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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 Tennessee. 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 $275.00 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 $10000.00 (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 $10000.00 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 the pharmacy you use. For example, preferred generic drugs have a $10 copay at preferred pharmacies and $20 at standard pharmacies. Once your total drug costs reach $2,000, you enter the catastrophic coverage phase and pay nothing for Part D covered drugs. If you qualify for the low-income subsidy (LIS), you may have reduced premium costs.
Additional Benefits
The Cigna True Choice Medicare (PPO) plan offers a range of benefits, including inpatient and outpatient hospital services, with varying copays. Primary care services like chiropractic and occupational therapy are covered, as are preventive services with no copay. This plan also includes coverage for hearing, vision, and dental services, with copays for exams and services, and also covers home health, and skilled nursing facility services. Additional benefits include ambulance and emergency services, with copays depending on the service. Diagnostic and radiological services have copays, and medical equipment is covered with 20% coinsurance. Home infusion bundled services and dialysis services are also covered, but require prior authorization.
Inpatient Hospital See details
Inpatient Hospital benefits are covered, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric. For days 1-5, the copay is $305, and for days 6-90, there is no copay.
Outpatient Services See details
Outpatient Services include coverage for all outpatient hospital services, observation services, ambulatory surgical center (ASC) services, outpatient substance abuse services, and outpatient blood services. Outpatient hospital services have a copay between $0 and $310, observation services have a $310 copay, and ASC services have no copay. Individual and group sessions for outpatient substance abuse have a copay of $45. Outpatient blood services are also covered, with a waived deductible of three pints.
Partial Hospitalization See details
Partial Hospitalization is covered by the Cigna True Choice Medicare (PPO) plan, with a $105 copay. Prior authorization is required for this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by Cigna True Choice Medicare (PPO). Ground ambulance services have a $300 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 $125 copay, while Urgently Needed Services have a $55 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 a variety of primary care services. Chiropractic Services have a $20 copay, Occupational Therapy Services have a $40 copay, Physician Specialist Services have a $45 copay, Physical Therapy and Speech-Language Pathology Services have a $40 copay, and Additional Telehealth Benefits have a copay between $0 and $45. Psychiatric Services, Individual and Group Sessions for Mental Health Specialty Services, and Podiatry Services are not covered.
Preventive Services See details
The Cigna True Choice Medicare (PPO) plan covers preventive services including Medicare-covered zero-dollar preventive services, annual physical exams, health education, kidney disease education services, and other preventive services. 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 benefit, 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 $20 copay. Fitting/Evaluation for Hearing Aids are also covered, and Prescription Hearing Aids (all types) are covered with a copay between $399 and $1800. Prescription Hearing Aids - Inner Ear, Outer Ear, and Over the Ear are not covered, nor are OTC Hearing Aids.
Vision Services See details
The Cigna True Choice Medicare (PPO) plan covers vision services, including routine eye exams with a copay between $0 and $40, and eyewear with a combined maximum benefit of $150 per year. Contact lenses and upgrades are also covered.
Dental Services See details
Dental Services are covered by the Cigna True Choice Medicare (PPO) plan with a $45 copay for Medicare Dental Services, and a $1,300 annual maximum plan benefit 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, but require prior authorization. The plan includes coverage for Medicare Part B Insulin Drugs with a $35 copay and 0-20% coinsurance, and also covers Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs with 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 20% coinsurance for these services.
Medical Equipment See details
Medical Equipment benefits include Durable Medical Equipment (DME) with 20% coinsurance and Prosthetics/Medical Supplies with 20% coinsurance, though Durable Medical Equipment for use outside the home and Diabetic Supplies are not covered. Diabetic Therapeutic Shoes/Inserts are covered with 20% coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services include coverage for all diagnostic services, diagnostic procedures/tests with a copay between $0.00 and $150.00, and lab services with no copay. Additionally, the plan covers diagnostic radiological services with a copay up to $225.00, therapeutic radiological services with a copay of $60.00, and outpatient X-ray services with a copay of $50.00.
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 with prior authorization, but no copay or coinsurance details are provided. However, Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, and SET for PAD Services are not covered.
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 per day; additional and non-Medicare covered SNF stays are not covered.
Other Services See details
Other services are not covered by the Cigna True Choice Medicare (PPO) plan, including acupuncture, over-the-counter items, meal benefits, and more. No authorization or referral is required for these services.
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