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 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 $200.00 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 an enhanced alternative drug benefit, and requires no deductible. In the initial coverage phase, you'll pay a copay for your prescriptions. For example, preferred generic drugs have a $10 copay, while preferred brand drugs have a $100 copay. Once your total drug costs reach $2000, you enter the catastrophic coverage phase and pay nothing for your Part D covered drugs. If you qualify for the low-income subsidy, your Part D costs are $0.
Additional Benefits
The Cigna True Choice Medicare (PPO) plan offers coverage for a variety of services with varying costs. Inpatient hospital stays have a copay, while outpatient services, including some mental health and substance abuse services, have copays as well. Emergency and urgent care services come with a copay, and ambulance services have a copay or coinsurance depending on the service. This plan also includes coverage for preventive, hearing, vision, and dental services, often with copays. Diagnostic, radiological, and home health services are covered with copays or coinsurance. It's important to note that some services, like skilled nursing facilities, require prior authorization and have associated copays.
Inpatient Hospital See details
Inpatient Hospital benefits, including acute and psychiatric, are covered by the Cigna True Choice Medicare (PPO) plan. For days 1-5, there is a $390 copay, while days 6-90 have no copay.
Outpatient Services See details
Outpatient Services, including all outpatient hospital services, are covered. Outpatient Hospital Services have a copay between $0 and $425, Observation Services have a $425 copay, and Ambulatory Surgical Center (ASC) Services have no copay. Outpatient Substance Abuse Services have a $30 copay for both individual and group sessions, and 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 benefit.
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 $300 copay, while Air Ambulance Services have a 20% coinsurance, and Transportation Services are not covered.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered under the Cigna True Choice Medicare (PPO) plan. Emergency Services and Worldwide Emergency Coverage have a $125 copay, while Urgently Needed Services have a $55 copay, and all services have no coinsurance.
Primary Care See details
The Cigna True Choice Medicare (PPO) plan covers Primary Care Physician Services, Occupational Therapy Services, Physician Specialist Services, Other Health Care Professional, Physical Therapy and Speech-Language Pathology Services, Additional Telehealth Benefits and Opioid Treatment Program Services. Chiropractic Services and Psychiatric Services are partially covered, but routine chiropractic care, individual and group sessions for mental health specialty services, and individual and group sessions for psychiatric services are not covered.
Preventive Services See details
Preventive Services, including Medicare-covered services, annual physical exams, and kidney disease education services, are covered by the Cigna True Choice Medicare (PPO) plan. Additional preventive services like Health Education, Glaucoma Screenings, Diabetes Self-Management Training, Barium Enemas, Digital Rectal Exams, and EKGs following Welcome Visits are covered, while In-Home Safety Assessments, Personal Emergency Response Systems (PERS), Medical Nutrition Therapy (MNT), and other services are not covered.
Hearing Services See details
Hearing Services are covered by Cigna True Choice Medicare (PPO), including routine hearing exams with a $20 copay, and fitting/evaluation for hearing aids. Prescription hearing aids (all types) are covered with a copay between $399 and $1800, while inner ear, outer ear, and over-the-ear prescription hearing aids, and OTC hearing aids are not covered.
Vision Services See details
Vision services include routine eye exams with a copay between $0 and $30, and are available once per year. Eyewear is partially covered, but contact lenses, eyeglasses (lenses and frames), eyeglass lenses, eyeglass frames, and upgrades are not covered.
Dental Services See details
Dental services are covered with a $30 copay for Medicare dental services, and a maximum plan benefit of $1,300 per year for both in-network and out-of-network 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, with prior authorization required. The plan covers Medicare Part B Insulin Drugs with a $35 copay and 0-20% coinsurance, and it 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
The Cigna True Choice Medicare (PPO) plan covers Durable Medical Equipment (DME) with a 20% coinsurance, Prosthetics/Medical Supplies - Non-Medicare benefit with coinsurance for Medicare-covered devices and supplies, and Diabetic Therapeutic Shoes/Inserts with a 20% coinsurance; however, Durable Medical Equipment for use outside the home and Diabetic Supplies are not covered. There is no copay for any of these services.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered, with some services requiring prior authorization. Diagnostic Procedures/Tests have a copay between $0 and $150, while Lab Services have no copay. Diagnostic Radiological Services have a copay up to $225, Therapeutic Radiological Services have a copay of $60, and Outpatient X-Ray Services have a $50 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. The plan requires prior authorization.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the Cigna True Choice Medicare (PPO) plan, with prior authorization required. For days 1-20, there is no copay, and for days 21-100, the copay is $214.
Other Services See details
Other Services are not covered by the Cigna True Choice Medicare (PPO) plan. Specifically, acupuncture, over-the-counter items, 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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