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 $525.00 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. In the initial coverage phase, you'll pay a copay for each prescription, which varies depending on the drug tier and pharmacy type. Once your total drug costs reach $2,000, you enter the catastrophic coverage phase, where you pay nothing for 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, including inpatient and outpatient hospital services with varying copays, and covers emergency services with a $110 copay. The plan also includes coverage for primary care services, preventive services, hearing and vision services, and dental services, each with specific copays and maximum benefits. Other services such as home health, medical equipment, and skilled nursing facilities are covered with varying copays or coinsurance.
Inpatient Hospital See details
Inpatient Hospital benefits are covered, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric. For Inpatient Hospital-Acute, you pay a $280 copay for days 1-7, and no copay for days 8-90; for Inpatient Hospital Psychiatric, you pay a $595 copay for days 1-3, and no copay for days 4-90. Additional days for Inpatient Hospital-Acute are covered, but Non-Medicare-covered Stay and Upgrades for Inpatient Hospital-Acute, and Additional Days and Non-Medicare-covered Stay for Inpatient Hospital Psychiatric 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 $350, observation services with a $280 copay, and ambulatory surgical center services with no copay. Outpatient substance abuse services include individual and group sessions, each with a copay between $35 and $35. Outpatient blood services are also covered, with three pints deductible waived.
Partial Hospitalization See details
Partial Hospitalization is covered by the Cigna True Choice Medicare (PPO) plan with prior authorization required, and has an $80 copay.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by the Cigna True Choice Medicare (PPO) plan, but require prior authorization. Ground Ambulance Services have a $290 copay, while 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, and Worldwide Emergency Services are covered by the Cigna True Choice Medicare (PPO) plan. Emergency Services and Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation have a $110 copay, while Urgently Needed Services have a $45 copay. There is no coinsurance for any of these services.
Primary Care See details
Primary Care benefits include coverage for Primary Care Physician Services, Chiropractic Services, Occupational Therapy Services, Physician Specialist Services, Mental Health Specialty Services, Other Health Care Professional, Psychiatric Services, Physical Therapy and Speech-Language Pathology Services, Additional Telehealth Benefits, and Opioid Treatment Program Services. Chiropractic Services have a $15 copay, and Occupational Therapy Services, Physician Specialist Services, Physical Therapy and Speech-Language Pathology Services have a $35 copay. Other Health Care Professional and Opioid Treatment Program Services have a copay between $0 and $35, and Additional Telehealth Benefits have a copay between $0 and $35. Individual and Group Sessions for Mental Health Specialty Services, Individual and Group Sessions for Psychiatric Services, and Podiatry Services are not covered.
Preventive Services See details
Cigna True Choice Medicare (PPO) covers preventive services including Medicare-covered services, annual physical exams, and additional preventive services like health education and fitness benefits, while other services such as in-home safety assessments, personal emergency response systems, and others are not covered. The plan also covers kidney disease education, glaucoma screening, diabetes self-management training, barium enemas, digital rectal exams, and EKGs following a welcome visit.
Hearing Services See details
Hearing services include routine hearing exams with a $25 copay, and fitting/evaluation for hearing aids. Prescription hearing aids (all types) are covered with a copay between $399 and $1800, but inner ear, outer ear, and over-the-ear hearing aids are not covered. 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 between $0 and $35, and eyewear with a combined maximum benefit of $250 every year. Contact lenses, eyeglasses (lenses and frames), eyeglass lenses, eyeglass frames, and upgrades are also covered.
Dental Services See details
The Cigna True Choice Medicare (PPO) plan covers dental services, including oral exams and other services, and has a maximum benefit of $1,400 per year. Medicare dental services have a $35 copay, and other dental services include 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, Maxillofacial Prosthetics, Implant Services, Prosthodontics, fixed, Oral and Maxillofacial Surgery, and Orthodontics.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, with prior authorization required. For Medicare Part B Insulin Drugs, you will pay a $35 copay with 0-20% coinsurance. Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs are covered with 0-20% coinsurance.
Dialysis Services See details
Dialysis Services are covered by the Cigna True Choice Medicare (PPO) plan, but require prior authorization. You will pay 20% coinsurance for these services.
Medical Equipment See details
Medical Equipment benefits are covered by Cigna True Choice Medicare (PPO), with Durable Medical Equipment (DME), Prosthetics, and Diabetic Therapeutic Shoes/Inserts each having a 20% coinsurance and no copay. 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 by the Cigna True Choice Medicare (PPO) plan. Diagnostic Procedures/Tests have a copay between $0 and $95, Lab Services have no copay, and Diagnostic Radiological Services have a maximum copay of $250. Therapeutic Radiological Services have a copay of $80, while 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. 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 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 no copay, and for days 21-100, the copay is $214. Additional days beyond Medicare-covered for SNF and non-Medicare-covered SNF stays are not covered.
Other Services See details
Other Services include Over-the-Counter (OTC) Items, with a maximum benefit of $45 every three months, as well as Nicotine Replacement Therapy (NRT) and Naloxone coverage. Acupuncture, Meal Benefit, Dual Eligible SNPs with Highly Integrated Services, and several other services are not covered.
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