurance, and prior authorization requirements. Additional benefits include coverage for OTC items.
Inpatient Hospital See details
The Cigna True Choice Medicare (PPO) plan covers inpatient hospital stays with a copay of $290 for days 1-8 and no copay for days 9-90 for acute inpatient hospital stays. The plan also covers inpatient hospital psychiatric stays with a copay of $595 for days 1-3 and no copay for days 4-90. Non-Medicare-covered stays, upgrades, and additional days for inpatient psychiatric are not covered.
Outpatient Services See details
Outpatient Services are covered under the Cigna True Choice Medicare (PPO) plan, including outpatient hospital services, ambulatory surgical center services, outpatient substance abuse services, and outpatient blood services. Outpatient Hospital Services have a copay between $0 and $315, Observation Services have a $290 copay, Ambulatory Surgical Center (ASC) Services have no copay, and Individual and Group Sessions for Outpatient Substance Abuse each have a copay of $30.
Partial Hospitalization See details
Partial Hospitalization is covered by the Cigna True Choice Medicare (PPO) plan. This benefit requires prior authorization and has a copay of $80.
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 $285 copay, and air ambulance services have a 20% coinsurance, while transportation services to health-related locations 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 has a $45 copay; all have no coinsurance. Worldwide Emergency Services has 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 Services with a $30 copay, Physician Specialist Services with a $30 copay, Physical Therapy and Speech-Language Pathology Services with a $30 copay, and Other Health Care Professional with a copay between $0 and $30. Psychiatric Services, Mental Health Specialty Services, Individual Sessions for Mental Health Specialty Services, Group Sessions for Mental Health Specialty Services, Individual Sessions for Psychiatric Services, and Group Sessions for Psychiatric Services are not covered.
Preventive Services See details
Preventive Services, including services not usually covered by Medicare plans, are covered. Health Education, Glaucoma Screenings, Diabetes Self-Management Training, Barium Enemas, Digital Rectal Exams, and EKG following Welcome Visits are covered. In-Home Safety Assessments, Personal Emergency Response Systems (PERS), Medical Nutrition Therapy (MNT), 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, Fitness Benefits, 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 with the Cigna True Choice Medicare (PPO) plan include hearing exams with a $25 copay, and Routine Hearing Exams and Fitting/Evaluation for Hearing Aids, both covered once per year. Prescription Hearing Aids (all types) are covered with a copay between $399 and $1800, while Prescription Hearing Aids - Inner Ear, Outer Ear, and Over the Ear, as well as OTC Hearing Aids, are not covered.
Vision Services See details
The Cigna True Choice Medicare (PPO) plan covers vision services, including routine eye exams with a copay of $0-$30. The plan also covers eyewear, including contact lenses, eyeglasses (lenses and frames), eyeglass lenses, and eyeglass frames, with a combined maximum benefit of $200 every year.
Dental Services See details
Dental Services are covered under the Cigna True Choice Medicare (PPO) plan, including Medicare Dental Services with a $30 copay, with a maximum benefit of $1400 per year for both in-network and out-of-network services. Other services like Oral Exams, Dental X-Rays, and more are covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, requiring prior authorization. For Medicare Part B Insulin Drugs, there is a $35 copay with 0-20% coinsurance; for Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs, there is a 0-20% coinsurance.
Dialysis Services See details
Dialysis Services are covered under the Cigna True Choice Medicare (PPO) plan, but require prior authorization. You will pay a coinsurance of 20% for these services.
Medical Equipment See details
The Cigna True Choice Medicare (PPO) plan covers medical equipment, including Durable Medical Equipment (DME) with 20% coinsurance and Prosthetic Devices and Medical Supplies with 20% coinsurance. Durable Medical Equipment for use outside the home and Diabetic Supplies are not covered, and 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 Medicare (PPO) plan. Diagnostic Procedures/Tests have a copay between $0 and $95, and Lab Services have no copay. Diagnostic Radiological Services have a copay up to $250, Therapeutic Radiological Services have a copay of $80, 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 or coinsurance, but authorization is required. Additional Hours of Care and Personal Care Services are not covered.
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). 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
The Cigna True Choice Medicare (PPO) plan covers Over-the-Counter (OTC) items with a maximum benefit of $45.00 every three months, including nicotine replacement therapy and Naloxone coverage. Acupuncture, meal benefits, Dual Eligible SNPs with Highly Integrated Services, and several other services are not covered.
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